Health
At LCMC Health, care starts at home. That means you’ll save the most when you use our trusted LCMC Health providers and facilities. Both of our plans provide access to the LCMC Health network, which is built exclusively for you and includes our providers—the ones that you know, trust, and work with every day.
| High Deductible Health Plan (HDHP) | Preferred Provider Organization (PPO) plan | |
|---|---|---|
| Plan considerations |
Consider whether you prefer having less taken out of your paycheck and are comfortable paying more when you need care. |
Consider whether you want to pay more from your paycheck but have more predictable costs when you need care. |
| Annual wellness visits | 
Covered 100% |
Covered 100% |
| Prescription coverage | |
|
| Funding account |
Health Savings Account (HSA) |
Flexible Spending Account (FSA) |
Provider tiers
Both plans include one network with two provider tiers. The amount you pay when you receive care depends on where you receive care. You will have the lowest costs when you use LCMC Health providers or facilities (Tier 1).
Tier 1
LCMC Health doctors, clinics, and hospitals.
You'll receive the highest level of benefits and pay the lowest out-of-pocket costs.
Tier 2
Louisiana Verity Network.
Additional provider options across Louisiana, but will cost more than LCMC Health providers.
Not covered
Ochsner providers and facilities are no longer part of the medical plan network for 2027.
ID cards
Always present your new ID card to your providers and pharmacy on your first visit of the year to ensure they have your new insurance information.
Eligibility and benefits
Before you see your provider for the first time each year, you should check Verity to determine if your provider is in the network. It is important to ensure that your provider is in network so you are not left with unexpected out-of-pocket costs
Resources
Quick Guide comparison
Compare common medical plan
costs for both plans.
How to find a provider
Knowing which tier your doctors and facilities are in can help you better understand what you may pay for care. To find a Tier 1 or Tier 2 provider, search the Verity provider directory.
- Select LCMC Health – Choice.
- Enter your address, city, or ZIP code.
- Choose how close you want the location to be.
- Search by specialty, doctor name, or facility type.
Look for the tier designation in the lower right-hand corner of the contact card.
Tier 1 includes LCMC Health hospitals and providers and offers the lowest costs.
Out of state? Use providers and facilities in the PHCS national network.
Out(opens in new tab)
Member portal
Manage your benefits and claims at webtpa.com.
- Access eligibility information for you and your dependents
- View, print, or order an ID card
- Check claim status and history
- View Explanation of Benefits
- Download plan documents and member resources
- Search for a provider (opens in new tab)
Provider contact
- Developed and funded by LCMC Health, managed by WebTPA
- Phone: 855.404.7776
- Website: webtpa.com
Plan basics
Included with your medical plan
- Use designated pharmacies for the lowest costs.
- Get a 3-month supply of your long-term medication mailed to you with free standard shipping and flexible payment options.
- Get a ContourNext blood glucose meter and test strips at no cost through Optum.
-
ID cards
Always present your new ID card to your providers and pharmacy on your first visit of the year to ensure they have your new insurance information.
Provider contact
- OptumRx
- Phone:800.285.3177
- Website: optumrx.com
The MERP can lower your out-of-pocket costs to almost nothing. If you are enrolled in the MERP, you can have eligible copays, deductibles, and coinsurance for qualified medical and prescription drug expenses reimbursed, up to the MERP maximum limits.
Plan basics
- LCMC Health facilities, physician visits, and prescription drugs are covered at 100%.
- 100% preventive care (including annual exams, screenings, and immunizations)
- The MERP maximums follow the Affordable Care Act annual limitations, $12,000/individual and $24,000/family.
-
ID cards
- You must present your alternate coverage ID card and your MERP ID card for any visits.
- Let the provider know that the MERP will pay the provider directly for eligible copays, deductibles, and coinsurance.
- Most providers accept the MERP ID card and file claims. If the provider has any questions about the coverage or claim submission process, the provider can call the toll-free number on the back of the MERP ID card.
-
Eligibility and benefits
If you have access to another employer’s health plan (often through a spouse) and choose to enroll in the MERP, LCMC Health will help cover your medical costs throughout the year.
Provider contact
- Catilize Health
- Phone: 877.872.4232
- Website: portal.catilize.com
How to submit a claim:
If you need to submit a claim electronically, go to portal.catilize.com and submit the required documentation for:
- Copay, coinsurance, or deductible: The Explanation of Benefits (EOB) from your alternate group health plan.
- Prescriptions: Submit the “tab” that includes that name of the drug, date filled, patient’s name, and copay.
- Do not submit a cash register or credit card receipt; these along are not acceptable as per IRS regulations.
Invest in your health — for now and the future. An HSA is a great way to save money before taxes for medical, dental, and vision costs. The money is yours forever — it rolls over each year and can even grow for retirement.
Plan basics
Included with the LCMC Health Choice HDHP medical plan
- Pay for eligible medical, dental, and vision expenses with a debit card from Fidelity.
- Unused money rolls over each year and can grow with investment options.
- You keep the money for life, even if you change jobs or retire.
-
Debit card
- Pay with the ease of a debit card
- To see a list of eligible expenses visit irs.gov.
- Reminder: You must open and activate your account with Fidelity to receive the LCMC Health contributions to your HSA.
-
2027 contribution limits
- $4,500 single / $9,000 family
- Extra $1,000 catch-up contribution may be made if you are 55-64 and not enrolled in Medicare.
Member portal
Manage your account at netbenefits.com/LCMC.
- Check your balance
- Change your contribution amount
- Review claims and reimbursements
Provider contact
- Fidelity
- Phone:800.343.0860
- Website: netbenefits.com/LCMC
Plan basics
Healthcare FSA
-
Pay for eligible medical, dental, or vision expenses (including many over-the-counter items) with a debit card from DBS.
- You must be enrolled in the PPO medical plan or waived medical coverage.
Limited Purpose FSA
-
Pay for eligible medical, dental, or vision expenses (including many over-the-counter items) with a debit card from DBS.
- You must be enrolled in the HDHP medical plan.
-
Debit card
- Pay with the ease of a debit card
- You can access the full amount on January 1.
- Debit cards are valid for 5 years and reloaded each year with your new election. Do not throw your cards away!
- Use it or lose it – you can only rollover up to $700 each year.
- Keep your receipts! The IRS may ask for proof your FSA dollars were spent on eligible expenses.
- To see a list of eligible expenses visit irs.gov.
-
2027 contribution limits
- $3,500
- Direct deposit is required for all FSA reimbursements. Complete the FSA Direct Deposit Form here.
Online account access
Manage your account via the DBS phone app or online at dbsbenefits.com.
- View your account details including balance, claims, and reimbursements.
- Diversified Benefit Services mobile app is also available for download in the App Store and Google Play.
- You will need the following PIN to create an online account if you have not done so already: HVNCXX7R426F9JJN.
Provider contact
- Diversified Benefit Solutions (DBS)
- Phone: 800.234.1229
- Website: dbsbenefits.com
Dependent Care FSAs
The DCFSA allows you to set aside pre-tax dollars to pay for dependent care services.
- You contribute pre-tax dollars via payroll deduction.
- Pay for eligible expenses such as licensed day care or adult care facilities, before or after school care, or summer camps.
- DCFSA funds are forfeited if they are not used by the end of the plan year (December 31).
2027 contribution limit
- $7,500 each year if married, or $3,750 if married and filing separately.
Plan basics
Included with the dental plan
- You can visit any dentist, but you’ll save more with in-network dentists.
-
Preventive care is covered 100% in our network
- Orthodontia is only covered on high option 1 and high option 2.
-
ID cards
You can access your digital ID card at sunlife.com/account once coverage starts.
Provider contact
- Sun Life
- Phone: 800.442.7742
- Find a dentist: sunlife.com/findadentist
Plan basics
Included with the vision plan
- Independent practitioners and large retail chains such as Visionworks and Eye Works.
- $10 copay for exam, once per year with in-network providers.
- If you have the High Plan, you have additional benefits and can get new frames every year.
Provider contact
- Sun Life
- Phone: 800.877.7195
- Website/Find a provider: vsp.com