United Healthcare
United Healthcare is a national insurance carrier with a large network of doctors and facilities throughout the country. UHC administers our medical plans and their pharmacy benefit manager OptumRx administers the prescription drug plan.
There are two UHC medical plans offered to you: the High Deductible Plan (HSA) and the traditional PPO medical plan. While the plan designs are different between the HSA and PPO, the provider networks are the same.
When you choose a provider in the UHC network you will receive the highest level of benefits payable under the plan. To further reduce the cost of your office visit or specialist copayment or coinsurance amount, choose a network provider who has earned the UHC Tier 1 designation. Tier 1 Providers have been recognized within the UHC network for providing higher value in healthcare delivery to patients.
To find a Tier 1 provider register at MyUHC.com to get a personalized view of your provider network. Or, you may call UHC Customer Service at 1-833-760-7890.
UHC also offers many other programs and tools to help you get the most from your membership.
Tier 1 Primary Care doctors include:
- Family Practice
- Internal Medicine
- Pediatric Internal Medicine
- Gynecology
Obstetrics - Pediatrics
- Pediatric Adolescent
Tier 1 Specialty Care doctors include:
- Allergy
- Cardiology
- ENT
- Endocrinology
- Gastroenterology
- General Surgery
- Nephrology
- Neurology
- Orthopedics
- Oncology
- Pulmonology
- Rheumatology
Resources
High Deductible Plan
| Plan Benefits | In-Network | Out-of-Network |
| Annual Deductible (non-embedded) | $2,000 EE | $4,000 Family | $4,000 EE | $8,000 Family |
| Coinsurance (after deductible) | 20% | 40% |
| Out of Pocket Max (non-embedded) (Includes deductible and coinsurance) |
$3,500 EE | $6,850 Family | $7,000 EE | $14,000 Family |
| Tier 1 Designated Primary Care Visit | Deductible Only | Deductible then 40% coinsurance |
| Primary Care Visit | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
| Tier 1 Designated Specialist Visit | Deductible Only | Deductible then 40% coinsurance |
| Specialist Visit | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
| Virtual Visits | Deductible; after deductible no charge | Not Covered |
| Urgent Care | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
| Emergency Room | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
| Prescription Drugs | ||
| Generic | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
| Brand Preferred | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
| Brand Non-Preferred | Deductible then 20% coinsurance | Deductible then 40% coinsurance |
Monthly Contributions
High Deductible Health Plan: Tier 1 – Salary < $56,325
| Standard rate | Discounted rate (Health Screening) |
Discounted rate (Tobacco-free) |
Discounted rate (Health screening AND (Tobacco-free) |
|
| Employee Only | $99.44 | $79.54 | $69.61 | $49.72 |
| Employee + Spouse | $124.80 | $99.84 | $87.36 | $62.40 |
| Employee + Child(ren) | $120.32 | $96.26 | $84.23 | $60.16 |
| Family | $275.45 | $220.36 | $192.81 | $137.72 |
High Deductible Health Plan: Tier 2 – Salary > $56,325
| Standard rate | Discounted rate (Health Screening) |
Discounted rate (Tobacco-free) |
Discounted rate (Health screening AND (Tobacco-free) |
|
| Employee Only | $99.44 | $79.54 | $69.61 | $49.72 |
| Employee + Spouse | $148.96 | $119.17 | $104.27 | $74.48 |
| Employee + Child(ren) | $138.22 | $110.58 | $96.76 | $69.11 |
| Family | $400.74 | $320.59 | $280.52 | $200.37 |
PPO Plan
| Plan Benefits | In-Network | Out-of-Network |
| Deductible (Single/Family) | $1,000 /individual $3,000/family |
$2,000/individual $6,000/family |
| Calendar Year Out-of-Pocket Maximum | $5,000/individual $10,000/family |
$5,500/individual $11,000/family |
| Coinsurance (amount you pay) | 20% after deductible | 40% after deductible |
| Preventive Care | No charge | 40% after deductible |
| PCP Office Visit | $25 copay | 40% after deductible |
| Tier 1 PCP Visit | $10 copay | 40% after deductible |
| Specialist Office Visit | $45 copay | 40% after deductible |
| Tier 1 Specialist Visit | $25 copay | 40% after deductible |
| Urgent Care | $50 copay | 40% after deductible |
| Emergency Services | $200 copay | 40% after deductible if deemed not a true emergency. |
| Hospital Services | 20% after deductible | 40% after deductible |
| Diagnostic X-ray and Lab | 20% after deductible | 40% after deductible |
| Prescription Drugs | ||
| Generic – Retail Prescription Drug (30-day supply) | $10 copay | |
| Generic – Mail Order Prescription Drug (90-day supply | $10 copay | |
| Brand Preferred – Retail and Mail Order | 25% coinsurance | |
| Brand Non-Preferred – Retail and Mail Order | 50% coinsurance | |
Physician office visit copays, ER and urgent care copays, and prescriptions do not count toward your deductible, but do accumulate toward your out-of-pocket maximum. The annual deductible is included in the out-of-pocket maximum.
Monthly Contributions
PPO Plan: Tier 1 – Salary < $56,325
| Standard rate | Discounted rate (Health Screening) |
Discounted rate (Tobacco-free) |
Discounted rate (Health screening AND (Tobacco-free) |
|
| Employee Only | $328.15 | $262.52 | $229.71 | $164.08 |
| Employee + Spouse | $578.21 | $462.50 | $404.68 | $289.06 |
| Employee + Child(ren) | $530.49 | $424.39 | $371.34 | $265.24 |
| Family | $923.13 | $738.50 | $646.19 | $461.57 |
PPO Plan: Tier 2 – Salary > $56,325
| Standard rate | Discounted rate (Health Screening) |
Discounted rate (Tobacco-free) |
Discounted rate (Health screening AND (Tobacco-free) |
|
| Employee Only | $328.15 | $262.52 | $229.71 | $164.08 |
| Employee + Spouse | $602.28 | $481.82 | $421.60 | $301.14 |
| Employee + Child(ren) | $538.39 | $438.71 | $383.87 | $274.19 |
| Family | $1,048.43 | $838.74 | $733.90 | $524.21 |
