Our High Deductible Health Plan (HDHP) is where cost-efficient care meets convenience. Enjoy the flexibility to choose any doctor, clinic, hospital, or healthcare facility within our expansive national network, designed to help reduce costs. However, if you decide to opt for a provider out-of-network, you will be responsible for covering all costs.
No referrals are required to see a specialist, placing you more in control of your health journey. Plus, 100% coverage for preventive care* is available within the network.
Important to note, our plan comes with a 2024 HDHP global out-of-pocket limit of $3,000 for individuals and $6,000 for families. This limit encompasses both medical and pharmacy expenses.
Unlock the gateway to cost-efficient care with HDHP, which may help you on a path toward improved health and well-being.
*Certain preventive care items and services, including immunizations, are provided as specified by applicable law, including the Patient Protection and Affordable Care Act (ACA), with no cost-sharing to you. These services may be based on your age and other health factors. Other routine services may be covered under your plan, and some plans may require copayments, coinsurance or deductibles for these benefits. Always review your benefit plan documents to determine your specific coverage details.
Compare to help find the right health plan
Our comparison chart helps you find your best fit by listing important plan benefits side-by-side.
Summary
Network Coverage
Only network providers are covered.
Primary Care Provider
Choosing a primary care provider is not required.
Deductible & Coinsurance
Deductible and Coinsurance applies.
Health Savings Account Options
Health savings account (HSA) offered through Chard Snyder.
Plan Details
| Individual | Family | |
|---|---|---|
| Deductible | $1,600.00 | $3,200.00 |
| Out-of-pocket Limit | $3,000.00 | $6,000.00 |
Are your providers in network?
Network Coverage
Find cost savings and quality care through our robust network coverage. Gain access to a group of healthcare providers and facilities that have a contract with UnitedHealthcare.
Finding providers within our network is easy when you utilize our user-friendly Provider Search tool. Unlock the power of network coverage and experience the difference it makes in your healthcare journey.
Stay in the Network
To help save on costs, choose care and services from within our network.
Look for the Hearts
From primary care providers to specialists, UnitedHealthcare makes it easy to find network physicians who consistently meet the UnitedHealth Premium quality care criteria which includes safe, timely, effective and efficient care — just look for the 2 blue hearts on myuhc.com.
*The UnitedHealth Premium®️ designation program is a resource for informational purposes only. Designations are displayed in UnitedHealthcare online physician directories at myuhc.com®️. You should always visit myuhc.com for the most current information. Premium designations are a guide to choosing a physician and may be used as one of many factors you consider when choosing a physician. If you already have a physician, you may also wish to confer with him or her for advice on selecting other physicians. You should also discuss designations with a physician before choosing him or her. Physician evaluations have a risk of error and should not be the sole basis for selecting a physician. Please visit myuhc.com for detailed program information and methodologies.
Primary Care Provider
While choosing a primary care provider (PCP) is not mandatory with this plan, we highly recommend selecting one for you and your covered family members. Your PCP acts as your invaluable health guide, coordinating your care, helping you avoid cost surprises and supporting you in achieving your best health.
Finding a network PCP is easy. Simply visit our Provider Search page and take the first step toward personalized care. Your health journey is important to us, and having a trusted PCP by your side may make all the difference.
Finding a Primary Care Provider
Discovering your network Primary Care Provider (PCP) is simple with our Provider Search feature. Follow these simple steps to make an informed choice:
- Click on the Provider Search link above to access the network for your selected plan.
- Under “What type of Medical Care can we help you find near.” click Change Location, provide your location details, and click Update Location.
- Under “Find healthcare by Category,” select People > Primary Care > All Primary Care Providers to view the list of PCP
- Scroll through the options and find the network PCP whose care you’d like to coordinate.
- Click on the PCP’s name to find their 14-digit Provider ID number. Make sure to jot it down for easy enrollment.
Taking charge of your health is just a few clicks away. Access quality care with your chosen network PCP and to help you achieve your best health.
Understanding Deductibles and Coinsurance
Navigating the world of health plans can be overwhelming, with terms like “deductible” and “coinsurance” adding to the confusion. Don’t worry; we’re here to help simplify it for you.
Health plans typically involve three key aspects: the cost of care, when you pay for it, and the percentage of those costs shared between you and your plan. Let’s break it down with a clear example of how health plans work.
Navigating Your Health Plan Costs
At the beginning of your health plan year, you will be responsible for covering 100% of the costs for covered healthcare until you reach your deductible. The deductible is the initial amount you pay before your plan starts sharing costs. Age-appropriate preventive care is covered 100% when you visit a network provider.
Reaching Your Deductible
Once you reach your deductible, coinsurance comes into play, and your health plan begins sharing a percentage of the costs with you. This sharing continues until you reach your out-of-pocket limit.
Reaching Your Out-of-Pocket Limit
The good news is that your out-of-pocket limit is the maximum amount you'll have to pay for healthcare costs in a plan year. Once this limit is reached, your health plan covers 100% of the costs for the rest of the plan year, helping protect you from excessive expenses. For the HDHP, your medical out-of-pocket limit and global out-of-pocket limit, which includes prescription expenses, are the same.
Health Savings Account Offered by Chard Snyder
Unlock the potential of our HDHP with a Health Savings Account (HSA), a tax-free bank account designed exclusively for your eligible healthcare expenses. With an HSA, you have the power to save and invest wisely in your well-being.
With your HSA, enjoy the freedom to use your funds for eligible health expenses when you need them. You also have the power to build up your savings for the future. Rest assured that your HSA balance carries over year after year, even if you change jobs.
Embrace the tax benefits that come with an HSA. Your deposits are exempt from federal and state income tax, and your savings grow tax-free. What’s more, any money you spend on eligible healthcare expenses is income tax-free as well.
To be eligible for an HSA, you must meet certain criteria defined by the IRS:
- Be covered under a qualifying high-deductible health plan (HDHP) on the first day of the month.
- Not have other health coverage except what is permitted by the IRS.
- Not be enrolled in Medicare, TRICARE, or TRICARE for Life.
- Cannot be claimed as a dependent on someone else’s tax return.
- Have not received Veterans Affairs (VA) benefits within the past three months, except for preventive care. If you have a disability rating from the VA, this exclusion doesn’t apply.
Remember, there may be other restrictions and exceptions, so it’s wise to consult a tax, legal, or financial advisor to discuss your personal circumstances.
Services and Programs Covered
With this cost-effective plan choice, you have the option of establishing an HSA (Health Savings Account) through Chard Snyder, the designated HSA provider for state employees. An HSA acts as your personal bank account, allowing you to save money for healthcare expenses like deductibles and coinsurance, all while providing valuable tax benefits.
For members enrolled in the family tier, this plan covers all 100% of eligible medical and pharmacy expenses throughout the plan year. The coverage encompasses preventive care, which includes annual checkups, routine screenings, and immunizations. Additionally, diagnostic care covers treatments for symptoms or pre-existing health conditions.
Both the Choice HMO Plan and the HDHP ensure that preventive care appointments are fully covered at 100%*. However, it’s worth noting that any diagnostic treatments conducted during your preventive exam might entail extra costs. Here’s just a partial list of what else is covered. For the full list, check out our Summary of Benefits and Coverage. You can also learn more about these covered services and programs on the Member Benefits page.
Doctor Office Visits and Labs
With this plan option, you have the freedom to use any doctor or hospital in the UnitedHealthcare Choice network. For non-preventive care services, you’ll pay the full amount until your deductible is met. Once you meet your deductible, the plan pays 80% of covered services. If you do not use a network provider, you will be responsible for the entire cost of the service, except in the case of an emergency.
Emergency and Outpatient Care
Outpatient surgeries and diagnostic care, which include lab tests and X-rays, follow a specific payment structure until the out-of-pocket maximum is reached. Initially, members will bear the full cost until they satisfy their deductible. Once the deductible is met, a 20% coinsurance applies for these services, continuing until the out-of-pocket limit is reached.
Pregnancy and Newborn Care
Learn what to expect and how to manage your health through pregnancy and postpartum using the resources and tools offered by UnitedHealthcare Maternity Support.
OptumRx®
For pharmacy-related needs, OptumRx is here to help make things simpler and more convenient, and it may help you save on costs through home delivery, network pharmacies, and generic or lower-tier drugs.
Wellness Programs
Once your health plan becomes active, we encourage you to sign up for wellness programs and take advantage of health support services — all at no additional cost to you.
Behavioral Health Services
From everyday challenges to more serious issues, you can receive the confidential help of a psychiatrist or therapist and schedule in-person or virtual appointments. UnitedHealthcare also offers self-service digital tools designed to help with behavioral health issues like anxiety and depression.
Your Path to Choosing a Health Plan
Find the plan that’s the right fit for you. Our comparison chart empowers you to make an informed decision by presenting essential plan benefits side-by-side, making it easier than ever to find the health plan that suits you best.
Ready to discover your ideal fit? Access our Plan Comparison page and embark on a journey to better health and well-being.
*Administrative services provided by United Healthcare Services, Inc., or their affiliates.