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Choose from 2 health plan options

You have 2 plan options from UnitedHealthcare: the Choice HMO Plan and a High Deductible Health Plan (HDHP).

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Choice HMO

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HDHP

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Deductible
Individual No deductible $1,650
Family No deductible $3,300
Coinsurance (plan pays) 100% 80% after deductible
Medical out-of-pocket maximum
(includes covered medical expenses only)
Individual $1,500 $3,000
Family $3,000 $6,000
Global out-of-pocket maximum
(includes covered medical and prescriptions drugs)
Individual $9,450 $3,000
Family $18,900 $6,000

Choice HMO

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HDHP

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Preventive care
Adult $0 copay 100% covered
Well visits $0 copay 100% covered
Routine mammograms $0 copay 100% covered
Colorectal cancer screenings $0 copay 100% covered
Medical services
PCP visits (in person or virtual) $20 copay per visit 20% coinsurance after deductible has been met
Specialist visits (in person, virtual or telehealth) $40 copay per visit 20% coinsurance after deductible has been met
Allergy injections $0 copay 20% coinsurance after deductible has been met
24/7 Virtual Visits (teleheath) UHC-approved providers $0 copay 20% coinsurance after deductible has been met
Urgent care $25 copay per visit 20% coinsurance after deductible has been met
Convenience care clinics $25 copay per visit 20% coinsurance after deductible has been met
Emergency room visit $100 copay per visit, waived if admitted 20% coinsurance after deductible has been met
Ambulance $0 copay 20% coinsurance after deductible has been met
Inpatient hospital $250 copay per admission, covered at 100% after copay 20% coinsurance after deductible has been met
Outpatient hospital $0 copay 20% coinsurance after deductible has been met
Maternity
Inpatient $250 copay per admission, covered at 100% after copay 20% coinsurance after deductible has been met
Outpatient $40 copay, first visit only 20% coinsurance after deductible has been met
Mental health/substance use
Inpatient $250 copay per admission, covered at 100% after copay 20% coinsurance after deductible has been met
Outpatient $20 copay per visit 20% coinsurance after deductible has been met
Other services
Diagnostic lab $0 copay 20% coinsurance after deductible has been met
Diagnostic X-ray $0 copay 20% coinsurance after deductible has been met
Complex imaging (MRI, MRA, CT) $0 copay 20% coinsurance after deductible has been met
Outpatient surgery $0 copay 20% coinsurance after deductible has been met
Skilled nursing facility $0 copay 20% coinsurance after deductible has been met
Home health care $0 copay 20% coinsurance after deductible has been met
Durable medical equipment $0 copay 20% coinsurance after deductible has been met
Diabetic supplies Pharmacy cost-sharing applies 20% coinsurance after deductible has been met
Spinal manipulation therapy* $40 copay per visit 20% coinsurance after deductible has been met
Outpatient short-term rehab therapy* $40 copay per visit 20% coinsurance after deductible has been met
Infertility Not covered Not covered
Hospice (inpatient or outpatient) $0 copay 20% coinsurance after deductible has been met
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