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United Healthcare Plans

Overview of Our United Healthcare Plans

These United Healthcare plans are available nationwide. You can choose the option that works best for you.

Healthcare Choice (EPO) Plan

Healthcare Choice Plus (PPO 500) Plan

HSA Choice Plus (PPO 2250) Plan

In-Network Only

In-Network

Out-of-Network**

In-Network

Out-of-Network**

Calendar Year Deductible

No deductible

$500 Individual; $1,000 Family

$2,250 Employee Only; or $4,500 Family Level

Maximum Out-of-Pocket

$3,500 Individual

$7,000 Family

$3,000 Individual

$6,000 Family

(Excludes the deductible)

$10,000 Individual

$20,000 Family

(Excludes the deductible)

$3,000 Employee Only; or $5,500 Family Level

(Includes the deductible)

Preventive Care

$20

$35 (deductible waived)

Not covered

$35 (deductible waived)

Not covered

Preventive Lab Work

$10

$35 (deductible waived)

Not covered

20% (deductible waived)

Not covered

Virtual Visits

$10

$10 (deductible waived)

Not covered

20%*

Not covered

Office Visits/Urgent Care

$20

$35 (deductible waived)

40%*

20%*

50%*

Naturopathy Visits

$20

$35 (deductible waived)

40%*

20%*

50%*

Diagnostic Lab & X-rays

$10

$35 (deductible waived)

40%*

20%*

50%*

Well Baby Care

(screenings, immunizations & vaccinations)

$20

$35 (deductible waived)

Not covered

$35 (deductible waived)1

Not covered

Pregnancy & Maternity

$20***

20%*

40%*

20%*

50%*

Rehabilitative Therapy

$20

$35*

40%*

20%*

50%*

Chiropractic

$20 up to 12 visits

$25* up to 12 visits

40%* up to 12 visits

20%* up to 20 visits

50%* up to 20 visits

Acupuncture

$20 up to 12 visits

$25* up to 12 visits

40%* up to 12 visits

20%* up to 20 visits

50%* up to 20 visits

Emergency Room

$100

$100 facility fee;* 20% physician fee*

20% facility fee;* 20% physician fee*

Hospitalization

Inpatient Physician

$500/day up to 3 days/adm

20%*

40%*

20%*

50%*

Semi-Private Room

included in above

$250 + 20%*

40%2*

20%*

50%*

Outpatient Surgery

Ambulatory Service Center

$200

20%*

40%*

20%*

50%*

Hospital/Facility

$400

$125 + 20%*

40%*

20%*

50%*

Treatment & Supplies

No charge

20%*

40%*

20%*

50%*

Prescriptions: Mail order available under all plans (up to a 90- or 100-day supply)

Tier 1

$10

$10

25% + $10

$10*

25% + $10*

Tier 2

$20

$20

25% + $25

$25*

25% + $25*

Tier 3

$35

$35

25% + $35

$40*

25% + $40*

*Coinsurance/co-pay rate applies after the deductible has been met.

**Out-of-network benefits are based on usual, reasonable and customary (UCR) charges. If the provider charges more than the UCR, you are responsible for the excess charges plus the co-pay or co-insurance. Certain services require pre-authorization. See the Plan Documents for details.

***For office visits and for inpatient stay, refer to the hospitalization benefit.

  1. Preventive and well-baby care office visit are not subject to the deductible. Other covered non-preventive services received during or in connection with the office visit are subject to the deductible and applicable copayment percentage.
  2. The maximum allowed for hospital services received from a non-preferred hospital is $600 per day. Members are responsible for the co-insurance percentage of this $600 plus all charges in excess of $600.

Healthcare Choice (EPO) Plan

The Healthcare Choice Plan doesn’t require you to select a primary care physician and you don’t need a referral before seeing a doctor or specialist. You also can take advantage of selecting from a vast network of doctors and hospitals in your area.

  • You’ll pay $10 for tier-1 drugs (generic), $20 for tier-2 drugs (preferred brand name), and $35 for tier-3 drugs (non-preferred brand name) at a preferred retail store.

    Want to save more time and money? Sign up for mail order pharmacy for your maintenance medications and get a 3-month supply for the cost of two months. For information about signing up for mail order pharmacy, see the Optum Rx Welcome Guide.

Healthcare Choice Plus (PPO 500) Plan

The Healthcare Choice Plus Plan doesn’t require you to select a primary care physician and you don’t need a referral before seeing a doctor or specialist. You also can take advantage of selecting from a vast network of PPO doctors and hospitals in your area. Although you can see any doctor or use any hospital—even those that aren’t in the network—it’s always more cost-effective to choose a network provider.

With the PPO plan, you’ll pay an annual deductible ($500 individual/$1,000 family). These amounts must be satisfied before the plan begins to pay benefits. However, the deductible does not apply to preventive care or general in-network office visits.

For many in-network services (except for doctors' office visits), you’ll pay 20% of the cost (coinsurance) until you reach the out-of-pocket limit ($3,000 individual/$6,000 family).

  • After your deductible, you'll pay $10 for tier-1 drugs (generic), $20 for tier-2 drugs (preferred brand name), and $35 for tier-3 drugs (non-preferred brand name) at a preferred retail store.

    Want to save more time and money? Sign up for mail order pharmacy for your maintenance medications and get a 3-month supply for the cost of two months. For information about signing up for mail order pharmacy, see the Optum Rx Welcome Guide.

HSA Choice Plus (PPO 2250) Plan

With the HSA Choice Plus Plan, all medical costs, aside from preventive care, are your responsibility up until you meet the annual deductible ($2,250 individual/$4,500 family). If you meet the deducible amount, you would then be responsible for the coinsurance amounts (20%) up until you reach the out-of-pocket maximum ($3,000 individual/$5,500 family).

  • After your deductible, you'll pay $10 for tier-1 drugs (generic), $20 for tier-2 drugs (preferred brand name), and $35 for tier-3 drugs (non-preferred brand name) at a preferred retail store.

    Want to save more time and money? Sign up for mail order pharmacy for your maintenance medications and get a 3-month supply for the cost of two months. For information about signing up for mail order pharmacy, see the Optum Rx Welcome Guide.

  • The high-deductible medical plan qualifies you to open a Health Savings Account (HSA). The Health Savings Account not only allows you to contribute pre-tax dollars for current and future medical expenses (no “use it or lose it”), but it also allows you to take advantage of the company’s dollar-for-dollar matching monthly contribution.

    Each year, you could receive up to $1,125 for individual coverage and $2,250 for family coverage in company contributions. This covers half of your deductible amount. Your Health Savings Account dollars can then be used to pay for eligible medical expenses tax-free. For more information on what the IRS considers an eligible medical expense, see  Publication 502.