UnitedHealthcare
XYZ Company offers a choice of medical plan options so you can choose the plan that best meets your needs – and those of your family.
Important Notes:
This is a synopsis of coverage only; the benefits summary contains exclusions and limitations that are not shown here. Please refer to the benefits summary for the full scope of coverage. In-network services are based on negotiated charges; out-of-network services are based on Reasonable & Customary (R&C) charges.
UnitedHealthCare HSA
HOW THE PLAN WORKS
Preventive Care: The plan pays 100% for in-network preventive care.
Annual Deductible: You pay all non-preventive care costs, including prescription drugs, up to the annual deductible. The annual deductible is $3,000 for Individual and $6,000 for Family when you use in-network providers.
Preventative Prescription Medication: This plan covers some preventative medications at 100% (See list under resources).
Coinsurance: Once you have met the deductible, you will pay coinsurance for services received. When you use in-network providers, your coinsurance cost will be 20% for individual and family.
Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All medical and prescription drug deductibles, copayments and coinsurance apply toward the out-of-pocket maximum. Once you meet the out-of-pocket maximum, then the plan pays 100% of your eligible expenses, including the cost of all office visits and prescription drugs, for the remainder of the year.
*If you are a tobacco user, there is a $75 monthly surcharge added to the premium rates above
**If your spouse has access to coverage through their own employer, they are not eligible for XYZ Company’s medical plan
If you are enrolled in the HSA medical plan, you have access to the Health Savings Account (HSA) administered by Optum Bank. An HSA is like a 401(k) plan but for healthcare. It is a tax-advantaged personal savings or investment account that individuals can use to save and pay for qualified healthcare expenses, now or in the future. For more information on how an HSA works and XYZ Company contribution, please see the Health Savings Account page.
Resources
UnitedHealthCare PPO
Preventive Care: The plan pays 100% for in-network preventive care.
Annual Deductible: For non-preventive care there is an annual deductible that must be met. The annual deductible is $1,500 for Individual coverage and $3,000 for Family coverage when you use in-network providers.
Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All medical and prescription drug deductibles, copayments and coinsurance apply toward the out-of-pocket maximum. Once you meet the out-of-pocket maximum, then the plan pays 100% of your eligible expenses, including the cost of all office visits and prescription drugs, for the remainder of the year.
*If you are a tobacco user, there is a $75 monthly surcharge added to the premium rates above
**If your spouse has access to coverage through their own employer, they are not eligible for XYZ Company medical plan
Resources
UnitedHealthcare Tools
www.myUHC.com
Go online and create access to your individual portal. You will have access to your family’s health information-including EOB’s, benefit details, amounts paid toward your deductible and out of pocket. Additionally, you can search in-network providers, access the cost estimator tool and so much more!
Health4Me™ Mobile App
Health4Me provides instant access to your family’s health information anytime and anywhere. Whether you want to find a physician near you, estimate the cost of a service or prescription, check the status of a claim or speak directly with a health care professional, Health4Me is your go-to resource.
myHealthcare Cost Estimator
- Find the estimated cost for your procedure, treatment or prescription and find out how that will impact your deductible and out of pocket maximum.
- Available on myUHC.com and on the Health4Me App.
- To obtain estimates search terms such as: “back pain”, “MRI”, “x-rays”, “low thyroid”, name of your medication, etc.
Virtual Visits
- A virtual visit provides access to board certified physicians from your mobile device or computer 24/7 and can be used by all family members covered on your plan!
- Physicians can consult for symptoms relating to common illness and prescribe medication when needed. Common diagnoses include: pink eye, ear infection, flu, rashes, and more.
- Login to myuhc.com® or the UnitedHealthcare Health4Me® app to learn more
24 Hour Registered Nurses
Call 1-888-887-4114 to speak with a registered nurse 24/7. No cost to you! No appointment needed!
On-Line Health Coach
You can call UHC Wellness Coach at 800-478-1957 to begin working on your improvement plan and find out about resources to quit tobacco.
Health & Wellbeing: Rally and Real Appeal
- Rally: log on through myUHC.com to access your Rally website. This program offers personalized recommendations and customized missions to help improve your diet, fitness and every day mood. Earn ‘rally coins’ to win rewards.
- Real Appeal: lose weight without turning your life upside down! Providing you everything you need including a success guide, scale, blender, recipe book, measuring tools, etc. (AT NO COST TO YOU!), the real appeal program provides access to a health coach and helps you make small changes that support your lose weight journey.
