2018 Postdocs - Medical Plan Summary Chart

The Medical Plan Summary Chart below summarizes the Choice Plus 80 plan provisions:

 

Medical Plan Summary

Benefit

Choice Plus 80

 In-NetworkOut-Of-Network*
Annual Deductible
  Individual
  Family

 
$600 per person**


$850 per person
Coinsurance (% paid by the Plan)80% after deductible60% after deductible
Out-of-Pocket Maximum
  Individual
  Family
$3,750
$7,500
$5,250
$10,500
Preventive Care100%Not covered
Physician Office Visits, including specialists$30 copay60% after deductible
Laboratory/Radiology Services, including services rendered in a physician’s office80% after deductible60% after deductible
Inpatient Hospital Care80% after deductible60% after deductible; Precertification required
Outpatient Hospital Care80% after deductible60% after deductible; Precertification required
Mental Health and Substance Abuse – Inpatient care80% after deductible60% after deductible; Precertification required
Mental Health and Substance Abuse – Outpatient programs$30 copay70% after deductible for facility based care, including intensive
outpatient programs; Precertification required
Mental Health and Substance Abuse – Outpatient Counseling$30 copay70% after deductible
Emergency Room 
 
$150 copay (waived if admitted)$150 copay (waived if admitted)
Basic and Comprehensive Infertility TreatmentUnlimited benefit for diagnosis and basic medical treatment, including artificial insemination
Advanced Infertility Treatment$30,000 lifetime maximum for advanced treatments and Assisted Reproductive Technology including IVF, GIFT and ZIFT
Prescription Drug coverage with OptumRxRetail (30-days)


• Generic: $10 copay

• Single-source brand: $25 copay

• Multi-source brand: $45 copay

Mail-order (90-days)


• Generic: $15 copay

• Single-source brand: $50 copay

• Multi-source brand: $90 copay


*Out-of-Network coinsurance reimbursement is indexed to 190% of the Medical Maximum Allowance Charge (MAC), including expenses in excess of the out-of-network out-of-pocket maximum.

**To meet the requirements of the U.S. Department of State, J-1 Visa holders will have a $500 per person deductible applied.

Remember: In the Choice Plus 80 plan, in-network deductible, coinsurance and medical and prescription drug copays accumulate toward the in-network out-of-pocket maximum. In addition, out-of-network expenses accumulate toward the in-network out-of-pocket maximum.

ImportantImportant Notes: UHC’s Choice network is a national provider network and does not require a primary care physician or referrals to see specialists. UHC requires precertification for some services. If you use an in-network provider, your participating network physician or hospital generally handles the precertification process. However, it is your responsibility to confirm that your provider has obtained the necessary authorizations from UHC. If you see a provider who is out-of-network, you are responsible for obtaining precertification for most services except routine office visits.