Medical

The Consumer Driven Health Plan (CDHP) combines a High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) that allows pre-tax contributions to be set aside in an interest-bearing account to cover eligible medical, dental and vision expenses, as well as future health care premiums such as those required for COBRA and retiree medical. The HSA is partially funded by the university, with the option for employees to contribute additional pre-tax funds.

This plan includes a network of hospitals and physicians that have agreed to accept a scheduled, discounted rate for their services. Participants may choose to visit any health care provider included in the network without a referral, and charges will be paid up to 80 percent of the scheduled amount after satisfying the annual deductible. Wellness care is covered at 100 percent for adults and children.

When using providers who are out-of-network, charges are paid up to 60 percent after the annual out-of-network deductible is satisfied. Out-of-network charges are paid in accordance with the Medicare reimbursement rate for service. Charges above the Medicare rate are not covered.

The PPO plan features a network of hospitals and physicians that have agreed to accept a scheduled, discounted rate for their services. Participants may choose to visit any health care provider included in the PPO network without a referral; charges will be paid at 80 percent of the scheduled amount after satisfying the annual deductible. Routine office visits are covered at 100 percent after a $30 co-pay for a primary care physician or a $50 co-pay for a specialist. Other procedures undertaken during the office visit may be subject to the deductible and co-insurance. Wellness care is covered at 100 percent for adults and children. When using providers who are not in the network, charges are paid at 60 percent after the annual out-of-network deductible is satisfied. Out-of-network charges are paid in accordance with the Medicare reimbursement rate for service. Charges above the Medicare rate are not covered.

The HMO plan provides a wide range of comprehensive health care services, including regular physicals and check-ups. Office visit co-pays are set at $30 for a primary care physician and $50 for a specialist. Most other services are covered at 100 percent. To receive coverage under the HMO, participants must use the doctors, hospitals and other health care providers within the HMO network, and must have their care coordinated by a primary care physician.

The following provides information about pharmacy benefits.

• Guide to Your Pharmacy Benefits
• Understanding Your Prescription Coverage Options
• Specialty Medication Information
• Pharmacy Mail Order Information