Check your plan eligibility:

CU Health Plan - Exclusive CU Health Plan - Extended   CU Health
Plan - High Deductible
CU Health Plan - Kaiser
Faculty Faculty Faculty Faculty
University staff University staff University staff University staff
Classified staff Classified staff Classified staff Classified staff
Non-Medicare-eligible retirees   Non-Medicare-eligible retirees Non-Medicare-eligible retirees
Non-Medicare-eligible surviving spouses   Non-Medicare-eligible surviving spouses Non-Medicare-eligible surviving spouses

 

Type of plan

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser
Health Maintenance Organization (HMO)Health Maintenance Organization (HMO)HMOs require that each member enrolled in the plan select a primary care physician, who will manage the member's care and refer members to specialists. Under an HMO, members must obtain services from providers and facilities that are inside the designated network. There are no out-of-network services available, except in cases of emergency or urgent care.
administered by Anthem Blue Cross Blue Shield
Preferred Provider Organization (PPO)Preferred Provider Organization (PPO)A PPO is a plan that does not require members to have a primary care physician, and it does not require referrals to specialists. This type of plan allows members to receive services outside the established network. However, members will have fewer out-of-pocket expenses if they receive care inside the established network. Typically, members of PPOs must pay a deductible. Once the deductible is met, the plan will pay a percentage of the charges (aka, coinsurance).
administered by Anthem Blue Cross Blue Shield
Preferred Provider Organization (PPO) Preferred Provider Organization (PPO)A PPO is a plan that does not require members to have a primary care physician, and it does not require referrals to specialists. This type of plan allows members to receive services outside the established network. However, members will have fewer out-of-pocket expenses if they receive care inside the established network. Typically, members of PPOs must pay a deductible. Once the deductible is met, the plan will pay a percentage of the charges (aka, coinsurance).
administered by Anthem Blue Cross Blue Shield
Exclusive Provider Organization (EPO)Exclusive Provider Organization (EPO)An EPO plan is similar to a Health Maintenance Organization in that members must seek care and services from providers and facilities inside the network. Typically, an EPO does not pay for services from out-of-network providers and facilities, except in emergency or urgent care situations. An EPO plan may or may not require members to select a primary care physician.
administered by Kaiser Permanente

Coverage areas

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
Colorado

Out-of-state dependent child coverage may be available. See plan details.
Nationwide Nationwide Colorado

Out-of-state dependent child coverage may be available. See plan details.

Monthly cost

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
Employee: $50.50


Employee & Spouse: $184.50

Employee & Child(ren): $114.50

Family: $239.50
Employee: $73.00


Employee & Spouse: $225.00

Employee & Child(ren):
$145.00

Family: $294.50
Employee:
$0

Employee & Spouse: $15.00

Employee & Child(ren): $14.00

Family: $19.00
Employee: $109.00

Employee & Spouse: $296.50

Employee & Child(ren): $188.00

Family: $378.50

Deductible(s)

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
Individual
$250

Family
$750
Individual
$750

Family
$1,500
Individual

In network: $1,500

Out of network: $3,000


Family

In network: $3,000

Out of network: $6,000

None

Out-of-pocket limit

In most instances, coinsurances and copays become $0 when plan maximum is met.

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
Individual
$7,900 (premiums, balance-billed charges and non-covered care not included)

Family
$15,800 (premiums, balance-billed charges and non-covered care not included)
Individual
$7,900 (premiums, balance-billed charges and non-covered care not included)

Family
$15,800 (premiums, balance-billed charges and non-covered care not included)
 
Individual

In network: $3,000 (includes deductible and coinsurance)

Out of network: 6,000 (includes deductible and coinsurance)


Family

In network: $6,000 (includes deductible and coinsurance)

Out of network: $12,000 (includes deductible and coinsurance)

Individual
$7,900 (includes copayments, except for prescriptions)

Family
$15,800 (includes copayments, except for prescriptions)

Covered Providers

CU Health
Plan - Exclusive
CU Health
Plan -
Extended 
CU Health
Plan - High Deductible
CU Health Plan - Kaiser
Visit Anthem's microsite, or
call 1-800-735-6072.

Visit Anthem's
microsite or
call 1-800-735-6072.
Must use Anthem network providers.

Visit Anthem's
microsite or call 1-800-735-6072.
Visit Kaiser's microsite
or call 1-866-213-3062.

Referrals for specialty care

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
Referral required No referral required No referral required Referral required, but you can self-refer to certain specialists

Medical office visit costs

All preventive care visits, including immunizations and screenings, are fully covered by each of the plans below when you see an in-network provider. Out-of-network preventive care is not covered*.

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser

 
$30 ($40 for specialists) $40 ($50 for specialists) 15 percent coinsurance after deductible $30 ($40 for specialists)

Not covered Not covered 35% coinsurance after deductible (*this includes out-of-network preventive care) Not covered

Diagnostic and imaging tests 

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser
Blood work and X-rays

   
No coinsurance after deductible 10% coinsurance after  deductible 15% coinsurance after  deductible Fully covered

Not covered 10% coinsurance after  deductible 35% coinsurance  deductible Not covered
Scans (CT and PET) and MRIs

 
No coinsurance after deductible 10% coinsurance after  deductible 15% coinsurance after deductible $100 per procedure

 
Not covered 10% coinsurance after deductible 
(must obtain pre-authorization)
35% coinsurance after deductible Not covered

Prescription drug coverage

For details about costs at each covered pharmacy, please review each plan's benefits summary.

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser
Generic drugs (Tier 1)
UCHealth Retail

$13 for a 30-day supply

$26 for a 90-day supply
 

Anthem Retail

$15 for a 30-day supply

$26 for a 90-day supply

Anthem & UCHealth Retail
$15 for a 30-day supply

UCH Mail Order
$30 for a 90-day supply
Anthem Retail
20 percent coinsurance after deductible for a 30-day supply

UCHealth Retail or UCH Mail Order
20 percent coinsurance after deductible for a 30-day supply
Retail
$15 for a 30-day supply

Mail Order
$30 for 90-day


Not covered

Not covered

20 percent coinsurance after deductible for a 30-day supply

Not covered
Preferred-brand drugs (Tier 2)

UCHealth Retail

$30 for a 30-day supply

$60 for a 90-day supply

Anthem Retail
$35 for a 30-day supply

UCH Mail Order
$60 for a 90-day supply
Anthem & UCH Retail
$35 for a 30-day supply

UCH Mail Order
$70 for a 90-day supply
Anthem Retail
20 percent coinsurance after deductible for a 30-day supply

UCHealth Retail or UCH Mail Order
20 percent coinsurance after deductible for a 30-day supply

Retail $35 for a 30-day supply

Mail Order
$70 for a 90-day supply


 Not covered

 Not covered

20 percent coinsurance after deductible for a 30-day supply

 Not covered
Non-preferred-brand drugs (Tier 3)

UCHealth Retail

$50 for a 30-day supply

$100 for a 90-day supply


Anthem Retail
$50 for a 30-day supply

UCH Mail Order
$100 for a 90-day supply
Anthem & UCHealth Retail
$50 for a 30-day supply

UCH Mail Order
$100 for a 90-day supply
Anthem Retail
20 percent coinsurance after deductible for a 30-day supply

UCHealth Retail or UCH Mail Order
20 percent coinsurance after deductible for a 30-day supply
Not covered


 Not covered

Not covered

20 percent coinsurance for a 30-day supply

Not covered
Specialty oral and injectable drugs (Tier 4)

Anthem Retail, UCHealth Retail and UCH Mail Order
$75 for a 30-day supply
Anthem Retail, UCHealth Retail & Mail Order
$75 for a 30-day supply
Anthem Retail, UCHealth Retail & Mail Order
20 percent coinsurance for a 30-day supply
20% coinsurance (up to a maximum of $75 per drug for 30 days)


Not covered

Not covered

20 percent coinsurance for a 30-day supply

Not covered

Outpatient surgery

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
No coinsurance after deductible (100% covered) 10% coinsurance after deductible 15% coinsurance after deductible $250 copayment

Not covered Not covered 35% coinsurance after deductible Not covered

Emergency or urgent care

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser
ER services
$250
(waived if admitted)

Trans-portation
No coinsurance after deductible

Urgent care
$30
ER services
$250
(waived if admitted)

Trans-portation
10 percent coinsurance after deductible

Urgent care
$40
ER services, trans-portation and urgent care
15 percent coinsurance after deductible
ER services
$250 copayment
(waived if admitted)

Trans-
portation

Fully covered

Urgent care
$30 copayment

ER services
$150

Trans-portation
No coinsurance after  deductible

Urgent care
$30
ER services
$150

Trans-portation
10 percent coinsurance after deductible

Urgent care
$40
ER services, trans-portation and urgent care
35 percent coinsurance after deductible
ER services
$150 copayment

Trans-
portation

Fully covered

Urgent care
$30 copayment

Hospital stays

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser

Facility fee
No coinsurance after deductible

Physician/
surgeon fee

Fully covered
Facility and physician/
surgeon fee

10 percent coinsurance after deductible
Facility and physician/
surgeon fee

15 percent coinsurance after deductible
Facility and physician/
surgeon fee

$250 copay per day ($1,000 maximum per admission)

Facility and physician/
surgeon fee

Not covered
Facility and physician/
surgeon fee

Not covered
Facility and physician/
surgeon fee

35 percent coinsurance after deductible
Facility and physician/
surgeon fee

Not covered

Mental or behavioral health, and substance abuse coverage

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser

Outpatient
$30 per office visit and no coinsurance after deductible for the outpatient facility

Inpatient
No coinsurance after deductible
Outpatient
$40 per office visit

Inpatient
10 percent coinsurance after deductible
Inpatient and Outpatient
15 percent coinsurance after deductible

 
Outpatient
$30 copayment

Inpatient
$250 copayment per day ($1,000 maximum per admission)

Not covered Not covered 35 percent coinsurance after deductible Not covered

Pregnancy

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser
Prenatal and postnatal care
$15 coinsurance for first prenatal care office visit

Delivery and all inpatient services
No coinsurance after you've met your deductible
Prenatal and postnatal care
$25 copayment for the first prenatal care office visit

Delivery and all inpatient services
10 percent coinsurance after you've met your deductible
Prenatal and postnatal care, and delivery and all inpatient services
15 percent coinsurance after you've met your deductible
Prenatal and postnatal care
Fully covered

Delivery and all inpatient services
$250 copayment per day

Not covered Not covered 35 percent coinsurance after you've met your deductible Not covered

Recovery 

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible  CU Health Plan - Kaiser

Home Health Care, Skilled Nursing Care & Hospice Care
No coinsurance
after deductible

Rehabilitation & Habilitation

Inpatient: No coinsurance after deductible

Outpatient: $30 per visit
 

Durable Medical Equipment
20 percent coinsurance (not subject to deductible for prosthetic appliances, and no copayment after deductible for all other durable medical equipment
Home Health Care, Skilled Nursing Care & Hospice Care
10 percent coinsurance after you've met your deductible

Rehabilitation & Habilitation

10 percent coinsurance after deductible

Outpatient: $40 per visit

Durable Medical Equipment
10 percent coinsurance after deductible

All services
15 percent coinsurance after  deductible
Home Health Care, Skilled Nursing Care & Hospice Care
Fully covered

Rehabilitation & Habilitation
$30 copayment

Not covered
Not covered
All services
35 percent coinsurance after deductible
All services
Not covered

Child dental and eye care

 = in-network provider
 = out-of-network provider

  CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser
Eye exam
$30 per visit (exam only)

Glasses
Not covered

Dental checkup
Not covered
Eye exam, glasses and dental checkup
Not covered
Eye exam, glasses and dental checkup
Not covered
Eye exam

$30 for an optometrist

$40 for an ophthalmologist


Glasses
Not covered

Dental checkup
Not covered

Eye exam
Up to a $35 maximum reimbursement

Glasses
Not covered

Dental checkup
Not covered
Eye exam, glasses and dental checkup
Not covered
Eye exam, glasses and dental checkup
Not covered
All services
Not covered

Uncovered services

Following are the major services each plan does not cover. Note: This is not a complete list; please see each plan's benefits booklet for additional information about excluded services.

CU Health Plan - Exclusive CU Health Plan - Extended CU Health Plan - High Deductible CU Health Plan - Kaiser

Abortion (except in cases of rape, incest, or when the life of the mother is endangered)

Adult dental care

Cosmetic surgery

Infertility treatment

Long-term care

Non-emergency care outside the United States

Private-duty nursing

Routine foot care

Weight-loss programs 

Abortion (except in cases of rape, incest, or when the life of the mother is endangered)

Adult dental care

Cosmetic surgery

Infertility treatment

Long-term care

Non-emergency care outside the United States

Private-duty nursing

Routine foot care

Routine vision exam

Weight-loss programs

Abortion (except in cases of rape, incest, or when the life of the mother is endangered)

Adult dental care

Cosmetic surgery

Infertility treatment

Long-term care

Private-duty nursing

Routine eye care

Routine foot care

Weight-loss programs

Adult hearing aids

Children's glasses

Cosmetic surgery

Dental care

Infertility treatment

Long-term care

Non-emergency care outside the United States

Non-preferred band drugs

Private-duty nursing

Weight-loss programs (unless in conjunction with approved bariatric surgery plan)