CU Health Plan - High Deductible/HSAHSA (Health Savings Account)A tax-savings account that must be paired with a High-Deductible Health Plan, which can be used to pay for qualified health care expenses now or in the future. An HSA is a savings account that you own. The funds in an HSA carry forward year after year, even if you change employers or retire.  Compatible is perfect for planners and savers. This Anthem-administered plan gives you access to health care services inside and outside your networkNetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services — but requires that you first meet your deductible. Once you've satisfied the deductible, you'll pay coinsuranceCoinsuranceThe portion of expenses that you have to pay for certain covered services, calculated as a percentage. For example, if the coinsurance rate is 20%, then you are responsible for paying 20% of the bill, and the insurance company will pay 80%.  for care.

This plan offers Anthem's nationwide network of providers and facilities, and you'll have the flexibility to schedule your own appointments with specialists — no Primary Care ProviderPrimary Care Provider (PCP)A physician (medical doctor or doctor of osteopathic medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services or referralsReferralA written order from your primary care provider for you to see a specialist or receive certain health care services for any covered service that cannot be performed by your primary care provider. This applies to our Anthem Exclusive and Kaiser plans.   needed.

Helpful tip: This health plan can be paired with a Health Savings Account.

Features and Considerations
Plan Type
 
PPOPreferred Provider Organization (PPO)A health care plan that has a contractual agreement with providers to offer health care services at discounted, negotiated fees within a network.  The PPO plans may require some cost-sharing with deductibles, copays and/or coinsurance.  /HSA Compatible
In-NetworkIn-NetworkThe providers, facilities and suppliers that CU Health Plans have contracted with to provide health care services.  Providers Out-of-NetworkOut-of-NetworkNon-participating providers or facilities that do not enter into a network agreement, usually resulting in higher out of pocket expenses to you. Providers
DeductibleDeductible - High Deductible PlanAn amount that you are required to pay before the plan will begin to reimburse for covered services. This plan has $1,500 deductible for single coverage or an “aggregate deductible” of $3,000 for family coverage (2+ members). This means than one or all members can contribute collectively to the $3,000 deductible.

$1,600 Single Coverage

$3,200 Family Coverage (2+ members)

Any member may contribute to overall deductible.

$3,200 Single Coverage

$6,400 Family Coverage (2+ members)

Any member may contribute to overall deductible.

Out-of-Pocket LimitOut-of-Pocket Limit/Maximum (OMP)The maximum amount of money you will pay for covered medical services during the plan year. These costs include deductibles, copays and coinsurance.  This maximum is designed to protect you from catastrophic health care costs. After you reach this amount, the plan will pay 100% of the allowed amount.  

$3,200 Single Coverage

$6,400 Family Coverage (2+ members)

$6,400 Single Coverage

$12,800 Family Coverage (2+ members)

Preventative Care VisitPreventative Care - MedicalA routine health care check-up that will include tests or exams, flu and routine shots, and patient counseling to prevent or discover illness, disease or other health problems. All recommended preventive services would be covered as required by the Affordable Care Act (ACA) and applicable state law. $0 coinsurance and no deductible 35% coinsurance after deductible
Office Visit 15% coinsurance after deductible 35% coinsurance after deductible
Emergency Room CareEmergency CareA medical or behavioral health condition that must be treated at the emergency department of a hospital due to an illness, injury, symptom or condition severe enough to risk serious danger to your health (or, with respect to a pregnant woman, the health of her unborn child) if you didn’t get medical attention. See where and when to get care. 15% coinsurance after deductible Covered as In-Network
Urgent CareUrgent CareCare for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care 15% coinsurance after deductible 35% coinsurance after deductible

 Prescription Benefits

Plan coverage is determined by medication type, supply amount and pharmacy services:

  30-day supply 90-day supply
  In-NetworkIn-NetworkThe providers, facilities and suppliers that CU Health Plans have contracted with to provide health care services.  Providers Out-of-NetworkOut-of-NetworkNon-participating providers or facilities that do not enter into a network agreement, usually resulting in higher out of pocket expenses to you. Providers  
Tier 1 10% coinsurance after deducitble at CVS Retail Network Pharmacies 20% coinsurance  5% coinsurance at CVS Retail Pharmacies or Mail Order
Tier 2 20% coinsurance after deducitble at CVS Retail Network Pharmacies 20% coinsurance  15% coinsurance at CVS Retail Pharmacies or Mail Order
Tier 3 20% coinsurance after deductible at CVS Retail Network Pharmacies 20% coinsurance  15% coinusrance at CVS Retail Pharmacies or Mail Order
Tier 4 20% coinsurance after deductible at CVS Retail Network Pharmacies

15% coinsurance at CVS Retail Pharmacies or Mail Order
20% coinsurance  N/A
  Maintenance medications may be purchased at a CVS Network Retail Pharmacy. After three fills, a CVS Retail Pharmacy or CVS Mail Order must be used for up to a 90-day supply.
Specialty medications (Tier 4) may be purchased at a CVS Network Retail Pharmacy. After three fills, CVS Specialty Pharmacy must be used.