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Low-deductible health insurance with provider options

This plan offers greater flexibility to choose providers from UK HealthCare, Anthem network or out-of-network. UK HealthCare facilities and physicians still offer excellent value with lower co-pays and co-insurance.

PPO vs HMO

PPO plan is available at the same monthly cost as HMO and offers greater flexibility to choose a doctor or health care facility. What you pay per month, called the monthly premium, is the same as the HMO plan. Members of the PPO plan pay for this extra flexibility through deductibles, co-insurance and higher co-pays for certain services.

News

April 21 No increase to your monthly health insurance cost

For employees eligible for the UK health credit for the year 2020-21

April 21 Increases to rates for retiree health insurance vary

Depends on your work status, hire date, retirement eligibility and coverage level

Employee monthly rates

HMO, PPO, Saver, Indemnity
Coverage Cost * UK pays You pay
Employee only $575 $542 $33
Employee + children $862 $719 $143
Employee + spouse $1,150 $885 $265
Family $1,437 $1,046 $391

* Regular part-time and temporary employees (less than 0.75 FTE or work less than an average of 30 hours per week in a 12 month measurement period), who are not eligible for the UK credit toward the costs of coverage, pay this rate.

$15 UK HealthCare primary care co-pay
$25 Anthem primary care co-pay
$50 Anthem specialist co-pay

Coverage highlights

Deductibles and out-of-pocket maximums vary based on who you see for care.

PPO plan designUK HealthCareAnthemOut-of-network
Lifetime Maximum BenefitUnlimitedUnlimitedUnlimited
Out-of-Pocket AmountAnnual deductible$100/member; $200/family$500/member, $1,000/family$1,500/member; $3,000/family
Medical out-of-pocket maximum$3,000/member; $6,000/family$3,000/member; $6,000/familyN/A
Prescription out-of-pocket maximum$4,900/member; $9,800/family$4,900/member, $9,800/family$4,900/member, $9,800/family

Costs for common services

PPO plan designUK HealthCareAnthemOut-of-network
Preventive Care (Coverage under preventive care category depends on age, symptoms and diagnosis)Routine mammogram and Pap smears$0$050% after deductible
Routine child care and immunizations (through age 18)$0$050% after deductible
Routine adult physical exam (19 years and above)$0$050% after deductible
Routine outpatient lab tests and X-rays $0$050% after deductible
Physician Services Primary care office visits (excludes certain diagnostic lab and X-ray)$15 co-pay per visit$25 co-pay per visit50% after deductible
Specialist office visits (excludes certain diagnostic lab and X-ray)$40 co-pay per visit $50 co-pay per visit50% after deductible
Lab tests and X-raysSame as office visit co-paySame as office visit co-pay 50% after deductible
Allergy injections $10 co-pay per visit $10 co-pay per visit50% after deductible
Inpatient services$300 co-pay per visit20% after deductible50% after deductible
Outpatient surgery$100 co-pay per visit20% after deductible 50% after deductible
Diagnostic tests (high costs - MRI, MRA, CT, and PET scans)$75 co-pay per visit20% after deductible 50% after deductible
Hospital ServicesInpatient care (semi-private room and board, nursing care, ICU)$300 co-pay per visit20% after deductible50% after deductible
Outpatient surgery$100 co-pay per visit20% after deductible50% after deductible
Diagnostic tests (high costs - MRI, MRA, CT, and PET scans)$75 co-pay per visit20% after deductible50% after deductible
Outpatient nonsurgical care$100 co-pay per visit20% after deductible50% after deductible
Outpatient tests, lab and X-ray$020% after deductible50% after deductible
Ancillary services$020% after deductible50% after deductible
Organ transplants$020% after deductible50% after deductible
Emergency room20% after $100 co-pay per visit (waived if admitted)20% after $100 co-pay per visit (waived if admitted)20% after $100 co-pay per visit (waived if admitted)
Other Medical ServicesUrgent treatment center$50 co-pay per visit100% after $50 co-pay per visit50% after deductible
Skilled nursing facility (up to 100 days/plan year)20% after deductible20% after deductible50% after deductible
Home health care (up to 100 visits/plan year) and hospice services20% after deductible20% after deductible50% after deductible
Durable medical equipment 20% after deductible20% after deductible50% after deductible
Ambulance20% after deductible20% after deductible50% after deductible
Chiropractic care*, physical, speech, music, hydrotherapy, occupational and acupuncture therapy (limited to 45 visits per plan year, combined) *Maximum 20 visits for chiropractic care$20 co-pay/visit$30 co-pay/visit50% after deductible
Mental Health and Substance AbuseInpatient$300 co-pay per visit20% after deductible50% after deductible
Outpatient$40 co-pay/visit$50 co-pay/visit50% after deductible

Making changes

Your first 30 days

Welcome to UK! You can sign up for benefits depending on your FTE. Enroll in your benefits quickly in myUK.

Qualifying events

If you experience a major life change outside of open enrollment you can also make changes to your insurance. This is known as a qualifying event. You'll need to fill out and submit a form within 30 days.

Benefits Open Enrollment

Our Benefits Open Enrollment happens every year so that you can make changes. Changes can be made in myUK, or with paper forms.

Retirees

Please use the Retiree Benefits Enrollment form and return to Scovell Hall.