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Compare CU Health Plans, 2021-22

Plans
  • Who is Eligibile?





  • Type of plan

  • Provider
  • Cost for
    Monthly premiums





  • Total Cost of
    premiums for
    the plan year,
    July 1 - June 30




  • Coverage areas




  • Deductible(s)








  • Out-of-pocket
    limits







  • Covered
    Providers

  • Referrals for
    Specialty care
      
  • Preventative care
    (screenings,
    Immunizations, etc.)



     
  • Medical office
    visit costs







  • Diagnostic tests
    (bloodworK,
    X-RAYS, etc.)           




  • imaging
    (CT/PET Scans, MRI)





  • Prescription
    drug coveragE 
    for Generic Drugs
    (Tier 1)
















  • Prescription
    drug coverage for
    PReferred-Brand
    Drugs (Tier 2)














  • Prescription
    drug coverage for
    Non-preferred
    Brand drugs
    (Tier 3)
















  • Prescription
    drug coverage for
    Specialty Oral &
    Injectable drugs
    (Tier 4)








  • Outpatient
    surgery
    Facility fees







  • OUTPATIENT
    SURGERY
    Physician &
    Surgeon fees


      
  • Emergency Care





















  • Urgent care






     
  • Hospital stays: 
    Facility FeeS 





  • HOspital Stays:
    Physician or
    SurgeoN Fees



      
  • Mental or
    behavioral
    health and
    substance
    abuse coverage











  • PregnancY:  
    Office Visits





      
  • prEGNANCY:
    dELIVERY
    prOFESSIONAl
    sERVICES


     

  • pregnancy:
    dELIVERY
    fACILITY
    sERVICES




  • home health care






     
  • REHABILITATION
    SERVICES










  • Habilitation
    ServiCes







  • Skilled Nursing
    Care






  • Durable MedicaL
    Equipment








  • Hospice services





     
  • Child eye care
















  •  CHILD DENTAL




  • Uncovered
    services






















  •  

     

     

    CU Health Plan - Exclusive

    • Faculty
      University Staff
      Classified Staff
      Non-Medicare-eligible retirees
      Non-Medicare-eligible
      Surviving spouses
    • Health Maintenance Organization (HMO)
    • Anthem Blue Cross Blue Shield
    • Employee: $54.00

      Employee + Spouse: $193.50

      Employee + Child(ren): $121.50

      Family: $251.50
    • Employee: $648.00

      Employee + Spouse: $2,322.00

      Employee + Child(ren): $1,458.00

      Family (3+): $3,018.00
    • Colorado

      Out-of-state dependent coverage may be available.

    • Individual: $250




      Family: $750



    • Individual:

      $8,550


      Family:

      $17,100

    • Visit Anthem's microsite,
      or call 1-800-735-6072.

    • Primary Care Physicans
      are required, and
      should direct your care 
    • In network:
      $0 per visit,
      deductible does not apply

      Out of network:
      Not covered
          
    • In network:
      $30 per visit for primary care
      $40 per visit for specialists



      Out of network:
      Not covered

    • In network:
      $0 per visit
      after deductible is met


      Out of network:
      Not covered
    • In network:
      $0 per visit
      after deductible is met

      Out of network:
      Not covered

    • In network:

      CVS Retail Pharmacies:
      $15 for up to a 30-day supply

      UCHealth Retail:
      $13 for up to a 30-day supply
      $26 for up to a 90-day supply

      UCH Mail Order:
      $26 for up to a 90-day supply




      Out of network:

      Not covered


    • In network:

      CVS Retail Pharmacies:
      $35 for up to a 30-day supply

      UCHealth Retail:
      $30 for up to a 30-day supply
      $60 for up t  a 90-day supply 

      UCH Mail Order:
      $60 for up to a 90-day supply



      Out of network:

      Not covered

    • In network:

      CVS Retail Pharmacies:
      $50 for up to a 30-day supply

      UCHealth Retail:
      $50 for up to a 30-day supply
      $100 for up to a 90-day supply 


      UCH Mail Order:
      $100 for up to a 90-day supply





      Out of network:

      Not covered

    • In network:

      CVS Retail Pharmacies, UCHealth Retail and
      UCH Mail Order:
      $75 for up to a 30-day supply



      Out of network:

      Not covered

    • In network:

      $0 after deductible is met



      Out of network:

      Not covered 

    • In network:
      No charge
       

      Out of network:
      Not covered  

    • In network:

      Emergency room care:
      $250 per visit
      (waived if admitted)

      Emergency medical transportation:
      $0 after deductible is met



      Out of network:

      Emergency room care:
      $250 per visit
      (waived if admitted)

      Emergency medical transportation:
      $0 after deductible is met

    • In network:
      $30 per visit
      deductible does not apply 


      Out of network:
      $30 per visit
      deductible does not apply 
    • In network:
      $0 after deductible is met


      Out of network:
      Not covered

    • In network:
      Fully covered, no charge


      Out of network:
      Not covered 

    • In network:

      Outpatient:
      $30 per office visit,
      deductible does not apply

      Inpatient:
      $0 after deductible is met




      Out of network:

      Not covered

    • In network:
      $15 copayment
      for first prenatal care office visit, deductible does not apply

      Out of network:
      Not covered

    •  In network:
      $0 - fully covered



      Out of network:
      Not covered

    • In network:
      $0 after deductible is met



      Out of network:
      Not covered
       
    • In network:
      $0 after deductible is met



          Out of network:
      Not covered

    • In network:

      Inpatient: $0

      Outpatient:
      $30 per visit,
      deductible does not apply


      Out of network:
      Not covered

    • In network:

      Outpatient:
      $30 per visit,
      deductible does not apply

      Out of network:
      Not covered

    • In network:
      $0 after deductible is met



      Out of network:
      Not covered

    •  In network:
      20% coinsurance
      not subject to deductible for prosthetic appliances;
      $0 after deductible for all other durable medical equipment (100% covered)

      Out of network:
      Not covered
    • In network:
      $0 after deductible is met


      Out of network:
      Not covered

    • In network:

      Eye exam:
      $20 per visit (exam only,
      deductible does not apply)

      Glasses:
      Not covered


      Out of network:

      Eye exam:
      $35 maximum reimbursement

      Glasses:
      Not covered
    • In network:
      Not covered   

      Out of network:
      Not covered 
    • 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
      when traveling outside
      the United States

      Private-duty nursing

      Weight-loss programs





  •  

     

     

    CU Health Plan - High Deductible

    • Faculty
      University Staff
      Classified Staff
      Non-Medicare-eligible retirees Non-Medicare-eligible
      Surviving spouses
    • Preferred Provider
      Organization (PPO)
    • Anthem Blue Cross Blue Shield
    • Employee: $0

      Employee + Spouse: $20.00

      Employee + Child(ren): $19.00

      Family: $29.00
    • Employee: $0

      Employee + Spouse: $240.00

      Employee + Child(ren):
      $228.00

      Family (3+): $348.00 
    • Colorado and nationwide




    • Individual:

      In network: $1,500
      Out of network: $3,000

      Family:

      In network: $3,000
      Out of network: $6,000
    • Individual:

      In network: $3,000
      Out of network: $6,000

      Family:

      In network: $6,000
      Out of network: $12,000
    • Visit Anthem's microsite,
      or call 1-800-735-6072.

    • No referral required 


    • In network:
      $0 per visit


      Out of network:
       35% coinsurance after deductible is met
    • In network:
      15% coinsurance after deductible is met for primary care or specialist visits


      Out of network:
      35% coinsurance after deductible is met
    • In network:
      15% coinsurance after deductible is met

      Out of network:
      35% coinsurance after deductible is met
    • In network:
      15% coinsurance after deductible is met

      Out of network:
      35% coinsurance after deductible is met
    • In network:

      CVS Retail Pharmacies:
      20% coinsurance after deductible for up to
      a 30-day supply

      UCHealth Retail or
      UCH Mail Order:
      20% coinsurance after deductible for up to
      a 90-day supply



      Out of network:

      20% coinsurance after deductible for up to
      a 30-day supply
    • In network:

      CVS Retail Pharmacies:
      20% coinsurance after deductible for up to
      a 30-day supply

      UCHealth Retail or
      UCH Mail Order:
      20% coinsurance after deductible for up to a
      90-day supply


      Out of network:

      20% coinsurance after deductible for a 30-day supply
    • In network: 

      CVS Retail Pharmacies:
      20% coinsurance after deductible for up to
      a 30-day supply


      UCHealth Retail or 
      UCH Mail Order:
      20% coinsurance after deductible for up to a
      90-day supply




      Out of network:

      20% coinsurance after deductible for a 30-day supply
    • In network:

      CVS Retail Pharmacies, UCHealth Retail & Mail Order:
      20% coinsurance after deductible for up to
      a 30-day supply


      Out of network:

      20% coinsurance after deductible for a 30-day supply
    • In network:

      15% coinsurance after deductible is met


      Out of network:

      35% coinsurance after deductible is met
    • In network:
      15% coinsurance
      after deductible is met

      Out of network:
      35% coinsurance after deductible is met  
    • In network:

      Emergency room care:
      15% coinsurance after deductible is met

      Emergency medical transportation:
      15% coinsurance after deductible is met


      Out of network:

      Emergency room care: 
      15% coinsurance after deductible is met

      Emergency medical transportation: 
      15% coinsurance after deductible is met
    • In network:
      15% coinsurance after deductible is met 


      Out of network: 
      35% coinsurance after deductible is met 
    • In network:
      15% coinsurance after deductible is met

      Out of network:
      35% coinsurance after deductible is met
    •  In network:
      15% coinsurance after deductible is met

      Out of network:
      35% coinsurance after you've met your deductible
    • In network:

      Outpatient:
      15% coinsurance after deductible is met

      Inpatient:
      15% coinsurance after deductible is met



      Out of network:

      35% coinsurance after    deductible is met
    • In network:
      15% coinsurance after deductible is met


      Out of network:
      35% coinsurance after deductible is met
    • In network:
      15% coinsurance after deductible is met


      Out of network:
      35% coinsurance after deductible is met  
    • In network:
      15% coinsurance after deductible is met


      Out of network:
      35% coinsurance after deductible is met
    • In network:
      15% coinsurance after deductible is met


      Out of network:
      35% coinsurance after deductible is met
    • In network:

      15% coinsurance
      after deductible is met





      Out of network:
      35% coinsurance after deductible is met 
    • In network:
      15% coinsurance
      after deductible is met



      Out of network:
      35% coinsurance after deductible is met  
    • In network:
      15% coinsurance
      after deductible is met


      Out of network:
      35% coinsurance
      after deductible is met  
    • In network:
      15% coinsurance after deductible is met





      Out of network:
      Not covered
    • In network:
      15% coinsurance after deductible is met

      Out of network:
      35% coinsurance after deductible is met
    • In network:

      Not covered







      Out of network:

      Not covered



       
    • In network:
      Not covered

      Out of network:
      Not covered 
    • 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 vision exam

      Routine foot care, unless
      you have been diagnosed
      with diabetes  

      Weight-loss programs  



  •  

     

     

    CU Health Plan - Extended

    • Faculty
      University Staff
      Classified Staff



    • Preferred Provider
      Organization (PPO)
    • Anthem Blue Cross Blue Shield
    • Employee: $105.00

      Employee + Spouse: $319.50

      Employee + Child(ren): $210.50

      Family: $420.00
    • Employee: $1,260.00

      Employee + Spouse: $3,834.50

      Employee + Child(ren): $2,526.00

      Family (3+): $5,040.00 
    • Colorado and nationwide




    • Individual: $750




      Family: $1,500



    • Individual:

      $8,550


      Family:

      $17,100

    • Visit Anthem's microsite,
      or call 1-800-735-6072. Must use Anthem providers.
    • No referral required

       
    • In network:
      $0 per visit,
      deductible does not apply

      Out of network:
      Not covered 

    • In network:
      $40 per visit for primary care
      $50 per visit for specialists



      Out of network:
      Not covered

    • In network:
      10% coinsurance after deductible is met

      Out of network:
      10% coinsurance after deductible is met
    • In network:
      10% coinsurance after deductible is met

      Out of network:
      10% coinsurance after deductible is met
    • In network:

      CVS Retail Pharmacies:
      $15 for up to a 30-day supply

      UCHealth Retail:
      $15 for up to a 30-day supply 

      UCH Mail Order:
      $30 for up to a 90-day supply





      Out of network:

      Not covered


    • In network:

      CVS Retail Pharmacies:
      $35 for a 30-day supply

      UCHealth Retail:
      $35 for a 30-day supply

      UCH Mail Order:
      $70 for a 90-day supply




      Out of network:

      Not covered
       
    • In network:

      CVS Retail Pharmacies:
      $50 for a 30-day supply

      UCHealth Retail:
      $50 for a 30-day supply

      UCH Mail Order:
      $100 for a 90-day supply







      Out of network:

      Not covered

    • In network:

      CVS Retail Pharmacies, UCHealth Retail and UCH Mail Order: $75 for up to
      a 30-day supply



      Out of network:

      Not covered

    • In network:

      10% coinsurance after deductible is met


      Out of network:

      Not covered

    • In network:
      10% coinsurance
      after deductible is met

      Out of network:
      Not covered 

    • In network:

      Emergency room care:
      $250 per visit
      (waived if admitted)

      Emergency medical transportation:
      10% coinsurance after you've met your deductible


      Out of network:

      Emergency room care:
      $250 per visit
      (waived if admitted)

      Emergency medical transportation:
      10% coinsurance after deductible is met
    • In network:
      $40 per visit
      deductible does not apply 


       Out of network:
      $40 per visit
      deductible does not apply 
    • In network:
      10% coinsurance after deductible is met

      Out of network:
      Not covered

    •  In network:
      10% coinsurance after deductible is met

      Out of network:
      Not covered

    • In network:

      Outpatient:
      $40 per office visit


      Inpatient:
      10% coinsurance after deductible is met



      Out of network:

      Not covered 

    • In network:
      $25 copayment
      for first prenatal care office visit,
      deductible does not apply

      Out of network:
      Not covered

    • In network:
      10% coinsurance after deductible is met


      Out of network:
      Not covered 

    •  In network:
      10% coinsurance after deductible is met


      Out of network:
      Not covered

    • In network:
      10% coinsurance after deductible is met


      Out of network:
      Not covered

    • In network:

      Outpatient:
      $40 per visit,
      deductible does not apply

       


      Out of network:
      Not covered
       
    • In network:  

      Outpatient:
      $40 per visit,
      deductible does not apply

      Out of network:
      Not covered

    • In network:
      10% coinsurance
      after deductible is met 


      Out of network:
      Not covered 

    • In network:
      10% coinsurance
      after deductible is met





      Out of network:
      Not covered  
    • In network:
      10% coinsurance after deductible is met

      Out of network:
      Not covered  

    • In network:

      Not covered







      Out of network:

      Not covered




    • In network:
      Not covered

      Out of network:
      Not covered 
    • Abortion (except in cases of rape, incest, or when the life of the mother is endangered)

      Cosmetic surgery

      Dental check-ups 

      Infertility treatment

      Long-term care

      Private-duty nursing

      Routine foot care, unless
      you have been diagnosed
      with diabetes

      Routine vision exam

      Weight-loss programs



  •  

     

     

    CU Health Plan - Kaiser

    • Faculty
      University Staff
      Classified Staff
      Non-Medicare-eligible retirees
      Non-Medicare-eligible
      Surviving spouses
    • Exclusive Provider
      Organization (EPO)
    • Kaiser Permanente
    • Employee: $116.00

      Employee + Spouse: $315.50

      Employee + Child(ren): $200.50

      Family: $403.00
    • Employee: $1,392.00

      Employee + Spouse: $3,786.00

      Employee + Child(ren): $2,406.00

      Family: $4,836.00
    • Colorado

      Out-of-state dependent coverage may be available.

    • $0, no deductibles








    • Individual:

      $8,550


      Family:

      $17,100

    • Visit Kaiser's microsite or
      call 1-866-213-3062.

    • Referral required, but you can self-refer to certain specialists
       
    • In network:
      $0 per visit


      Out of network:
      Not covered 
       
    • In network:
      $30 per visit for primary care
      $40 per visist for specialists



      Out of network:
      Not covered

    • In network:
      $0 per visit


      Out of network:
      Not covered

    • In network:
      $100 per scan


      Out of network:
      Not covered

    • In network:

      Retail:
      $15 for a 30-day supply


      Mail Order:
      $30 for a 90-day supply







      Out of network:

      Not covered


    • In network:

      Retail:
      $35 for a 30-day supply


      Mail Order:
      $70 for a 90-day supply






      Out of network:

      Not covered

    • In network:

      Not covered














      Out of network:

      Not covered

    • In network:

      20% coinsurance
      up to $75 per prescription





      Out of network:

      20% coinsurance up to
      $75 per prescription
    • In network:

      $250 per procedure



      Out of network:

      Not covered

    • In network:
      Included in facility fee


      Out of network:
      Not covered
       
    • In network:

      Emergency room care:
      $250 per visit
      (waived if admitted)

      Emergency medical transportation:
      $0 per trip



      Out of network:

      Emergency room care:
      $250 per visit
      (waived if admitted)

      Emergency medical transportation:
      $0 per trip

    •  In network:
      $30 per visit



      Out of network:
      $30 per visit

    • In network:
      $250 copay per day ($1,000 maximum per admission)

      Out of network:
      Not covered

    • In network:
      Included in facility fee
       

      Out of network:
      Not covered 

    • In network:

      Outpatient:
      $30 per visit



      Inpatient:
      $250 copayment per day ($1,000 max. per admission)


      Out of network:

      Not covered

    • In network:
      $0 - fully covered



      Out of network:
      Not covered

    • In network:
      Included in facility fee



      Out of network:
      Not covered
       
    • In network:
      $250 copayment per day ($1,000 maximum per admission)

      Out of network:
      Not covered 

    • In network:
      $0 per visit - fully covered



      Out of network:
      Not covered

    •  In network:
      $30 per visit
       






      Out of network:
      Not covered
       
    • In network:
      $30 per visit




      Out of network:
      Not covered

    •  In network:
      $0 per day



      Out of network:
      Not covered

    •  In network:
      $0 per day






      Out of network:
      Not covered
    • In network:
      $0 per visit


      Out of network:
      Not covered 

    • In network:

      Eye exam:
      $30 for an optometrist
      $40 for an opthalmologist

      Glasses:
      Not covered


      Out of network:

      Not covered 




    •  In network:
      Not covered

      Out of network:
      Not covered
    • Adult hearing aids

      Children's glasses

      Cosmetic surgery

      Dental care

      Long-term care

      Non-emergency care outside the United States

      Non-preferred brand drugs

      Private-duty nursing

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