Plans
- Eligibility
- Type of plan
- Monthly cost
- Coverage areas
- Deductible(s)
- Out-of-pocket
limit
(In most instances,
coinsurances and
copays become $0
Once plan maximum
is met.)
- Covered
Providers
- Referrals for
specialty care
- Medical office
visit costs
- Diagnostic and
imaging tests
- Prescription
drug coverage
- Outpatient
surgery
- Emergency and
urgent care
- Hospital stays
- Mental or
behavioral
health, and
substance
abuse coverage
- Pregnancy
- Recovery
- Child dental and
eye care
- Uncovered
services
-
CU Health Plan - Exclusive
- Faculty
University Staff
Classified Staff
Non-Medicare-eligible retirees
Non-Medicare-eligible
surviving spouses
- Health Maintenance Organization (HMO)
administered by Anthem Blue Cross Blue Shield
- Employee: $39.50
Employee + Spouse: $165.00
Employee + Child(ren): $99.50
Family: $215.50
- Colorado
Out-of-state dependent child coverage may be available. See plan details.
- Individual: $250
Family: $750
- Individual:
$7,350
Family:
$14,700
- Visit Anthem's microsite, or call 1-800-735-6072.
- Primary Care Physicians are required and should direct care
- In network:
$30
($40 for specialists)
Out of network:
Not covered
- Scans (CT and PET) and MRIs:
In network:
No coinsurance after you've met your deductible
Out of network:
Not covered
Blood work and
X-rays:
In network:
No coinsurance after deductible is met
Out of network:
Not covered
- Generic Drugs (Tier 1)
In network:
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
Out of network:
Not covered
Preferred-brand drugs
(Tier 2)
In network:
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
Out of network:
Not covered
Non-preferred-brand drugs
(Tier 3)
In network:
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
Out of network:
Not covered
Specialty oral and injectable drugs
(Tier 4)
In network:
Anthem Retail, UCHealth Retail and UCH Mail Order:
$75 for a 30-day supply
Out of network:
Not covered
- In network:
No coinsurance after deductible is met (100% covered)
Out of network:
Not covered
- In network:
Emergency services:
$250 (waived if admitted)
Transportation:
No coinsurance after you've met your deductible
Urgent care:
$30 per visit
Out of network:
Emergency services:
$250 (waived if admitted)
Transportation:
No coinsurance after deductible is met
Urgent care:
$30 per visit
- In network:
Facility fee:
No coinsurance after deductible is met
Physician and surgeon fee:
Fully covered
Out of network:
Facility,
physician and surgeon fees:
Not covered
- In network:
Outpatient:
$30 per office visit and no coinsurance after deductible is met for the outpatient facility
Inpatient:
No coinsurance after deductible is met
Out of network:
Not covered
- In network:
Prenatal and postnatal care:
$15 coinsurance for first prenatal care office visit
Delivery and
all inpatient services:
No coinsurance after deductible is met
Out of network:
Not covered
- In network:
Home Health Care, Skilled Nursing Care & Hospice Care:
No coinsurance after deductible is met
Rehabilitation & Habilitation:
Inpatient:
No coinsurance after after deductible is met
Outpatient:
$30
Durable Medical Equipment:
20 percent coinsurance (not subject to deductible for prosthetic appliances, and no copayment after deductible is met for all other durable medical equipment
Out of network:
Not covered
- In network:
Eye Exam:
$30 per visit (exam only)
Glasses:
Not covered
Dental checkup:
Not covered
Out of network:
Eye exam:
Up to a $35 maximum reimbursement
Glasses:
Not covered
Dental checkup:
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 outside the United States
Private-duty nursing
Routine foot care
Weight-loss programs
-
CU Health Plan - Extended
- Faculty
University Staff
Classified Staff
- Preferred Provider
Organization (PPO)
administered by Anthem Blue Cross Blue Shield
- Employee: $73.00
Employee + Spouse: $221.50
Employee + Child(ren): $145.00
Family: $291.50
- Colorado and nationwide.
- Individual: $750
Family: $1,500
- Individual:
$7,350
Family:
$14,700
- Visit Anthem's microsite, or call 1-800-735-6072. Must use Anthem providers.
- No referral required
- In network:
$40
($50 for specialists)
Out of network:
Not covered
- Scans (CT and PET) and MRIs:
In network:
10% coinsurance after you've met your deductible
Out of network:
10% coinsurance after you've met your deductible
Blood work and
X-rays:
In network:
10% coinsurance after deductible is met
Out of network:
10% coinsurance after deductible is met
- Generic Drugs (Tier 1)
In network:
Anthem & UCHealth Retail:
$15 for a 30-day supply
UCH Mail Order:
$30 for a 90-day supply
Out of network:
Not covered
Preferred-brand drugs
(Tier 2)
In network:
Anthem & UCHealth Retail:
$35 for a 30-day supply
UCH Mail Order:
$70 for a 90-day supply
Out of network:
Not covered
Non-preferred-brand drugs
(Tier 3)
In network:
Anthem & UCHealth Retail:
$50 for a 30-day supply
UCH Mail Order:
$100 for a 90-day supply
Out of network:
Not covered
Specialty oral and injectable drugs
(Tier 4)
In network:
Anthem & UCHealth Retail & Mail Order:
$75 for a 30-day supply
Out of network:
Not covered
- In network:
10% coinsurance after deductible is met
Out of network:
Not covered
- In network:
Emergency services:
$250 (waived if admitted)
Transportation:
10% coinsurance after you've met your deductible
Urgent care:
$40 per visit
Out of network:
Emergency services:
$250 (waived if admitted)
Transportation:
10% coinsurance after deductible is met
Urgent care:
$40 per visit
- In network:
Facility and physician surgeon fee:
10% coinsurance after deductible is met
Out of network:
Facility,
physician and surgeon fees:
Not covered
- In network:
Outpatient:
$40 per office visit
Inpatient:
10% coinsurance after deductible is met
Out of network:
Not covered
- In network:
Prenatal and postnatal care:
$25 copayment for first prenatal care office visit
Delivery and
all inpatient services:
10% coinsurance after deductible is met
Out of network:
Not covered
- In network:
Home Health Care, Skilled Nursing Care & Hospice Care:
10% coinsurance after deductible is met
Rehabilitation & Habilitation:
Inpatient:
10% coinsurance after deductible is met
Outpatient: $40
Durable Medical Equipment:
10 percent coinsurance after deductible is met
Out of network:
Not covered
- In network:
Eye Exam, glasses and dental checkup:
Not covered
Out of network:
Eye exam, glasses and dental checkup:
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 outside the United States
Private-duty nursing
Routine foot care
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)
administered by Anthem Blue Cross Blue Shield
- Employee: $0
Employee + Spouse: $15.00
Employee + Child(ren): $14.00
Family: $19.00
- 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:
15% coinsurance after deductible is met
Out of network:
35% coinsurance after deductible is met (includes out-of-network preventative care)
- Scans (CT and PET) and MRIs:
In network:
15% coinsurance after you've met your deductible
Out of network:
35% coinsurance after you've met your deductible
Blood work and
X-rays:
In network:
15% coinsurance after deductible is met
Out of network:
35% coinsurance after deductible is met
- Generic Drugs (Tier 1)
In network:
Anthem Retail:
20% coinsurance after deductible for a 30-day supply
UCH Mail Order:
20% coinsurance after deductible for a 30-day supply
UCHealth Retail or UCH Mail Order:
20% coinsurance after deductible a 30-day supply
UCH Mail Order:
20% coinsurance after deductible a 90-day supply
Out of network:
20% coinsurance after deductible for a 30-day supply
Preferred-brand drugs
(Tier 2)
In network:
Anthem Retail:
20% coinsurance after deductible for a 30-day supply
UCH Mail Order:
20% coinsurance after deductible for a 30-day supply
UCHealth Retail or UCH Mail Order:
20% coinsurance after deductible for a 30-day supply
UCH Mail Order:
20% coinsurance after deductible for a 90-day supply
Out of network:
20% coinsurance after deductible for a 30-day supply
Non-preferred-brand drugs
(Tier 3)
In network:
Anthem Retail:
20% coinsurance after deductible for a 30-day supply
UCH Mail Order:
20% coinsurance after deductible for a 30-day supply
UCHealth Retail or UCH Mail Order:
20% coinsurance after deductible for a 30-day supply
UCH Mail Order:
20% coinsurance after deductible for a 90-day supply
Out of network:
20% coinsurance after deductible for a 30-day supply
Specialty oral and injectable drugs
(Tier 4)
In network:
Anthem Retail, UCHealth Retail & Mail Order:
20% coinsurance after deductible for 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:
Emergency services, transportation and urgent care
15% coinsurance after deductible is met
Out of network:
Emergency services, transportation and urgent care
35% coinsurance after deductible is met
- In network:
Facility and physician surgeon fee:
15% coinsurance after deductible is met
Out of network:
Facility,
physician, and surgeon fees:
35% coinsurance after you've met your deductible
- In network:
Inpatient and Outpatient:
15% coinsurance after deductible is met
Out of network:
35% coinsurance after you've met your deductible
- In network:
Prenatal and postnatal care, and delivery and
all inpatient services:
15% coinsurance after deductible is met
Out of network:
35% coinsurance after deductible is met
- In network:
All Services:
15% coinsurance after deductible is met
Out of network:
All services:
35% coinsurance after deductible is met
- In network:
Eye Exam, glasses and dental checkup:
Not covered
Out of network:
Eye exam, glasses and dental checkup:
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 eye care
Routine foot care
Weight-loss programs
-
- Faculty
University Staff
Classified Staff
Non-Medicare-eligible retirees
Non-Medicare-eligible
surviving spouses
- Exclusive Provider
Organization (EPO) administered by Kaiser Permanente
- Employee: $101.00
Employee + Spouse: $276.50
Employee + Child(ren): $175.00
Family: $363.50
- Colorado
Out-of-state dependent child coverage may be available. See plan details.
- None
- Individual:
$7,350
Family:
$14,700
- Visit Kaiser's microsite or call 1-866-213-3062.
- Referral required, but you can self-refer to certain specialists
- In network:
$30
($40 for specialists)
Out of network:
Not covered
- Scans (CT and PET) and MRIs:
In network:
Fully covered
Out of network:
Fully covered
Blood work and
X-rays:
In network:
$100 per procedure
Out of network:
$100 per procedure
- Generic Drugs (Tier 1)
In network:
Retail:
$15 for a 30-day supply
Mail Order:
$30 for a 90-day supply
Out of network:
20% co-insurance after deductible for a 30-day supply
Preferred-brand drugs
(Tier 2)
In network:
Retail:
$35 for a 30-day supply
Mail Order:
$70 for a 90-day supply
Out of network:
20% coinsurance after deductible for a 30-day supply
Non-preferred-brand drugs
(Tier 3)
In network:
Not covered
Out of network:
Not covered
Specialty oral and injectable drugs
(Tier 4)
In network:
20% coinsurance after deductible for a 30-day supply
Out of network:
Not covered
- In network:
$250 copayment
Out of network:
Not covered
- In network:
Emergency services
$250 copayment (waived if admitted)
Transportation:
Fully covered
Urgent care:
$30 copayment
Out of network:
Emergency services
$250 copayment
Transportation
Fullly covered
Urgent care:
$30 copayment
- In network:
Facility and physician surgeon fee:
$250 copay per day ($1,000 maximum per admission)
Out of network:
Facility,
physician, and surgeon fees:
Not covered
- In network:
Outpatient:
$30 copayment
Inpatient:
$250 copayment per day ($1,000 maximum per admission)
Out of network:
Not covered
- In network:
Prenatal and postnatal care:
Fully covered
Delivery and all
inpatient services:
$250 copayment per day
Out of network:
Not covered
- In network:
Home Health Care, Skilled Nursing Care & Hospice Care:
Fully covered
Rehabilitation & Habilitation:
$30 copayment
Out of network:
All services:
Not covered
- In network:
Eye Exam:
$30 for an optometrist
$40 for an opthalmologist
Glasses:
Not covered
Dental checkup:
Not covered
Out of network:
All services:
Not covered
- Adult hearing aids
Children's glasses
Cosmetic surgery
Infertility treatment
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)