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Compare CU Health Plans, 2020-21

Plans
  • Eligibility





  • Type of plan

  • Provider
  • Monthly cost






  • Coverage areas




  • Deductible(s)








  • Out-of-pocket
    limit






  • Covered
    Providers

  • Referrals for
    specialty care

  • Medical office
    visit costs










  • Diagnostic tests -
    x-rays and
    bloodworK




  • imaging -
    CT/PET Scans, MRI





  • Prescription
    drug coverage -
    Generic Drugs
    (Tier 1)



















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



















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



















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







  • 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)
    • Anthem Blue Cross Blue Shield
    • Employee: $52.50

      Employee + Spouse: $188.50

      Employee + Child(ren): $118.50

      Family: $245.00
    • Colorado

      Out-of-state dependent coverage may be available.

    • Individual: $250

      Family: $750






    • Individual:
      $8,150



      Family:
      $16,300

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

    • Primary Care Physicans are required, and should direct your care
    • In network:
      $30
      ($40 for specialists)

      Preventive care:
      $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:

      UCHealth Retail:

      $13 for a 30-day supply
      $26 for a 90-day supply


      CVS Caremark:

      $15 for a 30-day supply


      UCH Mail Order:

      $26 for a 90-day supply



      Out of network:

      Not covered

    • In network:

      UCHealth Retail:

      $30 for a 30-day supply
      $60 for a 90-day supply


      CVS Caremark:

      $35 for a 30-day supply


      UCH Mail Order:

      $60 for a 90-day supply



      Out of network:

      Not covered

    • In network:

      UCHealth Retail:

      $50 for a 30-day supply
      $100 for a 90-day supply


      CVS Caremark:

      $50 for a 30-day supply


      UCH Mail Order:

      $100 for a 90-day supply




      Out of network:

      Not covered

    • In network:

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



      Out of network:

      Not covered

    • In network:

      $0 after deductible is met


      Out of network:

      Not covered


    • In network:

      Emergency services:
      $250 (waived if admitted)

      Transportation:
      $0 after deductible is met

      Urgent care:
      $30 per visit




      Out of network:

      Emergency services:
      $250 (waived if admitted)

      Transportation:
      $0 after deductible is met

      Urgent care:
      $30 per visit

    • In network:

      Facility fee:
      $0 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:
      $0 after deductible is met



      Out of network:

      Not covered

    • In network:

      Office visits:
      $15 coinsurance for first prenatal care office visit

      Delivery services:
      Fully covered


      Inpatient services:
      $0 after deductible is met



      Out of network:

      Not covered

    • In network:

      Home Health Care, Skilled Nursing Care & Hospice Care:
      $0 after deductible is met



      Rehabilitation & Habilitation:

      Inpatient:
      $0 after deductible is met

      Outpatient:
      $30



      Durable Medical Equipment:
      20% coinsurance (not subject to deductible for prosthetic appliances, and $0 after deductible is met for all other durable medical equipment


      Out of network:

      Not covered


    • In network:

      Eye Exam:
      $20 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

      Weight-loss programs




  •  

     

     

    CU Health Plan - Extended

    • Faculty
      University Staff
      Classified Staff



    • Preferred Provider
      Organization (PPO)
    • Anthem Blue Cross Blue Shield
    • Employee: $77.00

      Employee + Spouse: $234.50

      Employee + Child(ren): $154.50

      Family: $308.00
    • Colorado and nationwide




    • Individual: $750

      Family: $1,500






    • Individual:
      $8,150



      Family:
      $16,300

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


    • In network:
      $40
      ($50 for specialists)

      Preventive care:
      $0 - fully covered


      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:

      UCHealth Retail:

      $15 for a 30-day supply



      CVS Caremark:

      $15 for a 30-day supply


      UCH Mail Order:

      $30 for a 90-day supply



      Out of network:

      Not covered

    • In network:

      UCHealth Retail:

      $35 for a 30-day supply



      CVS Caremark:

      $35 for a 30-day supply


      UCH Mail Order:

      $70 for a 90-day supply



      Out of network:

      Not covered

    • In network:

      UCHealth Retail:

      $50 for a 30-day supply



      CVS Caremark:

      $50 for a 30-day supply


      UCH Mail Order:

      $100 for a 90-day supply




      Out of network:

      Not covered

    • In network:

      CVS Caremark, UCHealth Retail and UCH 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 services:
      10% coinsurance after deductible is met

      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% 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)

      Cosmetic surgery

      Dental care

      Infertility treatment

      Long-term care

      Non-emergency care outside the United States

      Private-duty nursing

      Routine foot care, unless you have been diagnosed with diabetes

      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: $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

      Preventive care:
      $0 - fully covered


      Out of network:
      35% coinsurance after deductible is met (includes out-of-network preventative care)
    • 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 Caremark:

      20% coinsurance after deductible for a 30-day supply


      UCHealth Retail or
      UCH Mail Order:

      20% coinsurance after deductible for a 90-day supply






      Out of network:

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

      CVS Caremark:

      20% coinsurance after deductible for a 30-day supply


      UCHealth Retail or
      UCH 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:

      CVS Caremark:

      20% coinsurance after deductible for 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 Caremark, 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:

      Outpatient:
      15% coinsurance after deductible is met


      Inpatient:
      15% coinsurance after deductible is met


      Out of network:

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

      Prenatal and postnatal care:
      15% coinsurance after deductible is met

      Delivery services:
      15% coinsurance after deductible is met

      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



  •  

     

     

    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: $109.00

      Employee + Spouse: $296.50

      Employee + Child(ren): $188.50

      Family: $378.50
    • Colorado

      Out-of-state dependent coverage may be available.

    • $0








    • Individual:
      $8,150



      Family:
      $16,300

    • 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)

      Preventive care:
      $0 - fully covered


      Out of network:
      Not covered


    • In network:
      $100 per procedure


      Out of network:
      Not covered

    • In network:
      $0 - fully covered


      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 copayment



      Out of network:

      Not covered

    • In network:

      Emergency services
      $250 copayment (waived if admitted)

      Transportation:
      $0 - fully covered

      Urgent care:
      $30 per visit



      Out of network:

      Emergency services
      $250 copayment

      Transportation
      $0

      Urgent care:
      $30 per visit

    • 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 per visit



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


      Out of network:

      Not covered

    • In network:

      Prenatal and postnatal care:
      $0 - fully covered


      Delivery and all
      inpatient services:
      $250 copayment per day
      ($1,000 maximum per admission)




      Out of network:

      Not covered

    • In network:

      Home Health Care, Skilled Nursing Care & Hospice Care:
      $0 - fully covered



      Rehabilitation & Habilitation:
      $30 per visit
















      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

      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)