Basic Medical Program (UHC)

 Basic Medical reimbursement of non-network hospital expenses

$1,000

Reimbursement decreases to $500

Basic Medical annual deductible

$349 enrollee; $349 spouse or partner; $349 all dependent children combined

$363 enrollee; $363 spouse or partner; $363 all dependent children combined

Basic Medical coinsurance out-of-pocket maximum

$1,676 per enrollee and  covered dependents combined

$1000 enrollee; $1000 spouse or partner; $1000 all dependent children combined

Complementary & Alternative Medicine (CAM) Program

Discount network of acupuncturists, massage therapists, & nutritionists

CAM no longer available

MHSA Program

Basic Medical reimbursement of non-network mental health hospital expenses

$1000

Reimbursement decreases to $500

Non-network mental health

annual deductible

$349 enrollee; $349 spouse or partner; $349 all dependent children combined

$363 enrollee; $363 spouse or partner; $363 all dependent children combined

Non-network mental health coinsurance out-of-pocket maximum

$1,676 per enrollee and covered dependents combined

$1000 enrollee; $1000 spouse or partner; $1000 all dependent  children combined

Rx Drug Program

Formulary (or Preferred Drug List) Flexibility

1) Only generic drugs placed on Tier 1 (lowest copay option)

2) Formulary includes all drugs regulated as prescription drugs by the FDA (except drugs that are not considered  medically necessary)

1) In addition to generic drugs, brand name drugs may be placed on Tier 1 (lowest copay option)

2) In certain therapeutic categories, where there are two or more clinically sound and therapeutically equivalent Tier 1 options, there may be no Tier 2 preferred brand name option.

3) A drug that has no clinical advantage over other generic and therapeutic alternatives may be excluded (not covered)