Medical Benefits
Medical Plan: Choice Plus Balanced
| In-Network | Out-of-Network | |
|---|---|---|
| Deductible | ||
| Individual | $2,000 | $7,500 |
| Family | $4,000 | $15,000 |
| Coinsurance | 20% after Deductible | 50% after Deductible |
| Out-of-Pocket Maximum | ||
| Individual | $4,250 | $15,000 |
| Family | $8,500 | $30,000 |
| Preventive Services | 100% Covered | 50% after Deductible |
| Office Visits — Primary Care | $25 | 50% after Deductible |
| Office Visits — Specialist | 50 | 50% after Deductible |
| Convenience Care Clinic | $25 | 50% after Deductible |
| Virtual Visits | 100% Covered | N/A |
| Urgent Care | $75 | 50% after Deductible |
| Emergency Room | $400 | See In-Network |
| Lab Testing and X-ray | 0 | 50% after Deductible |
| Major Diagnostic and Imaging Services | 20% after Deductible | 50% after Deductible |
| OP Mental Health/Substance Abuse | $25 | 50% after Deductible |
| Inpatient Hospital | 20% after Deductible | 50% after Deductible |
| Outpatient Surgery | 20% after Deductible | 50% after Deductible |
| Pediatric Dental and Vision | No | No |
Medical Plan: Choice Plus Traditional w/Deductible
| In-Network | Out-of-Network | |
|---|---|---|
| Deductible | ||
| Individual | $0 | $5,000 |
| Family | $0 | $10,000 |
| Coinsurance | 10% after Deductible | 50% after Deductible |
| Out-of-Pocket Maximum | ||
| Individual | $4,250 | $10,000 |
| Family | $8,500 | $20,000 |
| Preventive Services | 100% Covered | 50% after Deductible |
| Office Visits — Primary Care | $25 | 50% after Deductible |
| Office Visits — Specialist | 50 | 50% after Deductible |
| Convenience Care Clinic | $25 | 50% after Deductible |
| Virtual Visits | 100% Covered | N/A |
| Urgent Care | $75 | 50% after Deductible |
| Emergency Room | $250 | See In-Network |
| Lab Testing and X-ray | $25 | 50% after Deductible |
| Major Diagnostic and Imaging Services | 10% after Deductible | 50% after Deductible |
| OP Mental Health/Substance Abuse | $25 | 50% after Deductible |
| Inpatient Hospital | $500 | 50% after Deductible |
| Outpatient Surgery | $250 | 50% after Deductible |
| Pediatric Dental and Vision | No | No |
Contact Us
United Healthcare is your first point of contact for all your health needs and insurance-related questions.
Call: (866) 633-2446