Which Medical Plan is Right?
Evaluate Your Needs. Consider your prior health care usage and select plans and options that fit your lifestyle and needs.
- Do you take regular prescription medications?
- Are you anticipating surgery or non-preventive dental care?
- Did you experience a qualifying life event this year?
- Review your current plans to ensure you have the coverage you need.
Review this benefits website to learn about your plan options.
A little bit of planning will help you select the best plans, coverage levels, and financial programs for your unique situation.
Preventive Care
Covered at 100% on all medical plan options.
The following services are covered at 100% by UMR prior to your preventive care visit:
Routine preventive for Children*
Appropriate screenings based on gender and age
- Newborn visits
- Tuberculosis testing
- Anemia testing
- Lead exposure
- Pelvic exam and pap test
- Development and behavior
- Lipid profile
- Depression
- Obesity and counseling
- Nutrition counseling
*Birth to age 18
Routine preventive for Adults
Appropriate screenings based on gender and age
- Lipid profile
- Diabetes
- Pelvic exam and pap testing
- Breast exam and mammogram
- Bone density testing
- Colonoscopy
- Aortic aneurysm
Medical Plan Comparison
The charts below are a brief outline of what is offered. Please refer to the summary plan description for complete plan details.
Administered by UMR, a United Healthcare Company
| UMR Value HSA Plan |
UMR Base HSA Plan |
**New** UMR Value PPO Plan |
UMR Premium PPO Plan |
|||||
|---|---|---|---|---|---|---|---|---|
| Annual Deductible | ||||||||
| Individual | $5,000 | $2,500 | $5,000 | $2,000 | ||||
| Family | $10,000 | $5,000 | $10,000 | $4,000 | ||||
| Coinsurance | You pay 30% | You pay 20% | You pay 30% | You pay 10% | ||||
| Maximum Out-of-Pocket | ||||||||
| Individual | $6,900 | $6,900 | $6,900 | $6,600 | ||||
| Family | $13,800 | $13,800 | $13,800 | $13,200 | ||||
| Physician Office Visit | ||||||||
| Primary Care | 30% after deductible | 20% after deductible | $50 copay | $30 copay | ||||
| Specialty Care | 30% after deductible | 20% after deductible | $100 copay | $45 copay | ||||
| Preventive Care | ||||||||
| Adult Periodic Exams | Covered 100% | Covered 100% | Covered 100% | Covered 100% | ||||
| Well-Child Care | Covered 100% | Covered 100% | Covered 100% | Covered 100% | ||||
| Diagnostic Services | ||||||||
| X-ray and Lab Tests | 30% after deductible | 20% after deductible | 30% after deductible | 10% after deductible | ||||
| Complex Radiology | 30% after deductible | 20% after deductible | 30% after deductible | 10% after deductible | ||||
| Urgent Care Facility | 30% after deductible | 20% after deductible | 30% after deductible | $55.00 copay | ||||
| Emergency Room Facility Charges | 30% after deductible | 20% after deductible | $500 copay | 100% after $200.00 copay (waived if admitted) |
||||
| Inpatient Facility Charges | 30% after deductible | 20% after deductible | 30% after deductible | 10% after deductible | ||||
| Outpatient Facility and Surgical Charges | 30% after deductible | 20% after deductible | 30% after deductible | 10% after deductible | ||||
| Mental Health | ||||||||
| Inpatient | 30% after deductible | 20% after deductible | 30% after deductible | 10% after deductible | ||||
| Outpatient | 30% after deductible | 20% after deductible | 30% after deductible | 10% coinsurance deductible does not apply |
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| Substance Abuse | ||||||||
| Inpatient | 30% after deductible | 20% after deductible | 30% after deductible | 10% after deductible | ||||
| Outpatient | 30% after deductible | 20% after deductible | 30% after deductible | 10% coinsurance deductible does not apply |
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