Here's a more in-depth look at how Choice Plus works. Medical Benefits In Network
Out-of-Network
Annual Medical Deductible
Individual
$6,000
$12,000
Family
$12,000
$24,000
All individual deductible amounts will count toward the family deductible, but an individual will not have to pay more than the individual deductible amount. *After the Annual Medical Deductible has been met. You're responsible for paying 100% of your medical expenses until you reach your deductible. For certain covered services, you may be required to pay a fixed dollar amount - your copay. Annual Out-of-Pocket Limit
Individual
$8,150
$16,300
Family
$16,300
$32,600
All individual out-of-pocket maximum amounts will count toward the family out-of-pocket maximum, but an individual will not have to pay more than the individual out-of-pocket maximum amount. For the 2000X family plans, the out-of-pocket limit is capped at $6,550 for an individual and $8,000 for family. Once you’ve met your deductible, you start sharing costs with your plan - coinsurance. You continue paying a portion of the expense until you reach your out-of- pocket limit. From there, your plan pays 100% of allowed amounts for the rest of the plan year. What You Pay for Services
Copays ($) and Coinsurance (%) for Covered Health Care Services
Out-of-Network
Network
Preventive Care Services
Preventive Care Services
No copay
50%*
Certain preventive care services are provided as specified by the Patient Protection and Affordable Care Act (ACA), with no cost-sharing to you. These services are based on your age, gender and other health factors. UnitedHealthcare also covers other routine services that may require a copay, co-insurance or deductible. Includes services such as Routine Wellness Checkups, Immunizations, and Lab and X-ray services for Mammogram, Pap Smear, Prostate and Colorectal Cancer screenings. Office Services - Sickness & Injury
Primary Care Physician
All other covered persons
$25 copay
50%*
Covered persons less than age 19
No copay
50%*
Additional copays, deductible, or co-insurance may apply when you receive other services at your physician’s office. For example, surgery and lab work. Telehealth is covered at the same cost share as in the office.
*After the Annual Medical Deductible has been met. ¹Prior Authorization Required. Refer to SPD.
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