University of Cincinnati Medical Plan Summary and Comparison Non AAUP - Effective January 1- December 31, 2022
Covered Service
Health Saving Account/HDHP In network
Health Saving Account/HDHP Out-of-network
PPO Traditional Plan In network
PPO Traditional Plan Out-of-network
Annual Deductible
$1,900 individual $3,800 family
$3,800 per person $7,600 family
$700 individual $1,400 family Not applicable
$1,400 individual $2,800 family Not applicable
Annual Health Savings Account Funding (UC)
Varies by Annual Base Pay as of 1/1/22
Varies by Annual Base Pay as of 1/1/22
Copayment/co- insurance
As specified
As specified
As specified
As specified
Annual Out-of-Pocket Maximum*
$3,800 individual $7,600 family (includes in network medical and pharmacy expenses) $3,800 individual $7,600 family (non-embedded deductible) (includes in network medical and pharmacy expenses) No maximum, except as specified
$7,600 individual $15,200 family (includes out of network medical and pharmacy expenses)
$1,900 individual $3,800 family (Medical services only, excludes office visit and Rx copays) $8,700 individual $17,400 family (includes copays –medical and pharmacy)
$3,800 individual $7,600 family (Medical services, excludes copays)
Plan Maximum Out-of Pocket (per calendar year)**
$7,600 individual $15,200 family
Not applicable (no limit on your out- of- pocket expenses)
(includes in network medical and pharmacy expenses) No maximum, except as specified
Maximum Lifetime Benefit
No maximum, except as specified
No maximum, except as specified
Acupuncture
Based on setting where services received.
Based on setting where services received. 65% after deductible 65% after deductible 65% after deductible
Based on setting where services received.
Based on setting where services received.
Allergy Testing and Treatment/Serum
80% after deductible
80% after deductible
65% after deductible
Ambulance Anesthesia
80% after deductible 80% after deductible
80% after deductible 80% after deductible
65% after deductible 65% after deductible
Page 1 of 7 Rev. 10/2021
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