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
Infertility Services Inpatient Services Maternity Care (specialist office visit copay applies)
Refer to Plan Documents 80% after deductible
No coverage
Refer to Plan Documents 80% after deductible $50 copay first visit only by participating providers at participating facilities
No coverage
65% after deductible
65% after deductible
80% after deductible
65% after deductible
65% after deductible
Mental Health Inpatient 80% after deductible
65% after deductible 65% after deductible
80% after deductible
65% after deductible 65% after deductible
Mental Health Outpatient (primary care office visit co-pay applies)
80% after deductible
$30 copay per visit 65% without pre-authorization
Office visit- primary
80% after deductible
65% after deductible
$30 copay
65% after deductible
Office visit-specialist
80% after deductible
65% after deductible
$50 copay
65% after deductible
Outpatient services (e.g., surgery, pathology, MRI, surgical supplies, etc.)
80% after deductible
65% after deductible
80% after deductible
65% after deductible
Physician Services - inpatient
80% after deductible
65% after deductible
80% after deductible
65% after deductible
Page 3 of 7 Rev. 10/2021
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