University of Cincinnati Medical Plan Summary and Comparison Non AAUP - Effective January 1- December 31, 2021
HSA/HDHP The HSA/HDHP has a non-embedded deductible deductible. Once the family deductible is met, the plan will pay 80
out-of-pocket maximum is
reached. The individual deductible does NOT apply when family members are covered. The HSA/HDHP plan also has a non-embedded out-of-pocket which means if you, the subscriber, are the only person covered by this plan, only the ) . -of- pocket amounts can be satisfied by one family member or a combination of family members. Once the family out-of-pocket is met, it is considered met for all family members. The network and out-of-network pocket maximums are separate and cannot be combined. PPO The PPO has an embedded deductible . If you elect to cover dependents, both the individual and family deductible amounts apply. The family deductible amounts can be satisfied by any combination of family members, but you could satisfy your own individual deductible before the family deductible is met. Once you meet your individual deductible, the plan will pay 80% of your eligible expenses. This may occur before another family member reaches his/her deductible. Once the family deductible is met, all family eligible expenses will be paid at 80% until the family out-of-pocket maximum is met. The PPO plan has an embedded out-of-pocket -of- pocket amounts can be satisfied by any combination of family members, -of-pocket amount before the -of- -of- fam -of- -of-pocket is met. The network and out-of-network out-of-pocket maximums are separate and cannot be combined. Note: Medical out-of-pocket does not apply to the pharmacy out-of- pocket. The pharmacy out-of-pocket for an individual is $8,850 per person per calendar year. The combined family maximum out-of- pocket (medical and pharmacy) is $17,100 per family per calendar year.
The network and out-of-network out-of-pocket maximums are separate and cannot be combined. Explanations above based on network services.
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