Which Medical Plan is Right?
You have a choice of medical plan options to help you and your family take charge of your health care and find the right fit. These plans have different copayments, coinsurance, deductibles, and out-of-pocket limits.
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 new and existing plan options.
A little bit of planning will help you select the best plans, coverage levels, and financial programs for your unique situation.
Medical Plan Comparison - HMO
| Signature Value Advantage HMO | Signature Value HMO | Signature Value Alliance HMO (2J4) | ||||
|---|---|---|---|---|---|---|
| Provider network | SignatureValue Advantage HMO | Signature Value HMO | SignatureValue Alliance HMO | |||
| Annual Medical Deductible (calendar year) | ||||||
| (Individual/Family) | None | None | $500/$1,000 | |||
| Annual Out-of-Pocket Limit (calendar year) | ||||||
| (Individual / Family) | $2,000/$4,000 | $2,000/$4,000 | $3,000/$6,000 | |||
| Office Visit | ||||||
| Annual Preventative Visit | $0 | $0 | $0 | |||
| Primary Care Physician | $20 | $20 | $25 | |||
| Specialist | $40 | $40 | $50 | |||
| Urgent Care (Within Area*) | $20 | $20 | $25 | |||
| Urgent Care (Outside Area**) | $50 | $50 | $50 | |||
| Virtual Care Services*** | $0 | $0 | $0 | |||
| Diagnostic Services | ||||||
| Routine Lab & X-Ray | $20 | $20 | $25 | |||
| Complex Imaging | $150 | $150 | $150 | |||
| Hospital Services | ||||||
| Inpatient Stays | $500 Per Admission | $500 Per Admission | 20% coinsurance after deductible | |||
| Outpatient Surgery | $125 | $125 | 20% coinsurance after deductible | |||
| Emergency Room (Waived if admitted) | $250 | $250 | $250 | |||
| Mental Health and Substance Abuse | ||||||
| Inpatient | $500 Copay | $500 Copay | 20% coinsurance after deductible | |||
| Outpatient | $40 Copay | $40 Copay | $50 Copay | |||
| Chiropractic Services | ||||||
| 20 Visits Per Year | $15 | $15 | $20 | |||
*Urgent care services provided within the geographic area served by your medical group. Please consult your physician website or office for available urgent care facilities within the area served by your medical group.
**Urgent care services provided outside of the geographic area served by your medical group.
***Benefits are available only when services are delivered through a Designated Virtual Network Provider. You can find a Designated Virtual Visit Network Provider by contacting United Healthcare at myuhc.com or by calling the number on the back on your ID card.
How to Find a Doctor - HMO Plans
CA SignatureValue Advantage HMO – https://www.whyuhc.com/casvadvantage
CA SignatureValue HMO – https://www.whyuhc.com/casignaturevalue
CA SignatureValue Alliance HMO – https://www.whyuhc.com/casvalliance
Medical Plan Comparison - PPO
| Select Plus PPO Low | Select Plus PPO High | Select Plus PPO HDHP/HSA | ||||
|---|---|---|---|---|---|---|
| Provider network | Select Plus | Select Plus | Select Plus | |||
| Annual Medical Deductible (calendar year) | ||||||
| (Individual/Family) | $1,000/$2,000 | $2,000/$4,000 | $3,200/$6,400 | |||
| Coinsurance | 20% | 20% | 20% | |||
| Annual Out-of-Pocket Limit (calendar year) | ||||||
| (Individual / Family) | $3,500/$7,000 | $5,000/$10,000 | $5,000/$10,000 | |||
| Office Visit | ||||||
| Annual Preventative Visit | $0 | $0 | $0 | |||
| Primary Care Physician | $25 | $30 | 20% after deductible | |||
| Specialist | $50 | $60 | 20% after deductible | |||
| Urgent Care | $50 | $50 | 20% after deductible | |||
| Virtual Care Services* | $0 | $0 | $0 | |||
| Diagnostic Services | ||||||
| Routine Lab & X-Ray | 20% | 20% after deductible | 20% after deductible | |||
| Complex Imaging | 20% after deductible | 20% after deductible | 20% after deductible | |||
| Hospital Services | ||||||
| Inpatient Stays | 20% after deductible | 20% after deductible | 20% after deductible | |||
| Outpatient Surgery | 20% after deductible | 20% after deductible | 20% after deductible | |||
| Emergency Room | 20% after deductible | 20% after deductible | 20% after deductible | |||
| Mental Health and Substance Abuse | ||||||
| Inpatient | 20% after deductible | 20% after deductible | 20% after deductible | |||
| Outpatient | $25 Copay | $30 Copay | 20% after deductible | |||
| Chiropractic Services | ||||||
| 20 Visits Per Year | $25 Copay | $30 Copay | 20% after deductible | |||
*Benefits are available only when services are delivered through a Designated Virtual Network Provider. You can find a Designated Virtual Visit Network Provider by contacting United Healthcare at myuhc.com or by calling the number on the back on your ID card.
How to Find a Doctor - PPO Plans
Select Plus – https://www.whyuhc.com/selectplus
Select Plus HDHP HSA – https://www.whyuhc.com/selectplushsa
Signature Value Advantage HMO (TEJ)
Signature Value HMO (TDF)
Signature Value Alliance HMO (2J4)
Summary of Benefits Coverage – Signature Value Advantage HMO
Summary of benefits Coverage – Signature Value HMO
Summary of Benefits Coverage – Signature Value Alliance HMO
Select Plus PPO Low
Select Plus PPO High
Select Plus PPO HDHP HSA
Summary of Benefits Coverage – PPO Low
Summary of Benefits Coverage – PPO High
