UnitedHealthcare medical plans

What you need to know

The UnitedHealthcare (UHC) plans have their own network of doctors, hospitals, and providers that they contract with. You have two plans to choose from, and they differ in things like the annual deductible and out-of-pocket costs. No matter which plan you choose, you’ll always pay less when you see providers that are part of the UHC network.

$300 Deductible

Medium Paycheck CostMedium DeductibleChoose Any DoctorFree Preventive Care

 

The $300 Deductible is a UnitedHealthcare (UHC) plan that gives you the flexibility to see any provider, anywhere, but you pay less when you see in-network providers. If you see an out-of-network provider, you're responsible for any billed charges that exceed "customary and reasonable" charges.

How it works

Free in-network preventive care. That includes services like screenings, immunizations, and exams.

Low copays for covered services and prescription drugs when you see an in-network provider or use an in-network pharmacy. You and any covered family members must meet the deductible before the plan pays its portion of covered services.

Once you meet the deductible, the plan pays 90% of most in-network covered services, and you pay the rest until you reach the out-of-pocket maximum. You’ll also pay the copay and coinsurance for prescription drugs. But you’ll always pay less when you use in-network providers.

You’re protected against big medical bills with the out-of-pocket maximum. Once your medical and prescription drug bills hit the out-of-pocket maximum, the plan pays 100% of the costs for covered services for the rest of the year.

Pharmacy benefits are provided by CVS/caremark. You pay a copay ($10–$40) for generic, brand, and non-brand prescriptions at in-network pharmacies. You pay more if you use out-of-network pharmacies.

Certain medications cost nothing. This includes prescriptions to treat diabetes, high blood pressure, and high cholesterol when you get them filled by in-network pharmacies.

Visit welcometouhc.com/paypal to learn more or to find a provider.

CDHP with HSA

Low Paycheck CostHigh DeductibleChoose Any DoctorFree Preventive Care

 

The Consumer Directed Health Plan (CDHP) with Health Savings Account (HSA) is a high-deductible health plan administered by UnitedHealthcare (UHC). All care, including prescriptions, is subject to the deductible and coinsurance—except for preventive care and prescriptions used to manage certain medical conditions.

You also have the option to make tax-free contributions to an HSA to pay for qualified medical expenses or save for future medical expenses. The company makes an annual contribution to the HSA ($450 for individuals/$900 for family) that you can use now or in the future.

How it works

Free in-network preventive care. That includes services like screenings, immunizations, and exams.

You pay a percentage of the cost for services and prescription drugs, but you pay less when you see an in-network provider or use an in-network pharmacy. You must meet the entire deductible before the plan pays coinsurance—the amount the plan pays for covered services—for any one family member.

Coinsurance—after you meet your deductible, you and the plan share the cost of medical expenses, called coinsurance. You’ll always pay less when you use in-network providers.

You’re protected against extremely high medical bills with the out-of-pocket maximum. Once your medical and prescription drug bills hit the out-of-pocket maximum, the plan pays 100% of the costs for covered services for the rest of the year.

You can also use your HSA as protection against high medical bills. Or you can save the money in your HSA for expenses in the future.

Contributions to the HSA are tax-free. Your contributions to an HSA are tax-free, and you can use the money in your account to pay for qualified medical expenses, or you can save it for future medical expenses. Plus, PayPal contributes to your HSA—$400 for employee coverage and $900 if you cover dependents!

Pharmacy benefits are provided by CVS/caremark.  After you have satisfied the entire plan deductible, you typically pay 10% of the cost for generic, brand, and non-brand prescriptions at in-network pharmacies. You pay more if you use out-of-network pharmacies. Prescription drug costs count toward your deductible.

Certain medications cost you nothing. This includes prescriptions to treat diabetes, high blood pressure, and high cholesterol when you get them filled by in-network pharmacies.

Questions about the CDHP with HSA? Review the FAQs, watch this video, or visit welcometouhc.com/paypal.

How you pay for care under the CDHP

  • You see the doctor or fill a prescription.
  • Your provider sends a claim to UHC.
  • You are responsible for 100% of the cost until you reach the deductible.
  • UHC sends an Explanation of Benefits to you showing the full cost and the amount you’re responsible for paying. (In-network providers charge lower rates.) These expenses count toward the deductible.
  • Your doctor sends you a bill.
  • You pay the doctor using the money in your HSA or pay out of pocket.
  • At the pharmacy, you can pay with your HSA debit card (if a member of the CDHP) or pay out of pocket.

Provider contact information

UnitedHealthcare plans at a glance

The charts below give a brief comparison of the two plans.

UnitedHealthcare plans

  $300 Deductible CDHP with HSA
Network UnitedHealthcare UnitedHealthcare
Annual physical exams 100% covered 100% covered1
HSA eligible? No Yes
Annual HSA contribution by PayPal? None $450 employee-only coverage
$900 if you cover dependents

1 Deductible applies.

  $300 Deductible
In-network
CDHP with HSA
In-network
Annual deductible $300 Individual
$900 Family
$1,500 Individual
$3,000 Family
Out-of-pocket maximum $2,300 Individual
$4,900 Family
$3,500 Individual
$7,000 Family
Coinsurance Plan pays 90% Plan pays 90%
Emergency room2 (copay waived if admitted) $100 copay; then 90% covered after deductible 90% covered after deductible
Doctor office visits $20 copay3 90% covered after deductible3
Virtual visit $10 copay $40 consult fee subject to the deductible; 90% covered after deductible
Specialist office visits $35 copay 90% covered after deductible
Diagnostic X-ray/lab 90% covered after deductible 90% covered after deductible

2 If services are not a true emergency, you'll pay more for the cost of the visit.
3 In-network doctor office visits for care relating to diabetes maintenance are provided at no cost to you.

Back to top