What you need to know
Deductible. Coinsurance. Copays. Making sense of medical plans is no easy feat. The most important thing to know about our plans is that all of them protect your and your family’s health. The difference among them comes down to things like how much you pay when you get care, how much you pay in paycheck contributions, and how much flexibility you have in choosing providers and receiving care.
Your medical plan choices
How do I know which plan is right for me?
Use the Medical Plan Cost Estimator. In just a few clicks, you can see which plan is better for you financially. You can view important information like what you’ll pay out of your paycheck and what you’ll potentially pay out of pocket.
Before making a decision, consider these points:
Does your spouse/domestic partner have coverage through an employer?
You may find that your spouse’s/domestic partner’s coverage design better aligns with how you use health care, or it may be cheaper to be covered by his/her plan.
Which plan best aligns with how you and your family use health care?
If you or a covered family member need a particular type of care, you should consider a plan that gives you more coverage and better financial protection.
Are your doctors and other providers in-network?
You can use any of the plans’ Find a Doctor tools to check if yours is in-network.
How much prescription coverage do you need?
Each plan has different coverage, so evaluate your needs and see what each plan offers.
Do you want or need to save on taxes?
Only one plan—the CDHP—comes with the Health Savings Account (HSA), which lets you save pre-tax dollars for eligible medical expenses.
Need help understanding how the plans work?View a glossary of terms
Considering the CDHP with HSA?
The CDHP with HSA may be the right plan for you if you:
- Want to save on taxes with an HSA.
- Prefer to pay less out of your paycheck and more when you need care.
- Are comfortable with a plan that has a higher deductible for you to meet.
- Would like free money from PayPal in your HSA.
- Want flexibility in the providers you can see.
The CDHP with HSA may not be the right plan if you:
- Are currently covered by Medicare Part A or Part B, or will enroll in Medicare in 2020.
- Are covered under a spouse’s plan that’s not compatible with an HSA.
- Have a spouse enrolled in an FSA.
- Are unable to cover a health expense that is more than $1,500 or $3,000 (the deductible amounts for the CDHP).
- Need a lot of care or have a health condition that requires frequent doctor office visits and/or treatment, prescriptions or have a family member in this situation.
Preventive care is all about building healthy habits and catching problems early on. It’s generally your routine physical or annual checkup. Diagnostic care is when you have symptoms or risk factors and your doctor wants to diagnose them.
For example, it’s preventive care if:
- Your doctor recommends a colonoscopy because of your age or family history.
It’s not preventive care if:
- Your doctor recommends a colonoscopy because of symptoms you're having. You’ll have to pay your share of the costs for that service.
All of PayPal’s medical plans cover in-network preventive care services like screenings, immunizations, and exams at 100%—so you pay nothing for these services.
If you use an out-of-network provider, your deductible and out-of-network coinsurance will apply. (Remember: HMO members must use in-network providers to receive any benefits.)
Preventive care tips
- Take advantage of preventive care at no cost to you.
- Do other things to improve and maintain your health and make the most of your health care benefits, such as eating right and exercising.
- Find a primary care doctor whom you trust and feel comfortable with to coordinate your wellness care.
- Ask your doctor to help design a personalized wellness plan that includes diet, exercise, and, if needed, weight loss. Real Appeal can help you achieve your weight loss goal!
- Keep good records. Stay up to date on preventive care by scheduling a wellness visit once a year.
- Prepare for appointments. Doctors spend an average of 10 to 20 minutes with patients, so bring along a list of what you want to discuss.
- If you have diabetes, take advantage of additional free care. If you’re enrolled in a UHC medical plan, you won’t pay anything when you see a doctor for care related to your diabetes.
- Receive an extra dental cleaning and free eye exam every year if you’re enrolled in the dental and vision plans.
- If you’re a CVS/caremark member, you can now get the measles, mumps and rubella (MMR) and varicella (which protects against chickenpox) vaccinations at your local in-network pharmacy without an office visit.
Chat with a doctor at any time, day or night—from anywhere! With virtual visits, you can talk with a doctor from your mobile device or computer, without an appointment. Virtual visits are best for non-emergency medical conditions and minor health issues.
Sign up for virtual visits by logging in to myuhc.com or the UHC app. You’ll be able to access care through secure online video conferencing and chat with a real doctor who can evaluate and treat minor health conditions, such as a cold or sore throat, and prescribe medications if needed. Virtual mental health visits are also available to help evaluate and treat conditions like depression and anxiety.