Retiree Healthy Savings Plan

Your share of insurance premiums is determined by a formula that considers your age and years of service at retirement and the program under which your benefits are payable. For more information about retiree insurance eligibility and premiums, visit the Retiree benefits overview webpage.

For additional details, see the SPD for this plan on the All Summary Plan Description (SPD) Documents webpage.

**Refer to the Summary Plan Description (SPD) for additional details on allowable and eligible expenses when using an out-of-network provider.

The Retiree Healthy Savings Plan has one deductible that combines both medical and prescription drug costs.

• Medical and Rx deductible (combined):
  • In-network: $2,100/self*; $4,200/family*
  • Out-of-network: $4,000/self*; $8,000/family*

*Considerations for “self” and “family” are different for the Healthy Savings Plan than for the Retiree Health PPO Plan. Visit the glossary for details.

The Retiree Healthy Savings Plan

has one out-of-pocket limit that combines both medical and prescription drug costs.

• Medical and Rx out-of-pocket limit (combined):
  • In-network: $5,000/self*; $10,000/family*
  • Out-of-network**: $8,000 or more/self; $16,000 or more/family*

*Considerations for “self” and “family” are different for the Healthy Savings Plan than for the Retiree Health PPO Plan. Visit the glossary for details.
** Please refer to the Summary Plan Description (SPD) for additional details on allowable/eligible expenses when using an out-of-network provider.

To estimate prescription costs, visit Express Script's prescription cost estimator tool (exit UM System site) for UM System medical plans. Select the plan year and health plan you wish to review; then, select "price a medicine" and type in the medicine's name. You will be prompted to select the strength, form, quantity and frequency for the prescription to estimate the cost covered by the plan and the cost to you.

• Prescription drug: Retail (formulary generic, formulary brand or non-formulary brand):
  • In-network: 20% after deductible
  • Out-of-network**: 35% or more after deductible
• Prescription drug: Mail (formulary generic, formulary brand or non-formulary brand):
  • In-network: 20% after deductible
  • Out-of-network**: 35% or more after deductible

** Please refer to the Summary Plan Description (SPD) for additional details on allowable/eligible expenses when using an out-of-network provider

Retirees do not receive University contributions toward an HSA, but you may set up an HSA account if you are not enrolled in another insurance plan, including Medicare. If you meet the eligibility requirements, you may contribute your own after-tax money to the HSA. Visit the understanding your HSA webpage to learn more.

You may choose to visit either in-network or out-of-network doctors and other providers. Your costs will be lower, however, when you select in-network providers. Provider directories may be accessed on the plan contacts webpage.

Preventive Care

Many health plans include preventive care services, such as various screenings, vaccinations and well-woman visits, at no out-of pocket cost. Read about women's preventive healthcare or learn more about UHC's preventive care guidelines (exit UM System site).

Special Health Topics

Consult the following webpages for additional information on special health topics:

• Autism
• Behavioral Health
• Diabetes
• Hearing

Your share of insurance premiums is determined by a formula that considers your age and years of service at retirement and the program under which your benefits are payable. For more information about retiree insurance eligibility and premiums, visit the Retiree benefits overview webpage.

For additional details, see the SPD for this plan on the All Summary Plan Description (SPD) Documents webpage.

**Refer to the Summary Plan Description (SPD) for additional details on allowable and eligible expenses when using an out-of-network provider.

The Retiree Healthy Savings Plan has one deductible that combines both medical and prescription drug costs.

• Medical and Rx deductible (combined):
  • In-network: $1,875/self*; $3,750/family*
  • Out-of-network: $3,500/self*; $7,000/family*

*Considerations for “self” and “family” are different for the Healthy Savings Plan than for the Retiree Health PPO Plan. Visit the glossary for details.

The Retiree Healthy Savings Plan

has one out-of-pocket limit that combines both medical and prescription drug costs.

• Medical and Rx out-of-pocket limit (combined):
  • In-network: $3,750/self*; $7,500/family*
  • Out-of-network**: $7,000 or more/self; $14,000 or more/family*

*Considerations for “self” and “family” are different for the Healthy Savings Plan than for the Retiree Health PPO Plan. Visit the glossary for details.
** Please refer to the Summary Plan Description (SPD) for additional details on allowable/eligible expenses when using an out-of-network provider.

To estimate prescription costs, visit Express Script's prescription cost estimator tool (exit UM System site) for UM System medical plans. Select the plan year and health plan you wish to review; then, select "price a medicine" and type in the medicine's name. You will be prompted to select the strength, form, quantity and frequency for the prescription to estimate the cost covered by the plan and the cost to you.

• Prescription drug: Retail (formulary generic, formulary brand or non-formulary brand):
  • In-network: 20% after deductible
  • Out-of-network**: 35% or more after deductible
• Prescription drug: Mail (formulary generic, formulary brand or non-formulary brand):
  • In-network: 20% after deductible
  • Out-of-network**: 35% or more after deductible

** Please refer to the Summary Plan Description (SPD) for additional details on allowable/eligible expenses when using an out-of-network provider

Retirees do not receive University contributions toward an HSA, but you may set up an HSA account if you are not enrolled in another insurance plan, including Medicare. If you meet the eligibility requirements, you may contribute your own after-tax money to the HSA. Visit the understanding your HSA webpage to learn more.

You may choose to visit either in-network or out-of-network doctors and other providers. Your costs will be lower, however, when you select in-network providers. Provider directories may be accessed on the plan contacts webpage.

Preventive Care

Many health plans include preventive care services, such as various screenings, vaccinations and well-woman visits, at no out-of pocket cost. Read about women's preventive healthcare or learn more about UHC's preventive care guidelines (exit UM System site).

Special Health Topics

Consult the following webpages for additional information on special health topics:

• Autism
• Behavioral Health
• Diabetes
• Hearing