Healthy Savings Plan

• You pay the full cost of medical services and prescription drugs until you reach your annual deductible.
• The price of in-network medical services and prescription drugs is discounted. You pay the total of that discounted price until the deductible is met.
• After you meet the deductible, you pay 15% of the cost of covered in-network medical services and prescription drugs until you reach the out-of-pocket limit (comprised of deductibles, coinsurance and prescription drug charges).
• Once the annual out-of-pocket limit is met, the plan will pay 100% of covered services and prescription drugs for the rest of the year.
• The deductible for the Healthy Savings Plan combines medical services and prescription drug expenses, rather than having one deductible for each. Similarly, the out-of-pocket limit combines medical and prescription expenses.
• You may be eligible for a Dependent Care Flexible Spending Account (FSA) but not a Health Care FSA since you have access to an HSA.
• For those in the Columbia area, 90-day fills/refills are available at Mizzou pharmacies at the same cost as mail-order. Participants may fill specialty medications through a Mizzou Specialty Pharmacy or Accredo.

Benefit-eligible faculty and staff may enroll and may cover eligible dependents. 

Coverage for dependents

Dependents may include:

• Spouse or Sponsored Adult Dependent of an employee
• A child of an employee who is younger than 26 years of age
• A child of an employee over the age of 26 who is mentally or physically incapable of self-sustaining employment and meets other plan requirements
• Child for whom health care coverage is required through a Qualified Medical Child Support Order or other court/administrative order.

You should ensure you understand the details of your status by accessing the Summary Plan Description (SPD) for the insurance plan and reading the full definition.

The University will contribute funds to a Health Savings Account for eligible employees who enroll in the Healthy Savings Plan. Visit the understanding your HSA webpage to learn if you're eligible and/or the amount the University will contribute based on the elections you choose. In addition to University contributions, faculty and staff may choose to contribute tax-free money up to IRS limits.

Monthly employee premium cost* for active employees:

• Self only: $65
• Self and spouse: $185
• Self and child(ren): $164
• Self, spouse and child(ren): $317

*Premiums for faculty on a nine-month contract paid over nine months are different. For more information, visit the Premiums for 9-month faculty paid over 9 months webpage.

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

• Prescription drug: Retail (formulary generic, formulary brand or non-formulary brand):
  • In-network: 15% after deductible
  • Out-of-network**: 35% or more after deductible
• Prescription drug: Mail (formulary generic, formulary brand or non-formulary brand):
  • In-network: 15% after deductible
  • Out-of-network**: 35% or more after deductible

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

• Medical and Rx deductible (combined):
  • In-network: $1,750/self*; $3,500/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 Custom Network Plan and PPO Plan. Visit the glossary for details.

The Healthy Savings Plan has annual 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 Custom Network Plan and 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.

If you enroll in the Healthy Savings Plan, you may be eligible to sign up for a Health Savings Account (HSA) to help cover your health care expenses. The University even contributes funds to a Health Savings Account for eligible employees. Visit the understanding your HSA webpage to learn more.

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.

You may choose to visit either in-network or out-of-network physicians 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.

Virtual visits are also available to you. Virtual visits let you see and talk to a doctor from your mobile device or computer without an appointment, any time. Visit the virtual visits webpage to learn more.

Making an informed decision about your healthcare needs can save you time and money, but when you are ill or injured, assessing your condition and choosing the best place to go for treatment isn’t easy. You have four care options, but each is unique in the services it provides.

Primary care physician

Visit your primary care physician when you have a non-life threatening condition during regular hours of work week, or if you don’t need immediate attention. It’s always best to see your primary care physician, since they know you and your health history. 

• Examples include: Persistent cough; sore throat or rash; minor injuries or aches

Convenience care clinic

When you experience symptoms where you would normally see a primary care physician, but it’s after hours or on a weekend, a convenience care clinic can be a good option. Convenience care clinics are typically available in local retail or drug stores and usually have extended hours on weekdays and weekends.  

• Examples include: Persistent cough; sore throat or rash; minor injuries or aches

Urgent care clinic

Urgent care clinics are an appropriate choice when you have an unexpected illness or injury that requires immediate attention but is not necessarily life-threatening. These clinics offer many resources to treat a wound or injury and will often do so immediately. 

• Examples include: A cut that may need stitches; a sprained ankle

Emergency room

Seek an emergency room when an illness or injury is very serious or life-threatening. In most cases, you will know the condition is serious, sudden and/or requires immediate attention. If you are unable to get to an emergency room, call 9-1-1 for assistance. 

• Examples include: Broken bones with deformed appearances; head trauma; drug or alcohol overdoses; severe cuts or burns. 

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

Visit the health and wellness tools and discounts webpage to maximize your convenience and savings.