The Retiree Health PPO Plan is available to retirees and their dependents who are not yet eligible for Medicare.
Looking for plan providers or health care providers?
Visit our plan contacts page for more information.
2020 Retiree Health PPO
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. If you are looking for an idea of what premiums would be for your particular circumstances, use the Retiree Insurance Premiums Estimator. For additional details, see the Summary Plan Description for the Retiree Health PPO Plan under the forms and guides section of this page.
Retiree Health PPO Plan - Annual deductibles, 2020
|Rx||$75 per person covered by the plan.|
Annual university contributions to health savings accounts
The university does not contribute to a health savings account (HSA) for retirees. Under the Healthy Savings Plan, which is the university’s only high-deductible health plan qualified by the IRS, you may open an HSA but the university will not make contributions to it if you are a retiree.
The Retiree Health PPO Plan has two out-of-pocket limits: one for medical and a second for prescription drug costs.
Retiree Health PPO Plan - Annual out-of-pocket limits, 2020
|Medical||$2,400||$4,800||$3,400 or more||$6,800 or more|
Retiree Health PPO Plan- Prescription drug out-of-pocket cost, 2020
|Retail ($75 deductible)||In-network: Greater of (after deductible):||Out-of-network|
|Formulary generic||$7 copay or 20% coinsurance||50% coinsurance or more; minimum $30**|
|Formulary brand||$15 copay or 25% coinsurance|
|Non-formulary brand||$30 copay or 50% coinsurance|
|Maintenance||In-network: Greater of:||Out-of-network|
|Formulary generic||$10 or 25% coinsurance||50% coinsurance or more; minimum $30**|
|Formulary brand||$20 or 30% coinsurance|
|Non-formulary brand||$40 or 55% coinsurance|
|Mail-order*||In-network: Greater of:||Out-of-network|
|Formulary generic||$15 or 20% coinsurance||50% coinsurance or more; minimum $30**|
|Formulary brand||$30 or 25% coinsurance|
|Non-formulary brand||$60 or 50% coinsurance|
* 90-day fill/refill at Mizzou pharmacies at same cost as mail-order.
** Member will pay difference between the non-participating and participating pharmacy charge.
In some cases, prior authorization is necessary for non-emergency use of certain facilties, diagnostic testing, and other health services before care is provided. The Retiree Health PPO Plan uses the same preauthorization list as the active-employee insurance plans.
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.
- 2020 Retiree Health PPO Plan Summary of Benefits and Coverage (SBC)
- 2020 Retiree Health PPO Plan Summary Plan Description (SPD)View all available SPDs. Please note that, except for the specific information pertaining to the allowable/eligible expenses when using an out-of-network provider, information in the 2020 SPD for each plan may vary from information in the 2019 SPD.
- Proof of Relationship Requirement form
- 2020 preferred prescription drug formulary
- 2020 specialty drug list
- Full list of forms and guides about retiree medical insurance …
* In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.