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Retiree Healthy Savings Plan

The Retiree Healthy Savings Plan is available to retirees and their dependents who are not yet eligible for Medicare.

The plan is an IRS-qualified high-deductible health plan, which means you can enroll in a Health Savings Account (HSA) if you meet the eligibility requirements.


  2024 Retiree Healthy Savings Plan  

Costs

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💲 Premiums

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.

 

🩺 Covered Services

In-Network Services

  • Preventive Care: $0
  • Primary Care: 20% after deductible
  • Specialist Care: 20% after deductible
  • Urgent Care: 20% after deductible
  • Lab and X-ray: 20% after deductible
  • Outpatient Care: 20% after deductible
  • Inpatient Care: 20% after deductible
    • includes maternity delivery
  • Durable medical equipment: 20% after deductible
  • Emergency room: 20% after deductible
  • Ambulance: 20% after deductible

Out of Network Services

  • Preventive Care: 35% or more after deductible
  • Primary Care: 35% or more after deductible
  • Specialist Care: 35% or more after deductible
  • Urgent Care: 35% or more after deductible
  • Lab and X-ray: 35% or more after deductible
  • Outpatient Care: 35% or more after deductible
  • Inpatient Care: 35% or more after deductible
    • Includes maternity delivery
  • Durable medical equipment: 35% or more after deductible
  • Emergency room: 20% or more after deductible
  • Ambulance: 20% or more after deductible

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

 

➖ Deductible

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.

 

🧾 Out-of-Pocket Limit

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.

 

Making the Most of Your Plan

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💊 Prescription Drugs

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

 

💳 Annual University contribution to Health Savings Account

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.

 

🏥 Network Providers

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 and Special Health Topics

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:

 

*In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.

*In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.

Many documents on this webpage require Adobe Acrobat. A free reader is available to everyone. Read more about PDFs.

Reviewed 2024-02-28

 

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