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Retiree Health PPO Plan

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

Visit our plan contacts page.

Looking for plan providers or health care providers?
Visit our plan contacts page for more information.

Monthly 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. 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.

Annual deductible

Retiree Health PPO Plan - Annual deductibles

  In-network Out-of-network
  Self Family Self Family
Medical $325 $800 $1,000 $3,000
Prescription drug (does not apply to the No Rx plan) $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.

Out-of-pocket limit

The Retiree Health PPO Plan has only one out-of-pocket limit, but the myRetiree Health Plan with Rx 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

  In-network Out-of-network
  Self Family Self Family
Medical $2,000 $4,000 $3,000 $6,000
Prescription drug (does not apply to the No Rx plan) $3,250 per person for each person covered by the plan.

 

Preauthorization

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.

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.

Forms and guides

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

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Reviewed October 13, 2017.