United Healthcare is one of the biggest and best known insurers in the USA today. Their individual division, Golden Rule, is responsible for insuring individuals and families who don’t have insurance through a group plan. For ease of reference throughout this article, please note that when we say UHC insurance, we mean United Healthcare insurance, and that their individual division goes by the name Golden Rule.
There are a variety of UHC insurance plans you can choose from when you’re getting private health insurance. Let’s go through each UHC insurance plan one-by-one and look at the benefits of each.
UHC Insurance Plan One: Copay Select
The first UHC insurance plan we’ll look at is the robust Copay Select. This is a plan structure you’re probably very familiar with by now: you select a deductible of $500, $1000, $1500, or $2500. Once you meet that deductible, this UHC insurance plan will pay 80% of your bills until an additional $2000 comes out of your pocket. At that point, this UHC insurance plan will begin to pay 100% of your bills.
Doctor’s office visits are handled by a $25 copay with this UHC insurance plan. Well child care and immunizations (for children 6-18) are covered with that same $25 copay, but labs and x-rays performed outside of the doctor’s office are subject to the deductible (which means you’ll pay for that service out-of-pocket under this UHC insurance plan until you’ve met your deductible). With this UHC insurance you’ll pay $15 for generic prescriptions, and (after a $100 prescription deductible) $30 for preferred and $60 for non-preferred medications.
The verdict: This UHC insurance plan is for the people who want the best of the best and don’t care about cost. The $500 deductible plus a few optional benefits (discussed later) make this UHC insurance plan one of the strongest available on the private market – but it comes with a strong price tag, too.
UHC Insurance Plan Two: Copay Saver
UHC insurance plans are all like this: a great plan, and then a more stripped down “saver” version of the same plan. The Copay Saver UHC insurance plan is identical to the Copay Select with the following changes:
There’s a $3000 out-of-pocket after the deductible instead of a $2000 out-of-pocket
You can only select a deductible level of $2500
Outpatient x-rays and labs are only covered if performed within 14 days of surgery or medical confinement – a gap that severely weakens this UHC insurance plan
$35 copay instead of $25, and each person on the plan only has two visits per year
If you go to the ER with this UHC insurance plan but aren’t admitted, you’ll have a $500 copay to contend with
There are no preventative care benefits with the Copay Saver UHC Insurance plan, but you can add them on again later.
Several outpatient procedures aren’t covered – listing them all is beyond the scope of this article, but they’re outlined in the policy brochure available for download at the free health insurance quote page.
There is no name-brand prescription drug coverage, only $15 generics
The verdict: I strongly recommend against this plan. The gaps in coverage are too great to justify the savings on monthly premiums. If you really want a more affordable copay plan, then instead of this UHC insurance plan check out the Autograph Share 80 Humana Plan.
UHC Insurance Plan Three: HSA 100
HSA 100 is the number two most-loved UHC Insurance plan according to client satisfaction surveys. With it, you’ve got your choice of deductible ($1150, $1900, $2900, $3500, or $5000 for individuals; $2300, $3850, $5800, $7500, or $10000 for families). Under this UHC Insurance plan, once you meet that deductible the rest of your expenses for the remainder of the year will be paid at 100%. Prescription drug costs also apply to the deductible, and this UHC insurance plan is HSA eligible. The preventative benefits aren’t great unless you add the preventative care package, which is cheap and very robust.
The Verdict: the second best UHC insurance plan you can get, and a great price tag, too. If you’re in love with the HSA concept then this UHC insurance plan is the one for you – otherwise, hold out for Plan 100.
UHC Insurance Plan Four: HSA Saver
It’s set up again with a standard UHC insurance plan and then a stripped-down saver version. Again, the coverage for this UHC insurance plan is identical to HSA 100 with the following exceptions:
Outpatient x-rays and labs aren’t covered unless they’re within 14 days of surgery or confinement under this UHC insurance plan.
Doctor’s office visits aren’t a covered expense, a huge gap in this UHC insurance plan.
Emergency room fees are covered normally if you’re admitted to the hospital, but with this UHC insurance plan if you’re not admitted then you’re limited to $250 per person per year in benefits.
Outpatient prescription drugs, adult preventative care, and childhood immunizations are all not covered under this UHC insurance plan.
The Verdict: I don’t recommend this plan – the gaps in coverage are just too great.
UHC Insurance Plan Five: Plan 100
When it comes to UHC insurance, Plan 100 is where it’s at. This is the most popular UHC insurance plan by far and enjoys the highest customer satisfaction rating of all UHC insurance plans.
Plan 100 has a choice of a $2500, $3500, or $5000 deductible. These are individual deductibles, and the family deductible is always twice the chosen individual deductible. That means that even if you have twenty children, if you have the $2500 deductible level then your entire family’s medical bills for the rest of the year will be paid at 100% once the family’s medical costs reach $5000. Everything applies to the deductible – doctor’s visits, prescription drugs, hospitalizations, everything. Well care for the kids up to age five is covered at 100% before the deductible (in other words, under this UHC insurance plan it’s free).
The Verdict: This plan is not HSA eligible, so if you love the HSA concept then you’ll like HSA 100 better. Personally, I prefer Plan 100 for the more competitive price and the fact that this UHC insurance plan has more optional benefits (discussed later) available.
UHC Insurance Plan Six: HSA 80
This UHC insurance plan is identical in every way to HSA 100 in terms of what’s covered. The deductible levels are the same, the coverage is the same, everything is the same – the only difference is that this UHC insurance plan pays 80% once you meet the deductible instead of the 100% that HSA 100 pays. Once $3000 comes out of your pocket after the deductible is met, then this UHC insurance plan will pay 100% of your medical costs.
The Verdict: This is the only “budget” UHC insurance plan I’m comfortable recommending to any of my clients. There aren’t any gaps in coverage – it’s just a little cheaper and your benefits are a little slower to kick in. If you’re on a budget and don’t like the Monogram Humana Plan, then this is what you should have.
UHC Insurance Plan Seven: Saver 80
The cheapest UHC insurance plan is, of course, the one with the fewest benefits. Saver 80 has deductible levels of $500, $1000, $1500, $2500, $3500, and $5000. Once you meet your deductible, this UHC insurance plan will pay 80% of your medical costs until another $3000 comes out of your pocket. Then, this UHC insurance plan will pay 100%.
This plan has some pretty hefty gaps in coverage, though:
Doctor’s office visits aren’t covered
Outpatient x-rays and labs are only covered if performed within 14 days of surgery or confinement
Outpatient prescription drugs aren’t covered (this alone makes this UHC insurance plan not worth having)
The Verdict: Plan 80 is only a few dollars more, so if you’re really on a budget then that’s where you should be looking. I would shy away from Saver 80
UHC Insurance: Optional Benefits
There are a number of optional benefits available for add-on to some UHC insurance plans. Let’s look at them one-by-one:
UHC Insurance Preventative Care Package:
Note: this benefit isn’t available with the Copay Select plan.
The preventative care add-on gets you free well-child visits up to age 18, free childhood immunizations, free mammograms, free pap smears, and free PSA tests (all one per year). Also, after a twelve-month wait, adults can get preventative care for just a $35 copay. This is a no-brainer, a great add-on to any UHC insurance plan.
UHC Maternity Insurance:
We go over this one in pretty great detail at How Maternity Insurance Works, so we won’t re-hash it here. Just keep in mind that this benefit isn’t available with either HSA 100 or HSA 80 – most people like to add this to their Plan 100.
UHC Prescription Drug Card Benefit:
This one is available with Plan 100 and Plan 80 and it allows you to get any generic prescription for only $20. Name brand drugs can be had for a $50 copay, but you’ve got to meed at $250 per year, per person deductible first.
UHC Supplemental Accident Benefit:
This one isn’t available with the HSA plans, but if you add it on to any other UHC insurance plan you’ll get first-dollar coverage up to $500 for the treatment of an injury resulting from an accident. This is an awesome add-on to any UHC insurance plan, it’s super cheap, and can save you a bundle when you need it.
UHC HSA Hospital Indemnity Rider
With the two HSA plans, you can add on a hospital indemnity rider to help protect you against major hospitalization expenses before you’ve built up cash in your HSA. Basically, on the third day of hospital confinement, this UHC insurance add-on will pay you a lump sum of cash to help offset the hospital costs. There’s a one-time additional premium payment of $40 ($150 family), and the benefit will pay $1500 ($3200 family) if the hospitalization occurs in the first month of coverage. The benefit then slowly decreases until finally it disappears at month sixteen. This is a great add-on to a HSA eligible UHC insurance plan because it provides significant, early-on protection and buys you time to build up your HSA.
Now that you’ve learned more than you ever wanted to know about how UHC insurance plans work, you’re probably dying to know how much they cost. Well, Georgia Insurance Options has you covered there, too. Head up to our free, instant Georgia health insurance quote page where you’ll receive an instant, personalized proposal telling you just how much you can save and how you can get protection for your family today!