We offer three national medical plan options administered by UHC, which include prescription drug coverage through Express Scripts. Use whyuhc.com/thermofisher to find in-network providers and facilities.
In-Network Highlights
| BASIC HDHP | CORE HDHP | PPO | |
|---|---|---|---|
|
Annual Deductible |
$2,250 Individual / $4,500 Family |
$1,750 Individual / $3,500 Family |
$500 Individual / $1,000 Family |
|
Coinsurance |
You pay 20% |
You pay 20% |
You pay 10% |
|
Annual Out-of-Pocket Maximum includes deductible, copays and coinsurance |
$5,500 Individual / $11,000 Family |
$4,000 Individual / $8,000 Family |
$2,000 Individual / $4,000 Family |
|
Preventive Exams & Tests including routine physicals, gynecological exams, mammograms |
You pay nothing |
You pay nothing |
You pay nothing |
|
Non-Preventive Lab Work — Independent Lab such as LabCorp |
You pay nothing, after deductible |
You pay nothing, after deductible |
You pay nothing |
|
Non-Preventive Lab Work — Physician’s Office |
You pay 20%, after deductible |
You pay 20%, after deductible |
You pay 10%, after deductible |
|
Office Visits — PCP |
You pay 20%, after deductible |
You pay 20%, after deductible |
You pay $25 |
|
Office Visits — Specialist |
You pay 20%, after deductible |
You pay 20%, after deductible |
You pay $40 |
|
Convenience Care |
You pay 20%, after deductible |
You pay 20%, after deductible |
You pay $25 |
|
Urgent Care |
You pay nothing, after deductible |
You pay nothing, after deductible |
You pay $50 |
|
Emergency Room |
You pay 20%, after deductible |
You pay 20%, after deductible |
You pay 10%, after deductible |
|
Prescription Drug Coverage — Express Scripts |
|||
|
Deductible |
N/A; included in medical plan deductible |
N/A; included in medical plan deductible |
$200 Individual / $400 Family
|
|
Out-of-Pocket Maximum |
N/A; included in medical plan out-of-pocket maximum |
N/A; included in medical plan out-of-pocket maximum |
$4,000 Individual / $8,000 Family, separate from the medical OOPM |
|
Retail up to 31-day supply |
After you meet the annual deductible:
|
After you meet the annual deductible:
|
|
|
Mail Order up to 90-day supply |
After you meet the annual deductible:
|
After you meet the annual deductible:
|
|
Please note: Specialty Rx is covered at Brand non-formulary and limited to a 31-day supply per fill.
What to Expect
ID Cards: Once you enroll, you will receive both a UHC medical plan ID card and an Express Scripts ID card mailed to your home address.
Find Your Provider: Use whyuhc.com/thermofisher to find in-network providers and facilities.
Virtual Visits
UHC medical plan participants can visit the UHC member site to schedule a virtual visit. A wide range of treatments and therapies can be provided for these general virtual care options.
- Primary Care: Schedule a virtual appointment with a PCP and get care from the comfort and privacy of home.
- 24/7 Virtual Visits: Allow you to talk with a provider 24/7 for common urgent care needs (e.g., allergies, pink eye, common cold or seasonal flu) or when your PCP is not available. Many providers can also prescribe some medications and have them sent to your local pharmacy.
- Behavioral Health Care: For when you’re dealing with life challenges, feeling stressed, or need to speak with a psychiatrist or therapist.
Prescription Drug Coverage
To save you time and money and to avoid a penalty, some of your medications may need to be filled through a specific type of pharmacy. The PPO and HDHP plans have a mandatory mail order program for maintenance medications, which helps ensure costs are as low as possible. After your third maintenance medication fill at a retail pharmacy, you must fill your maintenance medication through the mail order service.
If you continue to fill your maintenance medication after the third fill at a retail pharmacy, you will pay 100% of the cost and this amount will not apply to your deductible or out of pocket accumulators. In order to avoid paying 100% of the cost, after the second fill of the maintenance medication at the retail pharmacy, please ask your doctor to submit a new prescription to be filled at the Express Scripts (ESI) home delivery pharmacy.
Specialty Medications must be filled through Accredo, the specialty pharmacy for ESI. You will pay 100% of the cost for any specialty medication filled at any pharmacy other than Accredo. The 100% cost will not apply to your deductible or out-of-pocket maximums.
You may be contacted by PillarRx about a copay assistance program that can save you money on specialty medications. Watch for more information mailed to you from PillarRx if this applies to you.
