Get the most out of your UVA benefits

• All three health plan options cover the exact same services, including prescription drugs
• Preventive care services (in-network only) are covered at 100%, with no deductible
• You must satisfy your annual deductible before coverage begins for most services; then you and your health plan option share the cost of covered services (co-insurance), up to the out-of-pocket maximum
• The out-of-pocket maximum is the same for all 3 health plan options:
  • $5,500 Individual
  • $11,000 Family
• Once you reach the out-of-pocket maximum, your health plan option pays for covered services at 100% for the rest of the year
• You can elect coverage for you and your eligible dependents
• Aetna is the plan administrator for medical services and prescription drug benefits

The services are the same for all three health plan options. It's how you pay for them that is different: 

• Would you want to pay more in premiums up front (UVA PPO and Choice) and pay less out of pocket for using health care services throughout the year?
• Or pay less in premiums (Health Savings) and pay more out of pocket as you use the services?
• The premiums and deductibles are different for each health plan option.

Compare the health plan options using the resources and tools below.

• Maximum Out-of-Pocket Comparison - The "UVA Health Plan Options at a Glance" tables below show your potential maximum annual out-of-pocket costs (premiums, deductibles, out-of-pocket max) for in-network services, for Health Savings, UVA PPO, and Choice Health options. Each table represents one employee group (individual, + spouse, + child, family). The tables include the UVA employer contribution to HSA for Health Savings participants. Each table is to scale, relative to its out-of-pocket maximum.

• UVA Health Plan Schedule of Benefits Comparison - The UVA Health Plan Schedule of Benefits Comparison  compares various health services (professional services, preventive services, urgent care, etc.) for the Health Savings, UVA PPO, and Choice Health options, and shows deductibles, coinsurance, and copay amounts for each option.

• UVA Health Plan Comparison Tools

  • Summary of Coverage and Benefits Glossary - English

  • Summary of Coverage and Benefits Glossary - Spanish

  • Health Savings

    • Health Savings schedule of benefits

    • Health Savings summary of benefits and coverage

  • UVA PPO

    • UVA PPO schedule of benefits

    • UVA PPO Out of Area (OOA) schedule of benefits (If your work location zip code in Workday is more than 50 miles from Charlottesville, you will automatically be covered under this option if you enroll in UVA PPO)

    • UVA PPO summary of benefits and coverage

    • UVA PPO OOA summary of benefits and coverage

  • Choice Health (closed to new enrolling starting 1/1/2026)

    • Choice Health schedule of benefits

    • Choice Health summary of benefits and coverage

• Aetna Tools: Visit the Aetna website and click on “Log in/Register” to access these resources:​​​​​  

  • Find Care & Pricing Tool - compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

  • Aetna Institute of Quality List: Lists IOQ facilities

  • Aetna Digital Care Tool- provides drug cost estimates based on the selected UVA Health Plan option. Use the links below to compare drug prices for the UVA Health Plan options.

    1. Enter the name of the drug

    2. Click "search" to view the estimate and plan details.

       • Health Savings

       • UVA PPO

       • Choice Health 

  • Personalized Assistance - If, after reviewing materials and resources on the Open Enrollment website, you would like additional 1:1 personalized assistance, please email AskHR@virginia.edu or call 434.243.3344 to schedule a Zoom appointment with one of our HR professionals. HR is offering a limited number of benefits appointments from now until Wednesday, October 16, with appointment start times from 8:00 am to 4:00 pm.

To be eligible for the UVA Health Plan:

• Employee: Must be an Academic Division or Medical Center salaried employee of UVA, full- or part-time, and regularly scheduled to work at least 20 hours/week

  • J visa holders are only eligible for the UVA J Visa Health option. Federal government regulations prohibit J visa holders from enrolling in the Health Savings, UVA PPO or Choice Health options.
• Spouse:

  • For the UVA Health Plan: 

    • Must be legally recognized as a spouse in the Commonwealth of Virginia and have no access to Affordable Healthcare Coverage of minimum value (as defined by the Affordable Care Act) through their non-UVA employer; OR

    • Must have access to affordable health coverage of minimum value through their non-UVA employer but ALL of their health options are HMOs and the spouse lives outside the HMOs' defined service areas. The spouse is therefore eligible to be a dependent on the UVA employee's health coverage.

  • For UVA Dental and Davis Vision: Must be legally recognized as a spouse in the Commonwealth of Virginia.

• Children: Must be your biological, step, adopted, or foster child, or any child declared a dependent on your federal tax return for whom you are the legal guardian with permanent custody. Children are eligible to the end of the birth month in which they turn 26.

• Children With Disabilities: Must be incapable of self-support due to a mental or physical disability. May continue beyond age 26, as long as:

  • Required documentation is approved in advance by the Aetna Claims Administrator prior to the dependent’s 26th birthday
  • They are unmarried
  • They live with you 100% of the time
  • They are declared a dependent on your federal tax return
  • For further details and additional assistance, contact Aetna Member Services at 800.987.9072, or the UVA Health Plan Ombudsman.

In order to enroll in the Health Savings option, you must:

• Be eligible for UVA’s Health Savings Account (HSA) program

• Be enrolled in a high deductible health plan (HDHP) if you are covered by another health care plan

• Not be covered by any part of Medicaid or Tricare, or be enrolled in Medicare Part A or Part B in the year 2023

• Not be a J Visa holder (federal government regulations prohibit J Visa holders from enrolling in the Health Savings option)

Just like getting an annual physical, it is a good idea to also review your benefits annually. You can do this by navigating to Workday and confirming the benefits you previously selected continue to meet the needs of you and/or your family.

Note key dates on your calendar.

Attend Open Enrollment presentations and benefits vendor webinars September 12 - October 2. See the schedule.

Review how you used your health plan last year. Did you use it for:

• Medical or dental procedures?
• Glasses or contact lenses?
• Changes in dependent care?
• Replacements to medical or assistive devices?
• Life events, like marriage, new children?

Review how you spent any funds and used your benefits by going to your benefit accounts:

• Medical & Pharmacy claims: Aetna website
• Dental: United Concordia website
• Vision:
  • Aetna website
  • Davis Vision website
• Flexible Spending Account/Health Savings Account: Fidelity website

Plan for use-or-lose benefits early with your Dependent Daycare Account and FSA.

If you're adding a new dependent to your health plan, have your dependent verification documentation ready to upload into Workday during Open Enrollment. You will not be able to submit your benefits elections if you have added a new dependent to your health plan and have not provided the required documentation.

Confirm home address, phone number, and add missing social security numbers for dependents in Workday.

Review new resources: New mini videos offer explanations about key benefit concepts.

Attend benefits vendor webinars through October 2. See the schedule.

Review Benefits and Make Changes in Workday:

• Modify medical, dental, vision benefits, if desired.
• Re-Elect FSA/HSA - Even if you do not want to make any changes to your health, dental, or vision plans, you still need to re-elect the FSA and HSA programs for 2025 during Open Enrollment. 2024 elections for FSAs and HSAs will NOT automatically carry over to 2025.
• Add or drop dependents, if applicable. Adding a spouse or dependent requires documentation confirming their relationship to you in order for your Open Enrollment change request to be approved. If you change your health, dental, or vision options, remember to re-add your dependents. If you add new dependents, you must upload required documentation.
• Confirm home address, phone number, and add missing social security numbers for dependents in Workday.
• Change supplemental retirement and life insurance options, if desired.
• Print elections once submitted in Workday, or save as PDF.

Look for additional Open Enrollment tasks in your Workday inbox.

Don't forget to earn and record activities for your 2024 Hoos Well rewards in the Hoos Well portal by November 30, 2024.

If you switched to Health Savings for the first time, spend down your Full FSA to $0.00 by December 31, 2024.

Look for additional Open Enrollment tasks in your Workday inbox.

The monthly premiums below apply to both part-time and full-time employees.

2025 Monthly Premiums

2025 Monthly Premiums

2025 Monthly Premiums - Choice Health

2025 Monthly Premiums - UVA PPO

*In the case of external fellowships that are provided directly to postdoctoral fellows, fellowship allowances may be used to support the full cost of postdoctoral fellow health insurance.  In all cases, departments and postdoctoral fellows must account for the full costs provided above.

2025 Monthly Premiums

Benefits-eligible Academic Division and Medical Center wage employees may only enroll in Wage plan option. 

To find out if benefits under this Plan will be reduced, Aetna must first use the rules listed below, in the order shown, to determine which plan is primary (pays its benefits first). The first rule that applies in the chart below will determine which plan pays first:

When the other plan pays first, the benefits paid under this Plan are reduced as shown here:

• The amount this Plan would pay if it were the only coverage in place, minus
• Benefits paid by the other plan(s)

This prevents the sum of your benefits from being more than you would receive from just this Plan. If your other plan(s) pays benefits in the form of services rather than cash payments, the Plan uses the cash value of those services in the calculation.

You are eligible for Medicare if you are:

• Eligible for, and covered by, Medicare
• Eligible for, but not covered by Medicare because you:
  • Refused Medicare coverage
  • Dropped Medicare coverage
  • Did not make a proper request for Medicare coverage

When you are eligible for Medicare, Aetna must determine whether this Plan or Medicare is the primary plan.

When This Plan is Primary

This Plan is primary, and Medicare is secondary, if a covered person is eligible for Medicare and falls into one of the following categories unless eligible for Medicare due to End Stage Renal Disease (ESRD):

• An active employee, regardless of age
• A totally disabled employee who is:
  • Not terminated or retired
  • Not receiving Social Security retirement or Social Security disability benefits
• A Medicare-eligible dependent spouse of:
  • An active employee
  • A totally disabled employee who is not terminated or retired
• Any other person for whom this Plan’s benefits are payable to comply with federal law

When this Plan is the primary plan, Aetna will not take Medicare benefits into consideration when determining the benefits payable by the Plan.

End-Stage Renal Disease

This Plan is primary for the first 30 months after any covered person becomes eligible for Medicare due to End-Stage Renal Disease (ESRD). The Plan will pay benefits for a covered expense first, before Medicare benefits are available.

Medicare becomes the primary plan, and this Plan is secondary, beginning with the 31st month of Medicare eligibility due to ESRD. If you’re eligible for Medicare only because of permanent kidney failure, your Medicare coverage will end 12 months after the month in which you stop dialysis treatments or 36 months after the month in which you have a kidney transplant.

When Medicare is Primary

Medicare is the primary plan, and this Plan is secondary, if a covered person is eligible for Medicare and does not fall into one of the categories above or is in their 31st month or later of Medicare eligibility due to ESRD.

These rules are based on regulations issued by the Centers for Medicare and Medicaid Services (CMS), and may be amended or changed at any time. It is the intent of the Plan to abide by the Medicare Secondary Payer Rules. If the Plan in any way conflicts with regulations issued by CMS, the Plan will pay Benefits in accordance with CMS regulations.

Yes, two UVA spouses may choose who covers and who waives, or they may have separate plans.

An employee's non-UVA spouse who has access to health benefits that meet affordability and minimum value standards as defined by the Affordable Care Act is generally not eligible for coverage as a dependent on the employee's UVA Health Plan. However:

• Spouses whose remote employer offers affordable health care that provides minimum value, but ALL of their health options are HMOs and the spouse lives outside the HMOs' defined service areas, are eligible to be a dependent on the UVA employee's health coverage. 

You can map out what you’ll need from your benefits in 2024 by reviewing how you’ve used them in 2023 and thinking about anything new you might need next year. Reviewing how you’ve spent funds and used benefits over the last year can be a huge help when selecting a plan. The following resources can help you look back, in order to take care of yourself in 2024:

• Medical & Pharmacy Claims: Aetna website
• Dental: United Concordia member website
• Vision: Davis Vision member website
• Flexible Spending Accounts/Health Savings Accounts:  Fidelity website

Here are helpful questions to ask yourself. Do you have: 

• Any medical or dental procedures planned? 
• Any upcoming glasses or contact lens needs?
• Any changes in dependent care ?
• A need for replacements to medical or assistive devices?
• Potential life events — for example, new marriage, new children, or children after age 13 no longer eligible for Dependent Care FSA funds?
• Dependents' social security numbers listed correctly in Workday?​

Remember that choosing a health plan option is a personal choice about how you pay for health care services. The services are the same for all three health plan options. It's how you pay for them that is different. Would you want to pay more in premiums up front and pay less out of pocket for using health care services throughout the year? Or pay less in premiums and pay more out of pocket as you use the services?

Preventive care services (in-network only) are the same for all health plan options, and are covered at 100%, with no deductible.

The Affordable Care Act Employer mandates that large employers (50+ employees) must offer health insurance that is affordable and provides minimum value to 95% of their full-time employees (or FTE equivalent) and their children up to age 26, or be subject to penalties.

What are the requirements for Academic Wage employees?

The Commonwealth has specific guidelines built within the Manpower Control Program that UVA is required to follow regarding working hour limitation for wage employees. This is a budgeting requirement, and we are mandated by the guidelines as a state institution of higher education.

Are there limitations regarding hours worked for Academic Wage employees?

Wage employees cannot work more than an average of 29 hours per week in a 12-month measurement. All wage employees are monitored through weekly reporting, and terminated prior to reaching 1500 hours.

What are the requirements for Medical Center Wage employees?

The Medical Center is not mandated by the Commonwealth, and as such they do offer benefits to wage employees who meet the ACA mandate.

Wage employees who average 30 hours per week in the 12-month measurement period are eligible for the Wage option (no HSA).

Academic division and medical center FT/PT employees who transfer to a wage position within the plan year may also qualify based on their hours.

What time frame are wage employees' hours monitored?

October to October. The plan is effective 1/1 through 12/31 of the current plan year.

A dependent is a person who is eligible to be covered by you under the health, dental and vision plans. A beneficiary can be a person or a legal entity that is designated by you to receive a benefit, such as life insurance.

A spouse included in your medical coverage and designated as a recipient of your life insurance is both a dependent and a beneficiary.

For another example, a parent is not an eligible dependent for medical coverage but could be designated as a beneficiary.

For additional details about required documentation for eligible dependents, visit the Open Enrollment Eligibility 2025 webpage.

Detailed information about eligibility for the UVA Health, Dental, and Vision Plans can be found on the Eligibility 2025 webpage. In a nutshell, the Plans are open to:

• UVA Academic and Health System salaried employees, full-time or part-time working at least 20 hours/week, except J visa holders, who are eligible for the UVA J Visa Health Plan
• Spouses of eligible UVA employees (some exception noted on the Eligibility 2025 webpage)
• Children of eligible UVA employees - children (as defined on the Eligibility 2025 webpage) are eligible through their birthday at age 26, or longer if documented to have mental or physical disabilities (see the Eligibility 2025 webpage for more details)

The Health Savings option has some additional requirements; please visit the Eligibility 2025 webpage for those details.

Below is a simple illustration of how deductibles, coinsurance, and out-of-pocket maximums work for a single employee on Health Savings. For additional examples, please call Aetna for customized scenarios based on your preferred health plan option and potential future health care expenses.

UVA employees and their dependents, covered by the UVA Health Plan may obtain a flu shot through their Primary Care Physician, or at a pharmacy in Aetna's National Pharmacy Network, if you present your Aetna ID card at the pharmacy.

Flu vaccines are covered at no cost, as a preventive service through the UVA Aetna Health Plan. When obtained through an in-network Primary Care Physician, or at a pharmacy in  Aetna's National Pharmacy Network. 

Here is a list of vaccine providers within the Aetna network.  

If you went to a participating pharmacy and were charged for your flu vaccine, you can submit a reimbursement to Aetna. Complete steps 1-25 in the reimbursement form, and attach your receipt and other supporting documentation.

No. If you plan to enroll in Medicare, you are not eligible to sign up for Health Savings and are not eligible for a Health Savings HSA. The UVA Health Plan does not allow movement from one health plan option to another during the year for any reason. Therefore, you cannot move from Health Savings to UVA PPO or Choice Health or vice versa anytime during 2025 if you are thinking about enrolling in Medicare for the same year. You will be out of compliance with IRS which may incur a penalty and will have to address this when you complete your 2024 tax returns.

When considering health plan options during Open Enrollment, make sure your choices for the following calendar year are appropriate for the entire year.

Yes. You may use HSA funds for your spouse even if your spouse is on Medicare. The spouse must be declared on your federal income taxes as a dependent (i.e. filing jointly), and the expense in question is not already covered by Medicare. Otherwise, if the expense is eligible, not already covered by the health plan, and your spouse is a tax dependent, then you may use HSA funds to pay for it.

You and your Medicare-eligible dependent will still receive $1,500 seed money for your Health Savings HSA.

You do not have to enroll in Medicare until you end your employment with UVA. Your benefits counselor will provide you with the form CMS-L564 to negate the late enrollment penalty. 

You can choose to enroll in part A, and waive part B, but this will terminate your eligibility for the HDHP (Health Savings). 

If you have been newly granted a J Visa during the year, you must move from the UVA Health Plan to the UVA J Visa Health Plan. These are two entirely different health plans, and moving from one to the other is allowed throughout the year in order to comply with federal health coverage requirements.

If you have been on the UVA J Visa Health Plan and are newly granted a different type of visa, you must stay on the UVA J Visa Plan for the rest of the calendar year.

Health Savings participants have a deductible that applies to both medical and prescription costs. You must pay for covered health care services and prescriptions up to your deductible amount before the UVA Health Plan begins to pay. 

UVA PPO and Choice Health participants have a deductible that applies to both medical and prescription costs for tier 2 and tier 3 retail drugs. You must pay for covered prescriptions up to your deductible amount before the UVA Health Plan begins to pay for tier 2 and tier 3 retail prescriptions. Tier 1 medications and specialty prescriptions are not subject to the deductible.

The table below shows costs for retail pharmacy outside of UVA pharmacies (such as CVS, Kroger, etc.); excludes specialty prescriptions and mail order prescriptions.

You can find information on our Prescription Drug Program 2025 webpage.

If you need additional details, contact Aetna for assistance.

To get specialty prescription drugs, you must use the UVA Specialty Pharmacy, which can be reached at 434.297.5500 or by email.