UVA_HRSame Coverage. Different Ways to Share Costs.
Understanding the UVA Health Plan
The UVA Health Plan is one plan with three cost-sharing options. All UVA Health Plan options cover the same essential heath care services, including preventive care. The main difference is how health care costs are shared between you and the plan.
Plan Options
Changes from last year:
- Premiums for the UVA Health Plan and UVA J Visa Health Plan will increase. You can compare premiums on the changes webpage.
- Choice is closed to new enrollees
-
Health Savings - Eligible for Enrollment
The High Deductible UVA Health Plan option offers lower monthly premiums and a higher deductible. This means higher upfront costs for health care services before the plan begins sharing covered in-network costs, but payroll deductions are lower throughout the year.
The Health Savings option also qualifies members to contribute to a Health Savings Account (HSA).
Learn More About HSAs -
UVA PPO - Eligible for Enrollment
The Preferred Provider Organization (PPO) UVA health plan option offers a higher monthly premium (payroll deduction) but lower deductibles. This means lower upfront costs before the plan begins sharing the cost of covered in-network care, but higher payroll deductions throughout the year.
-
Choice - Eligible Only for Re-Enrollment
This health plan option is only available to current Choice members. Employees may no longer newly enroll in Choice, which was designed with the highest premiums and lowest deductible.
-
Plan Option Overview Tables
1. Health Savings Option
Plan Feature Details Account Eligibility Health Savings Account (HSA) Eligible, subject to IRS requirements Full Health Care FSA Not eligible Limited Purpose FSA Eligible Dependent Care FSA Eligible UVA HSA Contribution $1,000 Employee Only / $1,500 Employee + Dependents Annual Deductible Employee Only $3,000 Employee + Dependents $6,000 Cost-Sharing Coinsurance 20% after deductible Out-of-Pocket Maximum Individual $6,500 Family $13,000 2. UVA PPO
Plan Feature Details Account Eligibility Health Savings Account (HSA) Not eligible Full Health Care FSA Eligible Limited Purpose FSA Not applicable Dependent Care FSA Eligible Annual Deductible Individual $800 Family $1,600 Cost-Sharing Primary Care (UVA Provider) $25 copay Primary Care (In-Network Provider) $40 copay Specialist (UVA Provider) $50 copay Specialist (In-Network Provider) $80 copay Coinsurance 20% after deductible Out-of-Pocket Maximum Individual $5,500 Family $11,000 3. Choice Health
Plan Feature Details Account Eligibility Health Savings Account (HSA) Not eligible Full Health Care FSA Eligible Limited Purpose FSA Not applicable Dependent Care FSA Eligible Annual Deductible Employee Only (In-Network) $500 Employee Only (Out-of-Network) $1,500 Employee + Dependents (In-Network) $1,000 Employee + Dependents (Out-of-Network) $3,000 Cost-Sharing In-Network Coinsurance 15% after deductible Out-of-Network Coinsurance 35% after deductible Out-of-Pocket Maximum Individual (In-Network) $5,500 Individual (Out-of-Network) $11,000 Family (In-Network) $11,000 Family (Out-of-Network) $22,000 Note: HSA eligibility is subject to IRS requirements, including restrictions on other health coverage. Dependent Care FSA eligibility is independent of medical plan selection.
Premium Tables -
Interactive Comparison of Benefits
Who can be Covered Under UVA Benefits?
Dependent Eligibility and Required Documentation
Choose a benefit, then choose who you are adding to see the eligibility requirements and documentation you may need to provide.
Select a benefit above to begin.
-
Health Plan Coordination With Medicare
When you are eligible for Medicare, Aetna must determine whether this Plan or Medicare is the primary plan.
When UVA Health Plan is Primary
The UVA Health Plan is primary, and Medicare is secondary, if a covered person is eligible for and covered by Medicare and falls into one of the following categories:
- 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.
Exception: 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.
Visualize The Cost Sharing Options
Choose your coverage level to compare employee premiums, deductibles, and UVA's contribution to the Health Savings Account.
UVA Health Plan Cost Division
Employee Only
Savings
The deductible and out-of-pocket maximum work differently.
There is no individual deductible when more than one person is covered under Health Savings. The full in-network family deductible must be met before the plan begins paying for services subject to the deductible.
One family member can meet the full deductible, or multiple covered family members can combine their eligible claims to meet it.
The out-of-pocket maximum is different from the Health Savings family deductible. Health Savings still has both a per-individual and a family out-of-pocket maximum.
View Out-of-Pocket Maximums
Out-of-Pocket Maximum
The out-of-pocket maximum is the most you would pay toward applicable covered in-network costs during the plan year before the UVA Health Plan begins paying 100% of covered in-network costs.
Most people do not reach their out-of-pocket maximum in a given year.
*Choice Health is closed to new enrollees.
Dates and Next Steps
- Open Enrollment begins on Monday, October 5 and remains open until 11:59 p.m. on Friday, October 16
- You will receive a task in your Workday Inbox on October 5 to get started
- After open enrollment ends, benefit changes will be limited to Qualifying Life Events
- On January 1, 2027, the elections you made during Open Enrollment will take effect
- Any updates to your paycheck deductions will appear on your first 2027 paycheck
I want to learn the Cost-Saving Benefits of a Flexible Savings Account
FSA WebpageI want to learn the Cost-Saving Benefits of a Health Savings Account
HSA WebpageI want to learn about Prescription Drugs and the Health Plan
Prescription Drug Program WebpagePostdoctoral Fellows
The Open Enrollment process for all Postdoctoral Fellows (non-UVA employees) is managed through UVA Human Resources. For additional information specific to Postdoctoral Fellows, contact AskHR@virginia.edu with the subject line "Postdoc Fellow Benefits".