Same Coverage. Different Ways to Share Costs.
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 preventative care. The main difference is how health care costs are shared between you and the plan.
Changes from last year:
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 HSAsThe 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.
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.
The sections below can help you understand who is eligible for coverage.
You may be eligible for UVA health benefits if you are:
J Visa Holders: Employees with J visas are only eligible for the UVA J Visa Health Plan. Federal regulations do not allow J visa holders to enroll in the Health Savings Plan or UVA PPO options. Visit J Visa Health Plan Webpage
Choose who you are adding to your benefits to see eligibility requirements and the documentation you may need to provide.
Select a dependent type above to see the requirements.
When you are eligible for Medicare, Aetna must determine whether this Plan or Medicare is the primary plan.
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:
When this Plan is the primary plan, Aetna will not take Medicare benefits into consideration when determining the benefits payable by the Plan.
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.
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.
This is an opportunity to learn common healthcare definitions as you explore the UVA Health plan options and how they affect your take-home pay and your out-of-pocket costs at the doctors office.
Services provided by doctors, hospitals, and facilities that have a contractual agreement with the Aetna.
Payroll deduction paid whether or not you go to the doctor, like a membership fee.
What you pay for covered, in-network services before co-insurance begins, not including in-network preventive care.
A fixed amount you pay for certain in-network health care services while your health plan covers the remaining cost.
The percentage of health care costs you share with your health plan after you meet your deductible.
The most you'd pay for covered, in-network services. After, the health plan pays 100% of covered, in-network services.
Choose your coverage level to compare annual employee premiums, deductibles, and UVA's contribution to the Health Savings Account.
The out-of-pocket maximum is the most you would pay for covered in-network medical care 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.
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