UHC HDHP

When you choose UnitedHealthcare, you'll have access to programs that empower you to make more informed health decisions and support to help you reach your own health and wellness goals.

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Health & Pharmacy

​​​​​​​​Health Plan - UHC HDHP Plan

HDHP In and Out of Network (OON) with in- and out-of-network coverage with a national network. The HDHP OON plan has lower monthly premiums but more out-of-pocket at the time of use until the annual deductible is met.  This is the out-of-network plan with a few extra benefits. 

  • The network is expanded for all and is the National Network. 
  • The County is funding the deductible for the HDHP upon completion of the Engagement Incentive with $1,200 for EE and $2,400 for EE+Dependent. 
  • The deductible for the plan has increased due to IRS regulations. Since this plan has In-network and Out-of-Network coverage the deductible has two levels.
    • In-Network - Deductible is $1,600 Single / $3,200 Family
    • Out-of-Network - Deductible is $3,000 Single / $6,000 Family (This amount could be higher as Out-of-Network does not have contracted rates.)
  • The Maximum Out of Pocket has two levels, Medical and Rx combined.
    • In-Network - $3,425 Single / $6,850 Family
    • Out-of-Network - $6,000 Single / $12,000 Family (This amount could be higher as Out-of-Network does not have contracted rates.)​

Highlights of HDHP OON​ (Information​ below assumes use of IN-Network Providers)

  • All health and prescription services are subject to the annual deductible and coinsurance based on the tier of coverage except mandated preventive services or designated preventive prescriptions (see Preventive Rx list​).
  • Medical and prescription expenses will be applied toward meeting the annual deductible and coinsurance amount based on the tier of coverage (Member Only coverage or Member + Dependents coverage).
  • Once the annual deductible is met, the health and pharmacy plan pays 80% and you pay 20% coinsurance of the eligible discounted costs (in-network).
  • When you reach the out-of-pocket maximum, the Plan pays 100% of eligible in-network health and prescription expenses.
  • Preventive services (see Complete Summary book​) and designated preventive prescriptions are covered at 100%.
  • An annual eye exam at no cost at a participating optometrist.
  • A Discount dental plan is included at participating dental providers.

EXCLUSIONS AND LIMITATIONS

All health plans have specific Exclusions and Limitations. Please contact the on-site UnitedHealthcare Reps for more information.

​Additional Programs:

RALLY Program -Employer Rewards
Real Appeal - Lifestyle Weight loss

​Contact Info:​

UHC Member Services: 866-633-2474

​On-Site Rep: 

Neerie Kolehma 954-357-7191 or 
Chris Sands 954-357-7192

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​​Pharmacy Services- UnitedHealthcare

Your pharmacy benefits are provided under the County's health plan through UnitedHealthcare​ (UHC). Some of the plan features include: a large network of participating pharmacies and a 90-day maintenance medication program (excludes specialty).​ 

Non-Preventive Prescription Drugs

  1. ​The discounted drug cost is applied to the deductible.
  2. After the annual health deductible is met, the plan pays 80% and the member pays 20% coinsurance of the discounted drug cost.
  3. 100% Coverage after the annual health out-of-pocket is met; prescription drugs are paid in full by the plan.​
Pharmacy Plan - Specialty Drugs Only: HDHP Plans: Manufacturer copay/financial assistance is a great benefit to help pay for costly Specialty drugs.  Members using Specialty drugs through (UHC) will have the manufacturer's assistance applied upfront and only the actual amount a member pays out of pocket will be applied to their annual deductible or coinsurance accumulators.  Member will continue to receive the same financial assistance from the manufacturer; however, that assistance will now be incorporated into the member’s health deductible and coinsurance.

Clinical Prior Authorization Program

Certain prescriptions require “clinical prior authorization,” or approval from your plan before they will be covered. The categories/medications that require clinical prior authorization may include but are not limited to -  Acne (topical-after age 24), ADHD/Narcolepsy (after age 19), Botulinum Toxins, Lamisil/Sporanox, Obesity, and Peniac. Upon receipt of a prescription falling into a covered category, UHC will contact your doctor’s office and request the documentation needed for Prior Authorization.

To verify in advance, members may contact UHC.
Contact Info:

UHC Member Services: 1-866-633-2474​

Spec​​ialty Pharmacy
UHC is the specialty pharmacy provider. They will assist members with their specialty medications to ensure safe and effective administration. UHC provides free home delivery to your home/work address. Please contact UHC for more information regarding specialty pharmacy.​​
UHC Contact Info:

For Rx Call: 1-866-633-2474

For Other Info Call: 1-877-633-4461

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