Medical plans

Medical plans

ASU offers two medical plan options for 2022-23. Within 30 calendar days of your eligibility, hire date, a qualified life event or during the annual open enrollment period, you may enroll in one of the two medical plan options. Both medical plans provide the option to choose Blue Cross Blue Shield or United Healthcare medical networks. Please refer to the eligibility and enrollment section for information about coverage effective dates.

Medical plan options 

Download details of the Triple Choice Plan and High Deductible Health Plan

2022-23 medical plan resources

2022-23 plan year deductibles and copays

Triple Choice Plan and HDHP with HSA out-of-network benefits are subject to reasonable and customary charges as defined by the insurance industry.

 Annual deductibles
  Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3, out-of-network In-network Out-of-network
Individual $200 $1,000 $5,000 $1,500 $5,000
Family aggregate $400 $2,000 $10,000 $3,000 $10,000
Annual out-of-pocket maximum
  Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3, out-of-network In-network Out-of-network
Individual $7,350 $7,350 $8,700 $3,500 $8,700
Family aggregate $14,700 $14,700 $17,400 $7,000 $17,400
Office visits - preventative
  Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
PCP $0 $0 50% after deductible. $0 50% coinsurance after deductible.
OBGYN $0 $0 50% subject to deductible. $0 50% coinsurance after deductible.
Specialist $0 $0 50% after deductible. $0 50% coinsurance after deductible.
Non-preventative services
  Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
PCP $20 after a deductible. $20 after a deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
OBGYN $20 after a deductible. $20 after a deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Specialist $40 after a deductible. $40 after a deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Outpatient services
  Triple Choice Plan  HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
Ambulance $0 $0 $0 10% coinsurance after deductible. 10% coinsurance after deductible.
ER $200 after deductible.
Fee is waived if admitted.
$200 after deductible.
Fee is waived if admitted. 
$200 after deductible.
Fee is waived if admitted.
10% coinsurance after deductible. 10% coinsurance after deductible.
Urgent care $75 after deductible. $75 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Hospital admissions
  Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
Admission $250 after deductible. $250 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
International coverage
Triple Choice Plan HDHP with HSA
Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
Coverage for emergency services only.
Mammogram - preventative
Triple Choice Plan    HDHP with HSA
Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
$0 $0 50% after deductible. $0 50% coinsurance after deductible.
Durable medical equipment
Triple Choice Plan HDHP with HSA
Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
$0 $0 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Chiropractic - limited to 20 visits-plan year
Triple Choice Plan

HDHP with HSA

Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
$40 after deductible. $40 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Radiology
Triple Choice Plan     HDHP with HSA  
Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
$100 after deductible. $100 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Home health services
Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
Days during plan year. 42, $0 42, $0 42, 50% coinsurance after deductible. 42 days, 10% coinsurance after deductible. 42 days, 50% coinsurance after deductible.
Bariatric surgery
Triple Choice Plan  HDHP with HSA
Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
20% Not covered. Not covered. 20% coinsurance after deductible. Not covered.
Behavioral health
Triple Choice Plan HDHP with HSA
  Tier 1 in-network Tier 2 in-network Tier 3 out-of-network In-network Out-of-network
Inpatient $250 after deductible. $250 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Outpatient primary care $20 after deductible. $20 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
Outpatient specialist $40 after deductible. $40 after deductible. 50% after deductible. 10% coinsurance after deductible. 50% coinsurance after deductible.
asoenair Tue, 10/31/2017 - 16:08

Medical plan premiums

Medical plan premiums

2022-2023 Triple Choice Plan rates per pay period

Coverage level   Employee Employer
Employee only  $26.17 $270.53
Employee, plus spouse $71.49 $557.12
Employee, plus one child $57.30 $362.34
Family $121.61 $630.83


2022-2023 High deductible health plan rates per pay period

Coverage level  Employee Employer, plus HSA
Employee only $10.15, plus HSA $182.68, plus $27.69
Employee, plus spouse $30.46, plus HSA $378.62, plus $55.38
Employee, plus one child $25.89, plus HSA $247.50, plus $55.38
Family $56.35, plus HSA $421.83, plus $55.38

 

twill100 Thu, 05/28/2020 - 16:33

Medical management

Medical management

Case management
This is a collaborative process whereby a case manager from your designated medical management vendor works with you to assess, plan, implement, coordinate, monitor and evaluate the services you may need. Often, case management is used with complex treatments for severe health conditions. The caseworker uses available resources to achieve cost-effective health outcomes for both the member and the medical plans.

Disease management
The purpose of disease management programs is to reach out to you and your dependents who want help managing their health conditions or information about complex or chronic health conditions. The programs are typically designed to improve self-management skills and help make lifestyle changes that promote healthy living. The following disease management programs are available to all members, regardless of their selected networks:

  • Asthma.
  • Chronic obstructive pulmonary disease.
  • Congestive heart failure.
  • Coronary artery disease.
  • Diabetes.
  • Pregnancy-maternity.
     

If you are eligible or become eligible for one of the programs above, a disease manager from your designated medical management vendor will assess your needs and work with your physicians to develop a personalized plan. Your personalized plan will establish goals and steps to help you positively change your specific lifestyle habits and improve your health. Your assigned disease manager may provide the following services:

  • Assist with understanding your doctor’s treatment plan.
  • Help you to maintain your necessary medical tests and annual exams.
  • Offer tips on how to manage stress and help control the symptoms of stress.
  • Provide tips on how to keep your diet and exercise program on track.
  • Review and discuss medications, how they work and how to use them.

Participation is optional, private and tailored to your specific needs. Generally, a disease manager will work with you as quickly or as slowly as you like allowing you to complete the program at your own pace. Over the course of the program, participants learn to incorporate healthy habits and improve their overall health.
 

Medical management services 
When you choose medical coverage, you get more than basic health care coverage. You get personalized medical management programs at no additional cost. Each medical network provides medical management services as follows:

  • American Health Holding serves Blue Cross Blue Shield of Arizona network only.
  • UnitedHealthcare serves only UnitedHealthcare members.

Professional, experienced staff work on your behalf to make sure you are getting the best care possible and that you are properly educated on all aspects of your treatment.

Nurse Line
A dedicated team of physicians, nurses and dietitians are available 24/7 for member consultations. Individuals needing medical advice or who have treatment questions can call the toll-free nurse line:

  • American Health Holding 866-244-8977.
  • UnitedHealthcare 800-401-7396.

Utilization management
AHH  and UnitedHealthcare provide prior authorization and utilization review when members require non-primary care services. Prior to any elective hospitalization and/or certain outpatient procedures, you or your doctor must contact your designated medical management vendor for authorization. Please refer to your plan document for the specific list of services that require prior authorization. Each vendor has a dedicated line to accept calls and inquiries:

  • American Health Holding 866-244-8977.
  • UnitedHealthcare 800-896-1067.
asoenair Thu, 05/28/2020 - 17:01

Medical plan FAQs

Medical plan FAQs

How do I obtain medical ID cards? 

Visit the following carriers online for information about how to obtain your insurance cards. 

  • BCBS of AZ.  If you have a different last name, notify the provider you are covered under the employee listed on the card. Contact BCBS of AZ for confirmation of coverage.
  • UHC

How do names appear on issued medical ID cards?
BCBS of AZ issues two cards in the employee’s name only. Additional cards may be obtained. If the employee requires additional cards then the employee will need to contact BCBS of AZ to request the card. For those with different last names, they will need to notify the provider they are covered under that employee listed on the card and to contact BCBS of AZ for confirmation of coverage.
UHC issues separate cards for the employee and each covered dependent in their names.

How do I change my doctor? 
An employee enrolled in the Triple Choice Plan(TCP) or HDHP with HSA— BCBS of AZ and United Healthcare—has access to any physician in the network without a referral or without having to notify the plan administrator.
 

I am turning 65 in October but still plan to work until January. Should I enroll in Medicare and how does it work?
You can defer enrolling in Part B while you are actively employed. You should apply for Part B three months prior to retiring. The SSA will provide you with a form for your employer to verify that you have been covered by a group medical plan. Fax the form to 480-993-0008. 

asoenair Thu, 05/28/2020 - 17:16