ASU offers two medical plan options for 2024-25. 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
2024-25 medical plan resources
2024–25 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
2024 | In-network
2025 | Out-of-network |
| Individual | $200 | $1,000 | $5,000 | $1,600 | $1,650 | $5,000 |
| Family aggregate | $400 | $2,000 | $10,000 | $3,200 | $3,300 | $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. | 50% 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. |