Although there are relatively few changes to UC health plans for 2021, the majority of the changes are to UC Care.
Those enrolled in the UC Care medical plan through Anthem Blue Cross can expect significant changes to their coverage, as detailed by the UC Davis Health Care Facilitator Program:
- The Emergency Room copayment is increasing from $200 to $300
- The Urgent Care Center copayment is decreasing from $30 to $20
- The UC Select (Tier 1) out-of-pocket maximum is increasing from $5,100 to $6,100 per person (from $8,700 to $9,700 per family)
- UC Select providers include all UC Medical Centers and a handful of other providers near UC campuses
- The Anthem Preferred (Tier 2) level of benefit has several changes:
- The deductible is doubling from $250 to $500 per person per year
- The coinsurance is increasing from 20% to 30% (this increase does not apply to foreign claims)
- The out-of-pocket maximum is increasing from $6,600 to $7,600 per person (from $13,200 to $14,200 per family)
- Anthem Preferred providers include Dignity Health, Hill Physicians, NorthBay Healthcare, Mayo Clinic, MD Anderson, Stanford, Sutter, etc.
- The Out-of-Network (Tier 3) level of benefit will also see increased deductibles and out-of-pocket maximums
- Out-of-Network providers have no contract with Anthem Blue Cross
You have choices
UC offers three different PPOs through Anthem Blue Cross: CORE, UC Care, and the UC Health Savings Plan.
To help you evaluate these plans, the Health Care Facilitator Program offers several tools, including a streaming video explanation of the plans.
- Start here to find premiums, a summary of major Davis/Sacramento-area health systems and their availability through the various health plans, as well as the UC Medical Plan Overview presentation (PDF slides | video) and more
- Comparing PPOs - best and worst-case scenarios
Part of the UC Medical Plan Overview referenced above directly compares the premiums and risks of the PPOs considering best- and worst-case scenarios:
PPO best case scenario: no claims (Single Coverage)
PPO worst case scenario: high claims (Single Coverage)
PPO best case scenario: no claims (Family Coverage)
PPO worst case scenario: high claims (Family Coverage)
As mentioned in the Overview, many UC Care members avoid high costs by using UC Select providers like UC Davis Medical Group. However, several services cost 30% or more even if obtained through UC Select providers:
- Durable Medical Equipment/Hearing Aids
- Home Health Care
- Infusions/Injection Therapy
- Retail Health Clinic
- Skilled Nursing Facility