2021 Open Enrollment

Medical Coverage

Here’s an overview of the 2021 plan changes for each University medical plan:

Classic Plan

 

SmartCare

Non-SmartCare

Disposable Medical Supplies (test strips, oxygen filters, lancets)

Plan covers $800 of disposable medical equipment and supply charges at 100%; then you pay deductible and 25% coinsurance

Emergency Room

Emergency: $250 copay

Non-emergency: $350 copay

Therapy Services (speech, physical, and occupational)

$40 evaluation copay; then you pay deductible and 20% coinsurance

$55 evaluation copay; then you pay deductible and 25% coinsurance

Premier Plan

 

SmartCare

Non-SmartCare

Disposable Medical Supplies (test strips, oxygen filters, lancets)

Plan covers $800 of disposable medical equipment and supply charges at 100%; then, you pay deductible and 20% coinsurance

Hospital Inpatient Services

 

$150 copay; then you pay deductible and 15% coinsurance

$300 copay; then you pay deductible and 20% coinsurance

Emergency Room

 

Emergency: $250 copay

Non-emergency: $350 copay

Therapy Services (speech, physical, and occupational)

$30 evaluation copay; then you pay deductible and 15% coinsurance

$45 evaluation copay; then you pay deductible and 20% coinsurance

Outpatient Diagnostic Lab Services

You pay 15% coinsurance

You pay 20% coinsurance

Outpatient Diagnostic Testing and Surgical Services

You pay deductible and 15% coinsurance

$75 copay; then you pay deductible and 20% coinsurance

Advanced Imaging (CT, PET, MRI)

Prior authorization required

$25 copay; then you pay deductible and 15% coinsurance

$50 copay; then you pay deductible and 20% coinsurance

Health Savings Plan

 

SmartCare

Non-SmartCare

Therapy Services (speech, physical, and occupational)

You pay deductible and 5% coinsurance

You pay deductible and 10% coinsurance

Prescription Drug Coverage

Prescription drug copays are changing for two of the health plans:

 

Classic Plan

Premier Plan

 

2020

2021

2020

2021

Tier 1

$17

$18

$12

$14

Tier II

$60

$62

$55

$57

Tier III

$95

$97

$90

$92

Diabetes Management and Healthy Heart Programs

The Diabetes Management Program and the Healthy Heart Program through UMR will not offer $0 medical and supply incentives in 2021, but you may still be eligible for up to $800 in no-cost disposable medical supplies through the health plan. However, you can continue to work with a health coach! Program coaches help you create health care goals and adhere to your treatment plan. If you are identified as high-risk, you may be invited to work with a health coach to bring your health conditions under control. You can also self-enroll by calling UMR Care Management at 866.575.2540.

Health Savings Account

2021 contribution limits will increase:

  • Individual: $3,600
  • Family: $7,200

Remember that an additional $1,000 catch-up contribution is allowed if you are 55 or older by December 31, 2021.

Flexible Spending Account

  • Flexible Spending Account 2020 contribution limits (set by the IRS):
  • Healthcare FSA: $2,750*
  • Dependent Care FSA: $5,000*
  • The annual rollover limit for Healthcare Flexible Spending Accounts (FSAs) will increase to $550 in 2021—a $50 increase from 2020.

*As of October 1, 2020, the IRS has not issued updated limits for 2021. Given campus-level coding and publication deadlines, the University will use 2020 maximums for 2021.

Enrolling for Coverage