UC Care is a PPO plan created just for UC. You can get care from most UC physicians and medical centers as well as the Blue Shield Preferred network of providers — the choice is yours. You also have coverage for non-network providers.
How the plan works
- You may choose any doctor or care facility, worldwide.
- You have two options for in-network care:
- You pay set copayments for covered services and there’s no deductible when you use providers in the UC Select network (available only in California).
- You also can choose a provider in the Blue Shield Preferred network and pay 20% of the cost of service after the deductible has been met.
- The Blue Shield Preferred network has a $250 deductible for individual coverage and $750 deductible for a family of three or more.
- Or, you can choose a non-preferred or out-of-network provider and pay 50% of the cost. There is a $500 deductible for individual coverage and $1,500 deductible for a family of three or more.
- Annual out-of-pocket maximums limit what you pay. If you reach the annual maximum, the plan pays 100% of your covered medical costs for the rest of the year. There is a separate prescription out-of-pocket for in-network prescriptions filled at in-network pharmacies.
- UC Select: $1,500/individual; $4,500/family
- Blue Shield Preferred: $3,000/individual; $9,000 family
- Out-of-network: $5,000/individual; $15,000 family
- Blue Shield will administer claims.
- Behavioral health benefits are provided by Optum. Optum providers generally have lower costs, but you also may use out-of-network providers. Costs are included in your deductible and out-of-pocket maximums.
Best fit for you if:
- You want direct access to most providers without a referral
- You want no deductible and fixed copay for using providers in the UC Select network
- You want coverage when you are traveling or living abroad
- You and/or your family members live outside California
Monthly plan costs
|Pay Band (per annum)||Self||Self +
|$51,000 and under||Employee Cost||$114.92||$206.86||$296.33||$388.26|
|$153,001 and above||Employee Cost||$226.28||$407.31||$528.81||$709.83|
Typical out-of-pocket costs
- Office visit/urgent care visit: UC Select: $20; Blue Shield Preferred: 20%; out-of-network: 50%; (preventive care with in-network provider has no charge)
- Emergency room visit not resulting in an admission: $200
- Hospital stay (facility only): UC Select: $250; Blue Shield Preferred: 20%; out-of-network: 50%
- Prescription drugs: $5, generic; $25, brand name; $40, non-formulary; specialty 30% for 30 day supply (up to $150 copayment maximum)