NUSS - Medical Coverage

NUSS Medical Coverage

Columbia University offers the UnitedHealthcare Choice Plus 90 and Choice In-Network medical plans to Non-Union Support Staff and their families. Each plan includes vision and prescription drug coverage. 

If you are enrolled in any of the University’s medical plans, you will have access to Primary Care through Columbia Doctors

Medical Plan Coverage

The Choice Plus 90 and Choice In-Network medical plans cover the same comprehensive set of medically-necessary services and supplies, including in-network preventive care—such as annual physicals, immunizations and well-baby visits—at 100% with no deductible, and coverage for out-of-network services. To manage disease and chronic illness, Health Condition Services are provided at no extra cost to you.

For details on medical plan options and coverage specifics, review each plan's Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC)

Preventive care is covered at 100%. Other than preventive care and copays, for most in-network medical services you must meet the annual deductible of $400 per member before the Choice Plus 90 plan pays the coinsurance of 90% of the negotiated fee; you are responsible for the remaining 10% of the coinsurance. After you reach the in-network out-of-pocket maximum of $3,250 for an individual and $6,500 for a family, the Choice Plus 90 plan pays 100% of covered in-network medical charges and prescription drug copays for the remainder of the calendar year.

Preventive care is covered at 100%.

The Plan has a $300 for all in-network services.

Copays apply for certain services and in some cases are dependent on where the service is received. For example, inpatient hospital services require a $500 per admission copay; outpatient hospital services, including lab and radiology, require a $150 copay. In addition, after you reach the in-network out-of- pocket maximum of $4,750 for an individual and $9,500 for a family, the Choice In-Network plan pays 100% of covered medical charges for the remainder of the calendar year. Out-of-network services are not covered.

Note: The $150 outpatient hospital copay does not apply if you obtain your lab and/or radiology at certain New York Presbyterian (NYP) locations. See list of participating NYP locations.

Whenever you are having diagnostic or preventive tests, be sure to ask your physician if he/she is referring you to a provider who is in-network.

View the NUSS - Medical Plan Summary Chart.

Important Notes on Referrals 

United Healthcare’s (UHC) Choice network is a national provider network. It does not require a primary care physician or referrals to see specialists. UHC does require precertification for some services. If you use an in-network provider, your participating network physician or hospital generally handles the precertification process. It is your responsibility to confirm your provider has obtained the necessary authorizations from UHC. If you see a provider who is out-of-network, you are responsible for obtaining precertification for most services except routine office visits.

Contributions are the amount you pay toward the cost of your medical, vision and prescription drug (“Rx”) coverage through pre-tax payroll contributions. Your healthcare contributions are deducted from your pay before any taxes are taken out.

2024 Monthly Contributions for Medical & Rx

University Contribution to Healthcare FSA

If you enroll in the Choice Plus 90 plan, you will automatically receive a University contribution to the Healthcare FSA (see FSA Contribution).

In-Network

In both plans, you pay a $30 copay for physician office visits (including specialists and urgent care) when you use a UHC network provider. Preventive care is covered at 100% with no deductible for in-network services. 

Out-of-Network

Out-of-network services are covered under the UHC Choice Plus 90 medical plan, and are subject to deductibles and out-of-pocket maximums. You are responsible for obtaining precertifications from UHC before most non-office visit treatment begins, and within 48 hours of an emergency hospital admission. If you do not obtain precertification, you will be subject to a $500 penalty.

Eligible expenses are determined in accordance with the claims administrator's reimbursement policy. For more information, contact UHC at 800-232-9357.

Out-of-Pocket Maximum

The in-network deductible, coinsurance and medical and prescription copays accumulate toward the in-network out-of-pocket maximum. In addition, under the Choice Plus 90 plan, out-of-network out-of-pocket eligible expenses accumulate toward the in-network out-of-pocket maximum.

Important Notes on Precertification

UHC’s Choice network is a national provider network and does not require a primary care physician or referrals to see specialists. UHC requires precertification for some services. If you use an in-network provider, your participating network physician or hospital generally handles the precertification process. However, it is your responsibility to confirm that your provider has obtained the necessary authorizations from UHC. If you see a provider who is out-of-network, you are responsible for obtaining precertification for most services except routine office visits.

If you are traveling out of the country, travel vaccinations will be covered under the medical plan.

Emergency Travel Assistance

If you travel 100 miles or more from home or abroad and need assistance, see the Emergency Travel Assistance program.

Global Travel Support 

The University maintains additional travel resources to support Columbia-related travel. To learn more—and register your trip—please visit globaltravel.columbia.edu.

Find basic information on the Patient Protection and Affordable Care Act (ACA).

Columbia University provides enhanced gender-affirming benefits to you and your family through UnitedHealthcare (UHC). Learn more.

Columbia University faculty and staff traveling outside the U.S. for Columbia Travel for less than 6 months automatically have health insurance coverage through Zurich Travel Assist.

Administered in conjunction with International SOS (ISOS), Zurich Travel Assist provides full coverage for illness and injury that occur while abroad. Medically-necessary services are covered at no cost if ISOS is contacted for assistance before a patient is treated. 

Zurich Travel Assist health coverage is coordinated through ISOS. In the event of an emergency while traveling outside of the U.S. for Columbia Travel, call ISOS at +1-215-942-8478 or use the ISOS mobile app.

For more information, go to CU Global Travel.

In the event of an emergency, if on Columbia business abroad, call International SOS: 215-942-8478.

If you travel 100 miles or more from home or abroad and need assistance, go to Emergency Travel Assistance.

Information Notice

ID Card

UHC ID cards have member information for medical, vision, and prescription drug coverage. You do not need separate cards for each benefit. After enrolling in a medical plan, it can take three weeks for a UHC ID card to arrive in your mail. If necessary, you can print a temporary UHC ID card two weeks after enrolling. Create an account on myuhc.com to print a temporary ID card. Use your Social Security Number, date of birth, and Group number 712790.