Officers - Medical Coverage

The University offers four comprehensive medical plan options through UnitedHealthcare (UHC). 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 Plans

If you enroll in a medical plan, you will be automatically enrolled in prescription drug and vision coverage.

All of the University's medical plans cover the same comprehensive set of services, and provide in-network preventive care, such as annual physicals, immunizations and well-baby visits, paid at 100% with no deductible. To manage disease and chronic illness, Health Condition Services are provided at no extra cost to you. You have the flexibility to use in-network or out-of-network providers each time you seek care. However, you can minimize your out-of-pocket expenses when you use in-network providers.

Medical Plan Descriptions

All University medical plans cover medically-necessary services and supplies for the purpose of preventing, diagnosing or treating an acute sickness, injury, mental illness, substance abuse or symptoms. For details on medical plans, review the Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC)

Important Note on Referrals and 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.

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.

Consider the Costs

As with any major purchase decision, cost will likely play a factor when selecting your medical plan. But costs can be difficult to accurately calculate. Lower payroll deductions might make a particular plan option look inexpensive, but you may have a higher deductible to meet. Or, a particular option may have higher payroll deductions, but lower costs when you receive care. Since everyone is different—requiring different levels of care—it is important to consider the total costs for each medical plan option: the cost you pay at the time you use health care (e.g., your deductible, coinsurance or copay) plus the cost you pay out of your paycheck. If you don’t take the time to consider the total cost of each medical plan, you may end up paying for more coverage than you need.

Use SmartSelect, a comparison tool on CUBES, to help determine which medical plan is best for you. You can model different health scenarios for yourself and your family to estimate what your total out-of-pocket costs will be.

Other than preventive care and copays, for most in-network medical services you must meet an annual deductible of $600 per member before the Plan pays the coinsurance of 80% of the negotiated fee; you are responsible for the remaining 20% of the coinsurance. After you reach the in-network out-of-pocket maximum of $3,750 for an individual and $7,500 for a family, the Choice Plus 80 plan pays 100% of covered in-network medical charges and prescription drug copays for the remainder of the calendar year. Most out-of-network services are covered at 60%* after the annual deductible of $850 per member.

* Eligible expenses are determined in accordance with the Claims Administrator's reimbursement policy. For more information contact UHC at 800-232-9357.

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 Plan pays 100% of covered in-network medical charges and prescription drug copays for the remainder of the calendar year. Most out-of-network services are covered at 60%* after the annual deductible of $850 per member.

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

The Choice Plus 100 plan has a $200 deductible for some in-network services, such as such as professional fees for surgical and medical 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 Plan pays 100% of covered in-network medical charges for the remainder of the calendar year. Most out-of-network services are covered at 60%* after the annual deductible of $850 per member.

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

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

Columbia University offers a High Deductible Health Plan (HDHP) that provides comprehensive coverage through UHC. The Plan has low monthly contributions in exchange for a higher deductible and out-of-pocket maximum. If you elect the HDHP, you can enroll in a Health Savings Account (HSA), a portable, personal savings account that lets you set aside pre-tax dollars to use for eligible healthcare expenses now or in the future. Note: If you enroll in the HSA, you cannot enroll in the Healthcare FSA at the same time.

What You Need to Know About the HDHP

  • Preventive medical care is covered at 100% with no deductible when you use an in-network provider.
  • For non-preventive care—and non-preventive drugs—you pay for your expenses until you reach your deductible: $1,600 for individual coverage or $3,200 for family coverage.
  • For family coverage, the entire deductible must be met, even if only one family member has expenses. There is no individual deductible when you elect family coverage.
  • After you reach the deductible, the Plan begins to pay for covered services.
  • Any additional medical expenses are shared between the Plan and you as coinsurance. The Plan’s coinsurance is 90% and your coinsurance is 10%.
  • When your coinsurance, plus deductible and prescription drug copays reach the out-of-pocket maximum, the Plan pays 100% of your remaining in-network covered medical services, including prescription drug costs, for the rest of the calendar year. The out-of-pocket maximum for in-network expenses is $3,650 for individual coverage or $7,300 for family coverage. For family coverage, the entire out-of-pocket maximum must be met, even if only one family member has claims. Most out-of-network services are covered at 60%* after the annual deductible of $2,900 per member.

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

 

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

Plan Comparisons & Costs

HDHP vs. Choice Plus Plans

*IRS limits are subject to change.
 

View the Officers - Medical Plan Comparison 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 for your medical, vision and prescription drug coverage are deducted from your pay before any taxes are taken out.

Cost of Coverage: Your Contributions

Use SmartSelect, the medical comparison tool in CUBES, to model different health scenarios, estimate out-of-pocket costs, and determine which medical plan is best for you and your family. SmartSelect can use your past calendar year’s health claims if you were enrolled in a University medical plan last year.

In-Network vs. Out-of-Network Coverage

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.

For the 80, 90 and 100 medical plans, you pay a $30 copay for physician office visits (including specialists and urgent care), when you use UHC network providers. Preventive care is covered at 100% with no deductible for in-network services. The deductible, coinsurance and all medical and prescription drug copays accumulate toward your annual out-of-pocket maximum.

Out-of-network services are covered identically by each of the University’s medical plans, and are subject to the out-of-network deductible and out-of-pocket maximum. You can use out-of-network providers for preventive services, subject to a separate deductible and coinsurance.

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.

Medical Coverage When Traveling

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.

The Cigna International Plan provides comprehensive coverage if you are traveling outside the U.S. for six months or more while still on the University’s U.S. payroll. To cover any dependents,  you must have this coverage as well.

Benefits include:

  • Easy access to comprehensive, quality healthcare anywhere in the world
  • 24/7 support; collect calls accepted
  • 24/7 connection to the nearest and most appropriate physician or hospital

If you believe you are eligible for this medical plan option, contact the Columbia Benefits Service Center at 212-851-7000 or [email protected] for more information, including monthly rates.

In the event of an emergency, if on Columbia business abroad, call International SOS:
+1-215-942-8478.

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

When you are covered under the University's Basic Term Life Insurance Plan, you and your eligible dependents are also covered for emergency travel assistance. 

For more information, 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.