Officers - Medical Coverage

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.}

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

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.

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.

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.