The Retiree Healthy Savings Plan is a high-deductible health plan designed for retirees and their eligible dependents who are not yet Medicare-eligible. It offers comprehensive coverage with lower monthly premiums. The plan is an IRS-qualified high-deductible health plan, which means you can enroll in a Health Savings Account (HSA) if you meet the eligibility requirements.
Plan Availability
Plan Availability
The Retiree Healthy Savings Plan is available to retirees and their dependents who are not yet eligible for Medicare.
For more information on eligibility for benefits coverage, including covering dependents, see Benefit Eligibility & Program Structure.
Costs
Costs
Monthly Cost
Premiums
Your share of premiums is determined by a formula that considers your age, years of service at retirement and the program under which your benefits are payable.
See Retiree Insurance for details on eligibility, subsidy and to estimate premiums.
For plan information, refer to the Summary Plan Description (SPD).
Amount Owed Before Insurance Pays
Deductible
The Retiree Healthy Savings Plan has one deductible that combines both medical and prescription drug costs.
- Medical and Rx deductible (combined):
- In-network: $3,000/self; $6,000/family
- Out-of-network: $6,000/self; $12,000/family
Only the individual or family deductible must be satisfied based on self or family coverage.
Max You Pay Annually
Out-of-Pocket Limit
The Retiree Healthy Savings Plan has one out-of-pocket limit that combines both medical and prescription drug costs.
- Medical and Rx out-of-pocket limit (combined):
- In-network: $6,000/self; $12,000/family
- Out-of-network: $12,000 or more/self; $24,000 or more/family
Once the annual out-of-pocket limit is met, the plan pays 100% of covered services for the rest of the year.
Covered Services
Covered Services
You may choose to visit either in-network or out-of-network physicians and other providers. Your costs will be discounted, however, when you select in-network providers. You pay the total of the discounted price until the deductible is met.
See Plan Contacts & Provider Directories
| Service | In-Network Cost | Out-of-Network Cost** |
|---|---|---|
| Preventive Care | $0 | 40% or more after deductible |
| Primary Care | 30% after deductible | 40% or more after deductible |
| Specialist Care | 30% after deductible | 40% or more after deductible |
| Urgent Care | 30% after deductible | $100 copay/visit or more |
| Lab & X-Ray | 30% after deductible | 40% or more after deductible |
| Outpatient Care | 30% after deductible | 40% or more after deductible |
| Inpatient Care (includes maternity delivery) | 30% after deductible | 40% or more after deductible |
| Durable Medical Equipment | 30% after deductible | 40% or more after deductible |
| Emergency Room | 30% after deductible | $250 copay/visit or more after deductible |
| Ambulance | 30% after deductible | 10% or more after deductible |
**Refer to the Summary Plan Description (SPD) for additional details on allowable and eligible expenses when using an out-of-network provider.
Prescription Drugs
Prescription Drugs
The cost of prescription drugs is discounted in-network based on the University¡¯s negotiated rate. You pay the total of the discounted price until the deductible is met. For out-of-network claims, members pay the difference between the non-participating and participating pharmacy charge.
Specialty medications are managed and processed through ArchimedesRx. For retail drugs, 90-day fills or refill at Mizzou pharmacies are the same cost as mail-order.
| Prescription Type | In-Network | Out-of-Network |
|---|---|---|
| Retail (Formulary Generic, Formulary Brand or Non-Formulary Brand) | 30% after deductible | 40% or more after deductible |
| Mail (Formulary Generic, Formulary Brand or Non-Formulary Brand) | 30% after deductible | 40% or more after deductible |
Refer to the Summary Plan Description (SPD) for additional details on allowable/eligible expenses when using an out-of-network provider.
Consider a Health Savings Account (HSA)
Consider a Health Savings Account (HSA)
If you meet the eligibility requirements, you may contribute your own after-tax money to a Health Savings Account (HSA). Retirees do not receive University contributions toward an HSA, but you may set up an HSA account if you are not enrolled in another insurance plan, including Medicare.
Making the Most of Your Coverage
Making the Most of Your Coverage
Whether you¡¯re learning about retiree insurance or already enrolled in a medical plan, you can use these resources to take the next steps. Find out more about enrolling or making plan changes, learn how to make the most of your insurance day-to-day, and explore how coverage applies to specific health needs.
Notice of Nondiscrimination
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Call UnitedHealthcare at 1-844-634-1237 for translation assistance.
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