HP Retirees – Review Plan Benefits
UnitedHealthcare®
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Review plan benefits & costs

Get a quick overview of your plan benefits and costs, and find more detailed information about additional coverage and benefit services. Note that you must be enrolled in Medicare Part A and Part B to be eligible for our retiree plans and you must continue to pay your Part B premium to the government as well as the employer-requested premium.

UnitedHealthcare® Group Medicare Advantage
(PPO) Core

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UnitedHealthcare® Group Medicare Advantage
(PPO) Plus

Benefits and costs UnitedHealthcare Group Medicare Advantage (PPO) Core UnitedHealthcare Group Medicare Advantage (PPO) Plus
Annual medical deductible $325 $0
Annual out-of-pocket maximum $3,000 $2,000
Office and clinic visits $30 copay for primary care

$40 copay for specialist visit
 
$25 copay for primary care

$35 copay for specialist visit
 
Hospital services (inpatient) $230 copay days 1-7

$0 copay days 8-999
 
$200 copay days 1-8

100% covered days 9+
Hospital services (outpatient) 20% coinsurance for observation, medical and surgical care
 
20% coinsurance for observation, medical and surgical care
Prescription drug coverage Retail

Tier 1: $10 copay
Tier 2: 30% coinsurance up to $45
Tier 3: 40% coinsurance up to $65

Mail Order (up to 90-day supply)

Tier 1: $20 copay
Tier 2: 30% coinsurance up to $112.50
Tier 3: 40% coinsurance up to $165
Retail

Tier 1: $10 copay
Tier 2: $35 copay
Tier 3: $50 copay

Mail Order (up to 90-day supply)

Tier 1: $20 copay
Tier 2: $90 copay
Tier 3: $125 copay

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Group retiree benefits for HP

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IMPORTANT DATES

2021 Open Enrollment Period

Began: 10/12/2020
Ended: 10/30/2020

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Last updated: 07.20.2021 at 12:01 AM CT  H2001_020321IMR