Oregon PERS Retirees – Review plan benefits
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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.

UnitedHealthcare® Group Medicare Advantage



UnitedHealthcare® Group Medicare Advantage (PPO)

Annual medical deductible $0

Annual out-of-pocket maximum


Office and clinic visits

$15 copay for primary care
$20 copay for specialist visit

Hospital services (inpatient)

$100 copay per day for days 1-3
$0 copay for days 4 and beyond

Hospital services (outpatient)

$125 copay

Hearing aids $2,400 hearing aid allowance per calendar year*
Calendar year pharmacy out-of-pocket maximum $6,550 per individual

Prescription drug coverage

Retail up to a 31-day supply:

Tier 1 – Preferred Generic: $8 copay
Tier 2 – Generic: $15 copay
Tier 3 – Preferred Brand: 40% coinsurance to $250 max per script
Tier 4 – Non-Preferred Drug: 40% coinsurance to $250 max per script
Tier 5 – Specialty: 40% coinsurance to $250 max per script
  *Hearing aids ordered through providers other than UnitedHealthcare Hearing are not covered

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PERS Health Insurance Program

Group retiree benefits for Oregon PERS Retirees



2022 Plan Change Period

Begins: October 1, 2021
Ends: November 15, 2021



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Last updated: 07.20.2021 at 12:01 AM CT  H2001_020121DMR