Medical Plans

The University offers three medical plan options: Aetna Select 1, Aetna Select 2, and the HRA. Your premiums, deductibles, copays and other costs vary depending on the plan you select.

Medical Plan Options
Medical Premiums
Medical Plan Comparison Chart
Behavioral Health Comparison Chart
Telemedicine
Healthy ‘Canes Clinic
UHealth at Walgreens
Additional Information
Save and Receive Quality Care at UHealth
Urgent Care Centers
Contact Aetna

Medical Plan Options

AETNA SELECT 1
The Aetna Select 1 plan offers access to a national network of providers and facilities. There are no out-of-network benefits. The Aetna Select 1 plan has a $200 deductible per person, up to $600 maximum. Once the deductible is met, participants pay copays for services. Preventive care is free and bypasses the deductible. Prescription drugs also bypass the deductible, but require copays.*

AETNA SELECT 2
The Aetna Select 2 plan offers access to a national network of providers and facilities. There are no out-of-network benefits.The Aetna Select 2 plan has a $300 deductible per person, up to $900 maximum. Once the deductible is met, participants pay copays for services. Preventive care is free and bypasses the deductible. Prescription drugs also bypass the deductible, but require copays.*

To find an Aetna Select 1 or 2 provider, visit www.aetna.com and click “Find a Provider” from the homepage. Search for providers in the “Aetna Select Open Access” Network.

HRA
The HRA plan offers access to a national network of providers and facilities and out-of-network benefits (at higher costs). The plan has a $400 per person health fund - paid by UM - to help pay for up front medical expenses, including the $1,500 per person deductible. In-network preventive care is free and bypasses the deductible. However, prescription drugs do not bypass the deductible, which must be met prior to copays.* 

The maximum fund a family will receive is $1,200. The unused funds roll over each year. Click here to view a presentation explaining how the HRA Plan works and here for a Quick Start Guide.

To find an HRA provider, visit www.aetna.com and click “find a provider” from the homepage. Search for providers in the “Choice POS II Open Access” Network. 

*Note, any prescription NOT covered by OptumRx is the full responsibility of the member and WILL NOT be applied toward your deductible or out-of-pocket maximum.

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2020 Medical Premiums

Faculty and Staff
University of Miami Medical Group (UMMG)
University of Miami Hospital (UMH)(biweekly)
Residents
Part-Time Faculty and Staff
Part-Time UMMG
Part-Time UMH
Long-Term Disability Faculty and Staff
Long-Term Disability UMMG
Early Retirees
COBRA

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 Medical Plan Comparison Chart

Review and compare plan details including copays, deductibles and out-of-pocket maximums.

2020 Medical Plan Comparison Chart

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Behavioral Health Comparison Chart

Review and compare plan details including copays and coinsurance.

2020 Behavioral Health Comparison Chart

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Telemedicine

In ongoing support of the health and well-being of our UM/Aetna medical plan members during the COVID-19 outbreak, Aetna is removing barriers to care and offering the following services for members (as of March 10, 2020):

Healthy ‘Canes Clinic

The Healthy ’Canes Employee Clinic is a UM Well ’Canes benefit for faculty and staff and their dependents, offering convenient access to UHealth medical services for common illnesses. Visits to the Healthy ’Canes Clinic are solely on a walk-in basis and services are provided for the low cost of $5 per visit. Each clinic is staffed by a UHealth nurse practitioner overseen by UHealth physicians.

For location information and operating hours, please visit www.healthycanesclinic.com.

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UHealth at Walgreens

UHealth Clinic at Walgreens provides convenient care from the experts you trust and is operated by the University of Miami Health System. UHealth at Walgreens provides faculty, staff and their dependents, with convenient access to UHealth medical services for common illnesses, seven days a week. Services at UHealth at Walgreens are provided for the low cost of $5 per visit. 

For location information and operating hours, please visit umiamihealth.org/patients-visitors/walgreens-clinics.

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Additional Information

• Dependents, up to age 26, are eligible for health coverage regardless of education, job, or marital status.
• If you are a smoker, your monthly premium will be increased by $100. If your spouse is a smoker, your monthly premium will be increased by an additional $100. If both of you are smokers, your monthly premium will increase by $200. To waive this surcharge, the individual must have been smoke free for 12 months at the time of initial enrollment or annual Open Enrollment, or the individual must have successfully completed the University’s BeSmokeFree smoking cessation program. 
• A $350 monthly spousal surcharge will apply to spouses who are eligible to participate in their employer sponsored medical plan (regardless of the cost), but choose to participate in the University’s group medical plan. The surcharge is waived if the spouse does not have access to medical coverage through his/her employer, is an employee of the University, or is on Medicare/Medicaid. If a spouse becomes eligible for or loses coverage during the plan year, HR-Benefits must be notified of the change within 30 days of the change via Workday.
• Only University employees, who are the primary subscriber on the UM/Aetna plan, are eligible for coverage of bariatric surgery. Additional information on employment, provider and clinical requirements can be found here.
• If you participate in both the Aetna HRA medical plan and a health care FSA, you will receive one WageWorks Visa card with both HRA and FSA funds on the card. HRA funds will be used for eligible medical and prescription expenses before flexible spending account funds are utilized.
• If you experience a qualifying status change (life event), HR-Total Rewards must be notified of the change within 30 days of the date of the event via Workday. Any changes made will be retroactive to the date of the event (such as marriage date) and the employee will be responsible for any owed premiums (if applicable).

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Save and Receive Quality Care at UHealth

Pay lower copays at UHealth.  To schedule an appointment with one of our 1,100 UHealth physicians, call UHealth Connect at 305-243-CARE (2273). This employee-dedicated appointment line is staffed to serve you and your family quickly and efficiently. The line is available only to UM employees and their immediate families. We hope this service will help enhance your UHealth experience. Call today.

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Contact Aetna

1-800-824-6411
www.aetna.com

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