Health plan options

What you’re getting

You have two plan options – the PPO plan or the High Deductible Health Plan (HDHP). Whichever you choose, you’re signing up for quality care that goes where you go, and the extra support you need to get the most from your plan. With UnitedHealthcare, you get:

A national network of over 1.8 million providers and 5,600 hospitals, so you can choose from a robust network of health care professionals and sites, including Mayo Clinics¹
A statewide network of 32,000+ providers and 76 hospitals¹ that lets you stay within Arizona and is extensive enough to meet most of your health needs
Specialist visits without a referral, saving you time when a concern won’t wait
Mental health benefits, including virtual behavioral health visits and digital tools – like the Calm Health app – that make it easier to get help anywhere
24/7 Virtual Visits, giving you access to urgent or routine care around the clock – from doctors on myuhc.com® or the UnitedHealthcare app – anywhere you are
Virtual primary and specialty care lets you visit with a PCP for things like annual checkups or see a specialist for a range of conditions – all via video, phone² or chat.
Condition management and wellness programs, to help you get – and stay – healthier, including the One Pass Select® fitness discount program with flexible membership options

Support above and beyond

You’ll get the information and advocacy to help you get the most of your health and wellness benefits:

24/7 Nurse Support lets you chat with a registered nurse anytime, day or night, for answers or guidance
If you have a device – computer, tablet or smartphone² – you can see a doctor or behavioral health specialist through virtual care
Advocacy for families who have children with complex medical needs offers one-stop support from a dedicated advisor, removing barriers and easing access to care
Maven offers 24/7 maternity care – virtual support and guidance for your pregnancy, postpartum and newborn journey
Real Appeal® is a digital program that helps guide, support and inspire you on your path to healthy weight management
Naviguard gives you help with unexpected, out-of-network medical bills over $300 by negotiating directly with providers on your behalf – at no additional cost with your plan (see the Resources)

All your health plan info in one place

The UnitedHealthcare secure member website, myuhc.com, is your personalized health plan hub, letting you search for care or see your plan information at a glance – on a smartphone, tablet or computer.

Easy care search for a provider, clinic, hospital or lab based on location, specialty, cost, services and more – plus, see how other patients rated them
Cost estimator that lets you estimate treatment costs before deciding where to go
Current claim information – whether claims history or their status right now – along with the ability to track, personalize and manage your claims
Benefit information and plan materials, including your Explanation of Benefits (EOB)
Options for replacing or printing a lost health plan ID card
Wellness tools, along with tips on healthier living and how to use your benefits to your best advantage
Care reminders, from when to schedule checkups and treatments to suggestions on immunizations, well visits, routine tests or lab work
24/7 Virtual Visits, virtual primary care and virtual specialty care right from your member site

Did you know?: The UnitedHealthcare app lets you access many of the same services as on myuhc.com

Options that fit the way you live

Get a closer look at the benefits of the PPO and HDHP plans.

How the plans compare

With both the PPO and High Deductible Health Plan (HDHP), you’ll have network and out-of-network coverage, including access to our UnitedHealthcare Premium® Care Physicians. Other benefits of both plans include:

100% coverage for preventive care when you use a network provider
Robust national network coverage that means one less stress when you travel
If you’re not yet a UnitedHealthcare member, you can find network providers easily with our online search tool (see the Providers section)
Out-of-network providers are covered, but will likely charge you more – plus you’ll be responsible for filing your own claims

Why Premium Care Physicians?: They are screened to meet the UnitedHealth Premium quality care criteria, which includes safe, timely, effective and efficient care. Premium providers are listed on myuhc.com and the UnitedHealthcare® app – just look for the two blue hearts.

What are the differences?

The primary difference between the two plans is the amount of your copay or deductible when you get care (See next tab for a full breakout).

With the PPO plan:

You’ll pay $0 deductible for non-preventive care when you use a network provider
If you go out-of-network, you’ll have a deductible to meet before the plan will start to pay; after that, you’ll be responsible for coinsurance with most services³
You will also have the option of a flexible spending account (FSA), which is a pre-tax way to help you pay eligible medical expenses

With the HDHP:

For all non-preventive care, you’ll have a deductible to meet before the plan will start to pay; after that, you’ll be responsible for coinsurance with most services³
You’ll be eligible to open a health savings account (HSA), another pre-tax way to save for qualified health costs
The plan is open only to current employees; retirees are not eligible

Plan comparison chart

Plan year deductible	January 1–December 31		January 1–December 31
	PPO		High Deductible Health Plan
	Network	Out-of-network	Network	Out-of-network
Individual	$0	$5,000	$1,700^	$5,000^
Family	$0	$10,000	$3,400^	$10,000^
Out-of-pocket limit
Individual	$7,350*	$8,700*	$3,500^^	$8,700^^
Family	$14,700*	$17,400*	$7,000^^	$17,400^^
Health savings account (HSA) employer contribution ^^^
Individual	Not applicable		$720^^^
Family	Not applicable		$1,440^^
Preventive care services Including preventive office visits, lab, radiology and other tests	No charge	You pay 50% after deductible	No charge	You pay 50% after deductible
Primary care office visit PCP: General practice, OB/GYN, internal medicine and pediatrician	$25 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Specialist office visit	$45 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Virtual visit	$25 copay	You pay 50% after deductible	You pay 10% (no deductible applies)	You pay 50% (after deductible)
Urgent care	$80 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Emergency room (ER copay waived if admitted)	$250 copay	$250 copay	You pay 10% after deductible	You pay 10% after deductible
Inpatient hospital	$300 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Outpatient facility	$150 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Lab & X-ray services	No charge or $0 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Major radiology	$100 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Maternity services Includes initial office visit, pre-natal, and post-natal care	$25 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Behavioral health, mental health & substance abuse services
Inpatient	$300 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible
Outpatient	$25 copay	You pay 50% after deductible	You pay 10% after deductible	You pay 50% after deductible

Tips for using your plan

Whichever plan you choose:

Choose a primary care physician (PCP) who’s in the network
Schedule preventive care with your PCP – it’s covered at no extra cost when you use a network provider
Avoid going out-of-network whenever possible, as it may mean higher or surprise costs
Register for myuhc.com® to track your expenses, find network providers and get estimates
Use the UnitedHealthcare 24/7 Nurse Support whenever possible for guidance to appropriate care (at no additional cost)
Schedule 24/7 Virtual Visits as a less-expensive, more convenient alternative to urgent care or the emergency room

If you choose the PPO:

Choose a Premium Care Physician for primary care
If you’re visiting a specialist, make sure the specialist is a Premium Care Physician too
Open a flexible spending account (FSA) to help pay for your medical, dental and vision expenses with pre-tax dollars
Be sure to use all the money you’ve put into your FSA so you don’t lose it when your plan year ends

If you choose the High Deductible Health Plan:

Choose a Premium Care Physician
Be sure to open your health savings account (HSA) so you don’t miss out on contributions from your state agency
Try to also make your own HSA contributions, since the contributions are taken pre-tax
Note that some members deposit the difference in premium between the High Deductible Health Plan and the PPO Plan into their HSA

Want to be walked through the plan differences?

Click on the videos below for each plan.
PPO plan
High Deductible Health plan

Footnotes

¹As of June 2025.
²Data rates may apply.
³Consult your plan materials for detailed benefit information.
*Deductible and copayments for covered medical and pharmacy services apply to the out-of-pocket maximum. Once the out-of-pocket maximum has been reached for the year, the Plan will pay 100% for all covered services the remainder of the year.
^If more than one person is covered under the Plan, the family deductible must be met before the Plan will start to pay. The deductible applies to all covered medical and pharmacy services.
^^If more than one person is covered under the Plan, the family out of pocket must be met. Deductible, coinsurance, and copays for covered medical and pharmacy services apply to the out of pocket maximum. Once the out of pocket has been met, the Plan will pay 100% for all covered services the remainder of the year.
^^^Applies to HDHP election only. Contribution made after account has successfully been opened. Annual contribution calculation based on 26 pay period cycles of $27.69 individual / $55.38 family.

Virtual Education Center

State of Arizona