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HSA Essential Plan

With this plan, you can use any doctor, clinic, hospital or health care facility you want in our national network.

There’s coverage if you need to go out of the network. However, seeing an out-of-network provider will likely cost you more. If you need to see a specialist, a referral is not required.

Preventive care is covered 100 percent in the network. You don't have to pay any out-of-pocket costs for age-appropriate preventive care as long as you use a network doctor.

View plan benefits

Our comparison chart helps you find your best fit by listing important plan benefits side-by-side.

Plan comparison

Plan at-a-glance

Network coverage

Both network and out-of-network providers covered

Primary care provider

Primary care provider is not required

Copays

Copay due for certain services and prescriptions

Savings account options

Savings account options not offered

Medical annual deductibles and out-of-pocket limits

Deductible amounts

	Network	Out-of-network
Individual	$4,000	$8,000
Family	$8,000	$16,000

Out-of-pocket limits

	Network	Out-of-network
Individual	$7,000	$14,000
Family	$14,000	$28,000

Deductible amounts

	Network	Out-of-network
Individual	$4,000	$8,000
Family	$8,000	$16,000

Out-of-pocket limits

	Network	Out-of-network
Individual	$7,000	$14,000
Family	$14,000	$28,000

Medical costs - copays ($) and coinsurance (%)

Doctors and specialists

	Network	Out-of-network
Preventive care visit	100%	60%
Primary care visit (illness or injury)	80%	60%
Mental health visit (outpatient)	80%	60%
Specialist visit	80%	60%

Virtual, urgent and emergency care

	Network	Out-of-network
24/7 Virtual Visit (online doctor)	80%	60%
Urgent care visit	80%	60%
Emergency room	80%	80%

Doctors and specialists

	Network	Out-of-network
Preventive care visit	100%	60%
Primary care visit (illness or injury)	80%	60%
Mental health visit (outpatient)	80%	60%
Specialist visit	80%	60%

Virtual, urgent and emergency care

	Network	Out-of-network
24/7 Virtual Visit (online doctor)	80%	60%
Urgent care visit	80%	60%
Emergency room	80%	80%

Network coverage

Network coverage plays a big part in delivering you cost savings and quality care. With the network, you'll have access to a group of health care providers and facilities that have a contract with UnitedHealthcare.

Are your providers in network?

The importance of a primary care provider (PCP)

Primary care provider

This plan does not require you to have a primary care provider (PCP), but choosing one for yourself and each covered family member is highly recommended. Your PCP is your health guide - coordinating your care, helping you avoid cost surprises and supporting you in achieving your best health.

Easily find and choose a primary care provider
Click the provider network link above to open the network provider directory for your selected plan.

Then follow these steps:

Under “What type of Medical Care can we help you find near:”, click Change Location, enter your location information, and click Update Location.
Under “Find Care by Category”, select People > Primary Care > All Primary Care Providers to see a listing of PCPs.
Scroll through the listing and select the name of the network PCP you'd like to coordinate your care.
Click on the PCP’s name for the Provider ID number.

Important: For health plans requiring a PCP, a PCP will be selected for you and your covered family members if you don’t pick one by the enrollment deadline. You can change your PCP anytime at myuhc.com.

The importance of a primary care provider (PCP)

Having a PCP to help guide and coordinate your care is important whether or not the health plan you select requires one.

Health Savings Account

This plan comes with an opportunity to open up a health savings account (HSA) — a bank account where you can put money aside, tax-free, to save and pay for eligible health care expenses.

Save today, spend whenever

Spend your HSA money on eligible health expenses now.
Build up your HSA savings and use it later.
Your savings can be carried over year to year, even if you change jobs, health plans, or retire.

Enjoy tax advantages

Money you deposit is federal income tax-free.
Your savings grow income tax-free.
Withdrawals for qualified health care expenses are income tax free.

Use your account easily

Use money in your HSA to pay for qualified health care expenses.
Pay bills online or pay with checks linked to your HSA.
Upload receipts and store them in your own online receipt vault.

HSA eligibility requirements
As defined by the IRS, to be eligible for an HSA you:

Must be covered under a qualifying high-deductible health plan (HDHP) on the first day of the month.
Must not have other health coverage except what is permitted by the IRS.
Must not be enrolled in Medicare, TRICARE or TRICARE for Life.
Cannot be claimed as a dependent on someone else’s tax return.
Have not received Veterans Affairs (VA) benefits within the past three months, except for preventive care. If you have a disability rating from the VA, this exclusion doesn’t apply.

Other restrictions and exceptions may apply. We recommend you consult a tax, legal or financial advisor to discuss your personal circumstances.
Pay for qualified expenses
Your HSA can be used for more than doctor visits.

Once you’ve contributed to your account, use the funds in your HSA to pay for qualified health care expenses such as:

Dental care, including extractions and braces
Vision care, including contact lenses, prescription sunglasses and laser eye surgery
Prescription medications
Certain over-the-counter drugs and medications
Chiropractic and acupuncture services
It’s important to know that you cannot use your HSA to pay for medical expenses you had before you opened your account—so be sure to open your HSA  as soon as you are eligible.

Covered services

Here’s a partial list of covered services when in network:

Preventive Care Service
Doctor Office Visits (both virtual and in-person) and Labs
Emergency and Outpatient Care
Mental Health and Substance Disorder Service
Pregnancy and Newborn Care

For a complete list of covered services, please refer to your Summary of Benefits and Coverage (SBC).

HSA Essential Plan

Compare to help find the right health plan

Plan at-a-glance

Network coverage

Primary care provider

Copays

Savings account options

Medical annual deductibles and out-of-pocket limits

Deductible amounts Deductible amounts

Out-of-pocket limits Out-of-pocket limits

Deductible amounts Deductible amounts

Out-of-pocket limits Out-of-pocket limits

Medical costs - copays ($) and coinsurance (%)

Doctors and specialists Doctors and specialists

Virtual, urgent and emergency care Virtual, urgent and emergency care

Doctors and specialists Doctors and specialists

Virtual, urgent and emergency care Virtual, urgent and emergency care

Network coverage

Are your providers in network?

The importance of a primary care provider (PCP)

Primary care provider

Easily find and choose a primary care provider Easily find and choose a primary care provider

The importance of a primary care provider (PCP)

Health Savings Account

Save today, spend whenever

Enjoy tax advantages

Use your account easily

HSA eligibility requirements HSA eligibility requirements

Pay for qualified expenses Pay for qualified expenses

Covered services

Deductible amounts

Out-of-pocket limits

Deductible amounts

Out-of-pocket limits

Doctors and specialists

Virtual, urgent and emergency care

Doctors and specialists

Virtual, urgent and emergency care

Easily find and choose a primary care provider

HSA eligibility requirements

Pay for qualified expenses