2025 INDIVIDUAL & FAMILY PLANS
We believe in the power of collaboration which leads to greater value, healthier members, and higher consumer satisfaction. This includes integration with — our clients, members, and leading healthcare systems.
If you live in Salt Lake or Davis County (* except Bingham Canyon—zip code 84006), you are eligible for U Health Plus — the lowest-premium product offered by University of Utah Health Plans.
Healthy Premier is one of Utah’s largest provider networks with access to U of U Health, Holy Cross Hospitals, MountainStar Healthcare, and many other local, award-winning hospitals and providers.
Highlights:
Select a plan for more details:
- Healthy Premier Gold COPAY
- U HEALTH PLUS GOLD
- HEALTHY PREMIER GOLD STANDARD
- U HEALTH PLUS GOLD STANDARD
- HEALTHY PREMIER SILVER ELECT COPAY (OFF)
- HEALTHY PREMIER SILVER COPAY
- U HEALTH PLUS SILVER
- HEALTHY PREMIER SILVER STANDARD
- U HEALTH PLUS SILVER STANDARD
- U HEALTH PLUS BRONZE
- HEALTHY PREMIER EXPANDED BRONZE STANDARD
- U HEALTH PLUS EXPANDED BRONZE STANDARD
- HEALTHY PREMIER BRONZE HSA
HEALTHY PREMIER GOLD COPAY
FEATURES | |
Annual Deductible (individual/family)* | $1,500 / $3,000 |
Prescription Drug Deductible (individual/family)* | $500 / $1,000 |
Annual Out-of-Pocket Maximum (individual/family) | $7,000 / $14,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | $200 copay/visit AD |
Urgent Care | $25 copay/visit DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $25 copay/visit DW |
Mental Healtd/Substance Abuse Services | $25 copay/visit DW |
Specialty Care | $40 copay/visit DW |
Otder Practitioner Care | $40 copay/visit DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 20% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 20% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prostdetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birtd. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | |
$15 copay DW | |
Formulary Preferred Brand Drugs (Tier 2) | $30 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 20% Co AD |
Radiology Services | 20% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 20% Co AD |
Medical / Surgical Services | 20% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 20% Co AD |
Hospice Care | 20% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | $250 copay/trip AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 20% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
U HEALTH PLUS GOLD
FEATURES | |
Annual Deductible (individual/family)* | $1,500/$3,000 |
Prescription Drug Deductible(individual/family)* | $500/$1,000 |
Annual Out-of-Pocket Maximum (individual/family) | $7,000/$14,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | $250 copay AD |
Urgent Care | $0 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $0 copay DW |
Mental Health/Substance Abuse Services | $0 copay DW |
Specialty Care | $50 copay DW |
Other Practitioner Care | $50 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 20% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 20% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $15 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $30 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 20% Co AD |
Radiology Services | 20% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 20% Co AD |
Medical / Surgical Services | 20% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 20% Co AD |
Hospice Care | 20% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | $250 copay/trip AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 20% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
HEALTHY PREMIER GOLD STANDARD
FEATURES | |
Annual Deductible (individual/family)* | $1,500/$3,000 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $7,800/$15,600 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 25% Co AD |
Urgent Care | $45 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $30 copay DW |
Mental Health/Substance Abuse Services | $30 copay DW |
Specialty Care | $60 copay DW |
Other Practitioner Care | $60 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | $30 copay DW |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | $30 copay DW |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $15 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $30 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | $60 copay DW |
Specialty Drugs (Tier 4) | $250 copay DW |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 25% Co AD |
Radiology Services | 25% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 25% Co AD |
Medical / Surgical Services | 25% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 25% Co AD |
Hospice Care | 25% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 25% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 25% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
U HEALTH PLUS GOLD STANDARD
FEATURES | |
Annual Deductible (individual/family)* | $1,500/$3,000 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $7,800/$15,600 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 25% Co AD |
Urgent Care | $45 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $30 copay DW |
Mental Health/Substance Abuse Services | $30 copay DW |
Specialty Care | $60 copay DW |
Other Practitioner Care | $60 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | $30 copay DW |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | $30 copay DW |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $15 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $30 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | $60 copay DW |
Specialty Drugs (Tier 4) | $250 copay DW |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 25% Co AD |
Radiology Services | 25% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 25% Co AD |
Medical / Surgical Services | 25% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 25% Co AD |
Hospice Care | 25% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 25% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 25% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
HEALTHY PREMIER SILVER ELECT COPAY (OFF)
FEATURES | |
Annual Deductible (individual/family)* | $4,500/$9,000 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $8,500/$17,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | $500 copay AD |
Urgent Care | $30 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $30 copay DW |
Mental Health/Substance Abuse Services | $30 copay DW |
Specialty Care | $75 copay DW |
Other Practitioner Care | $75 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $25 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $40 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 40% Co AD |
Radiology Services | 40% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 40% Co AD |
Medical / Surgical Services | 40% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 40% Co AD |
Hospice Care | 40% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | $250 copay/trip AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 40% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
HEALTHY PREMIER SILVER COPAY
FEATURES | |
Annual Deductible (individual/family)* | $3,000/$6,000 |
Prescription Drug Deductible(individual/family)* | $1,000/$2,000 |
Annual Out-of-Pocket Maximum (individual/family) | $7,000/$14,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | $500 copay AD |
Urgent Care | $30 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $30 copay DW |
Mental Health/Substance Abuse Services | $30 copay DW |
Specialty Care | $75 copay DW |
Other Practitioner Care | $75 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $25 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $40 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 40% Co AD |
Radiology Services | 40% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 40% Co AD |
Medical / Surgical Services | 40% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 40% Co AD |
Hospice Care | 40% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | $250 copay/trip AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 40% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
U HEALTH PLUS SILVER
FEATURES | |
Annual Deductible (individual/family)* | $4,000/$8,000 |
Prescription Drug Deductible(individual/family)* | $2,500/$5,000 |
Annual Out-of-Pocket Maximum (individual/family) | $7,000/$14,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | $500 copay AD |
Urgent Care | $0 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $0 copay DW |
Mental Health/Substance Abuse Services | $0 copay DW |
Specialty Care | $80 copay DW |
Other Practitioner Care | $80 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place within 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $25 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $40 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 40% Co AD |
Radiology Services | 40% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 40% Co AD |
Medical / Surgical Services | 40% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 40% Co AD |
Hospice Care | 40% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | $250 copay/trip AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 40% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
HEALTHY PREMIER SILVER STANDARD
FEATURES | |
Annual Deductible (individual/family)* | $4,000/$8,000 |
Prescription Drug Deductible(individual/family)* | $2,500/$5,000 |
Annual Out-of-Pocket Maximum (individual/family) | $7,000/$14,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | $500 copay AD |
Urgent Care | $0 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $0 copay DW |
Mental Health/Substance Abuse Services | $0 copay DW |
Specialty Care | $80 copay DW |
Other Practitioner Care | $80 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 40% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $25 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $40 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 40% Co AD |
Radiology Services | 40% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 40% Co AD |
Medical / Surgical Services | 40% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 40% Co AD |
Hospice Care | 40% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | $250 copay/trip AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 40% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
U HEALTH PLUS SILVER STANDARD
FEATURES | |
Annual Deductible (individual/family)* | $5,000/$10,000 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $8,000/$16,000 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 40% Co AD |
Urgent Care | $60 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $40 copay DW |
Mental Health/Substance Abuse Services | $40 copay DW |
Specialty Care | $80 copay DW |
Other Practitioner Care | $80 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | $40 copay DW |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | $40 copay DW |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $20 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $40 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | $80 copay AD |
Specialty Drugs (Tier 4) | $350 copay AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 40% Co AD |
Radiology Services | 40% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 40% Co AD |
Medical / Surgical Services | 40% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 40% Co AD |
Hospice Care | 40% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 40% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 40% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
U HEALTH PLUS BRONZE
FEATURES | |
Annual Deductible (individual/family)* | $9,000/$18,000 |
Prescription Drug Deductible(individual/family)* | $4,500/$9,000 |
Annual Out-of-Pocket Maximum (individual/family) | $9,200/$18,400 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 50% Co AD |
Urgent Care | $0 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $0 copay DW |
Mental Health/Substance Abuse Services | $0 copay DW |
Specialty Care | $80 copay AD |
Other Practitioner Care | $80 copay AD |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 50% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 50% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $30 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $50 copay DW |
Formulary Non-Preferred Brand Drugs (Tier 3) | 45% Co AD |
Specialty Drugs (Tier 4) | 50% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 50% Co AD |
Radiology Services | 50% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 50% Co AD |
Medical / Surgical Services | 50% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 50% Co AD |
Hospice Care | 50% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 50% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 50% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
HEALTHY PREMIER EXPANDED BRONZE STANDARD
FEATURES | |
Annual Deductible (individual/family)* | $7,500/$15,000 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $9,200/$18,400 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 50% Co AD |
Urgent Care | $75 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $50 copay DW |
Mental Health/Substance Abuse Services | $50 copay DW |
Specialty Care | $100 copay DW |
Other Practitioner Care | $100 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | $50 copay DW |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | $50 copay DW |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $25 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $50 copay AD |
Formulary Non-Preferred Brand Drugs (Tier 3) | $100 copay AD |
Specialty Drugs (Tier 4) | $500 copay AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 50% Co AD |
Radiology Services | 50% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 50% Co AD |
Medical / Surgical Services | 50% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 50% Co AD |
Hospice Care | 50% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 50% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 50% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
U HEALTH PLUS EXPANDED BRONZE STANDARD
FEATURES | |
Annual Deductible (individual/family)* | $7,500/$15,000 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $9,200/$18,400 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 50% Co AD |
Urgent Care | $75 copay DW |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | $50 copay DW |
Mental Health/Substance Abuse Services | $50 copay DW |
Specialty Care | $100 copay DW |
Other Practitioner Care | $100 copay DW |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | $50 copay DW |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | $50 copay DW |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | $25 copay DW |
Formulary Preferred Brand Drugs (Tier 2) | $50 copay AD |
Formulary Non-Preferred Brand Drugs (Tier 3) | $100 copay AD |
Specialty Drugs (Tier 4) | $500 copay AD |
Non-Preferred Specialty Drugs (Tier 5) | 60% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 50% Co AD |
Radiology Services | 50% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 50% Co AD |
Medical / Surgical Services | 50% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 50% Co AD |
Hospice Care | 50% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 50% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 50% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
HEALTHY PREMIER BRONZE HSA
FEATURES | |
Annual Deductible (individual/family)* | $8,300/$16,600 |
Prescription Drug Deductible(individual/family)* | Included in Med |
Annual Out-of-Pocket Maximum (individual/family) | $8,300/$16,600 |
BENEFITS | |
Emergency and Urgent Care | |
Emergency Room | 0% Co AD |
Urgent Care | 0% Co AD |
Office Visits | |
Preventive Care Screening/Immunizations/Well- Child Visits/Family Planning | No Charge |
Primary Care | 0% Co AD |
Mental Health/Substance Abuse Services | 0% Co AD |
Specialty Care | 0% Co AD |
Other Practitioner Care | 0% Co AD |
Habilitative Care (20 visit limit applies to PT/OT/ST combined) | 0% Co AD |
Rehabilitative Care (20 visit limit applies to PT/OT/ST combined) | 0% Co AD |
Vision Services | |
Adult Annual Routine Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Vision Exam | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Pediatric Corrective Lenses | No Charge on all 3 Except for Pediatric Corrective Lenses - Healthy Premier Bronze HSA is 0% Co AD |
Other Benefits | |
Prosthetics | 20% Co AD |
Adoption | Up to $4,000 reimbursement for covered adoption expenses after deductible has been met. Must take place witdin 90 days of birth. |
Prescription Drugs | |
Formulary Generic Drugs (Tier 1) | 0% Co AD |
Formulary Preferred Brand Drugs (Tier 2) | 0% Co AD |
Formulary Non-Preferred Brand Drugs (Tier 3) | 0% Co AD |
Specialty Drugs (Tier 4) | 0% Co AD |
Non-Preferred Specialty Drugs (Tier 5) | 0% Co AD |
Outpatient Hospital / Facility Services | |
Laboratory Services | 0% Co AD |
Radiology Services | 0% Co AD |
Specialized Scanning Services (CT, MRI, PET Scans) | 0% Co AD |
Medical / Surgical Services | 0% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 0% Co AD |
Inpatient Hospital Services | |
Medical/Surgical, Maternity Care, Mental Healtd, Substance Abuse, Skilled Nursing Care** | 0% Co AD |
Hospice Care | 0% Co AD |
Transportation Assistance | |
Emergency Transportation - Ground Ambulance (Emergencies Only) | 0% Co AD |
Emergency Transportation - Air Ambulance (Emergencies Only) | 0% Co AD |
PLAN DOCUMENTS | |
Summary of Benefits and Coverage (SBC) | |
Outline of Coverage (OOC) |
Choose the network that fits your needs
Expanded in 2025. 10 Hospitals. 15 Urgent Care Clinic. 6,400+ Providers. Our U Health Plus Network provides you access to award-winning hospitals and clinics in your neighborhood, including U of U Health and Primary Children’s Hospital.
U Health Plus includes all of Davis County and Salt Lake County (except Bingham Canyon—zip code 84006)
52 Hospitals. 106 Urgent Care Centers. 18,000+ Providers. Access to U of U Health, MountainStar Healthcare, Holy Cross, and many other local, award-winning hospitals and providers.
Healthy Premier is available in the following counties: Beaver, Box Elder, Carbon, Daggett, Davis, Duchesne, Emery, Garfield, Grand, Iron, Juab, Kane, Millard, Morgan, Piute, Salt Lake, San Juan, Seiver, Summit, Tooele, Uintah, Utah, Wasatch, Washington, Wayne and Weber.