Medical and Rx Plans
This is a traditional PPO plan. Visit any provider you wish; pay less when you visit an in-network provider.
For doctor’s office visits, you pay a copayment. For all other covered services, you must first satisfy the deductible and then pay coinsurance until you satisfy the out-of-pocket maximum.
- View information on the Flexible Spending Accounts below.
- View PPO Summary of Benefits
Spending Accounts help you save money on eligible out-of-pocket health care and dependent day care expenses. Your contributions come out of your paycheck before federal income and Social Security taxes so you pay less in taxes and may have more take-home pay.
Your options are the Health Care Spending Account and the Dependent Care Spending Account (See more information below).
The Health Care Spending Account allows you to use pre-tax dollars to pay for eligible health care expenses incurred by you or any other person you cover under you health care benefits or claim as a dependent on your federal income tax return (even if you do not cover them on your medical benefits).
See a list of qualified medical expenses.
In general, eligible expenses include those that are not covered by your medical plan, such as: deductibles, copayments and coinsurance; and prescription drug, dental, vision and hearing expenses.
You can contribute up to $2,700 per year to flexible spending accounts.
Limitations on Flexible Spending Accounts
- You must enroll in the Standard PPO Plan to participate.
- Both accounts must be treated separately. For example, you cannot use money deposited in your Health Care Spending Account to cover dependent day care expenses or vice versa. Funds cannot be transferred from one account to the other.
- All the money in the Spending Accounts each year must be exhausted. Any money remaining at the end of the year cannot be carried over and it is forfeited — “use it or lose it.”
Both types of spending accounts are administered by the experts at HealthEquity. You may contact them at 888-769-8696.
You may use this account to pay for care of your eligible dependents so you (and your spouse) can work (or actively look for work) or attend school full-time.
Generally, an eligible dependent is:
- Your child under age 13 (as long as you or your spouse is entitled to the income tax exemption for the child)
- Your disabled spouse
- A disabled dependent of any age who lives with you at least eight hours per day
Expenses eligible for reimbursement generally include:
- Child care at a day camp, nursery school or private sitter
- Expenses for preschool and after-school child care
- Cost of a housekeeper whose duties include care of a qualified dependent
- Elder care for an incapacitated adult who lives with you at least eight house per day
When you file your federal income tax return, you will be required to supply the name, address and Social Security or tax identification number of the individual or organization providing dependent care. If you are unable to supply this information, you should not use the DCSA to pay for these dependent care services. Also, if you participate in the DCSA, you cannot claim the child care credit for these expenses on your federal tax return.
You can contribute up to $5,000 per year ($2,500 if married and filing separately).
See Health Care Spending Account details above.
High-Deductible Health Plan (HDHP) with Health Savings Account (HSA)
The HDHP is an open access PPO plan. See any provider you choose, either in- or out-of-network. However, receive discounted rates and pay less when you visit in-network providers. In the HDHP, you pay 100 percent of covered health care expenses until you satisfy the annual deductibles. Then you pay coinsurance for covered services until you satisfy the out-of-pocket maximum.
Prescription medications listed on the Approved Preventative Drug List are covered at 100 percent, with no co-pay or deductible. To view the list log into your CVSCarmark account here. The list is subject to change. Prior authorization may be required and some strengths or dosage forms may not be included.
HDHP participants may also participate in an HSA. An HSA is an individual account you own that allows you and the university to contribute pre-tax dollars to pay for qualified, out-of-pocket medical expenses now or later – even in retirement.
View the HSA Chart for election amounts
An HSA combines some of the best features of a flexible spending account with those of a 401(k) plan or Individual Retirement Account.
- Individual account you own that allows you and the university to contribute pre‑tax dollars to pay for qualified, out-of-pocket medical expenses now or later.
- Remaining dollars at the end of the year roll over and can be saved for the future.
- HSA dollars earn interest and can be invested in mutual funds once your balance is $2,000 or greater.
- Interest and investment earnings are tax-free as long as they remain in your HSA and/or are used for eligible health care expenses.
- You own the money in your HSA, it’s yours to keep if you leave the university or retire.
Be sure to reference The Complete HSA Guidebook provided by HealthEquity for more detailed information on Health Savings Accounts.
Contributing to an HSA
- The university helps fund your HSA through matching contributions.
- The university’s matching contribution is deposited into your account each pay period until the maximum amount has been deposited.
Spending Your HSA Dollars
- Use your HSA funds tax-free to pay for qualified health care expenses for you, your spouse and any dependents you claim on your federal tax return.
- You are responsible for ensuring tax-free withdrawals are spent on qualified health care expenses.
- Your contributions and withdrawals to and from your HSA must be declared on your federal tax return.
HSA participants receive a Health Equity Visa check card. This card is linked to your HSA balance and works just like a conventional check card. Participants can also use online bill pay.
Expecting a baby? Take advantage of the Bright Beginnings program through Blue Cross of Idaho.
The 24-hour Nurse Advice Line is there for you when you need it most. Speak with a Registered Nurse day or night to get peace of mind about your family's health.
Through Blue Cross of Idaho's WellConnected Tools, you have the resources you need to get healthy. Start with a free health assessment, then take advantage of all of the extras that will help you live a healthier life. You have access to health trackers, digital health coaching, workshops, a health library and much more. You will need to log in to your Blue Cross of Idaho account in order to take advantage of these WellConnected Tools.
The University of Idaho offers two PPO Medical plans for its eligible Faculty and Staff, both administered by Blue Cross of Idaho. Choose between the Standard PPO or the High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA). Both plans pay 100 percent for eligible, in-network preventive care services. CVS Caremark administers prescription drug benefits and provides mail-order services. Please see the link above for the side-by-side comparison of the two plans. Log into CVS Caremark here.
In addition, preventative/wellness services are covered at 100 percent on both plans with your Blue Cross of Idaho medical insurance.
Prescription Discount Cards, Manufacturer’s Coupons & Rebates
Using a discount card, manufacturer’s coupon or rebate may cause you to receive improper benefits and potentially even commit fraud if you accumulate expenses towards your deductible or out-of-pocket maximum that you did not actually pay out of pocket when using the University of Idaho Medical Program.
It is YOUR responsibility; you can do this by calling the customer service number listed on the back of your member ID card. All applicable claims will be re-adjudicated and you will be responsible for amounts that were incorrectly applied toward your deductible and/or out-of-pocket maximum. To advise Blue Cross of Idaho so an adjustment can be made to your deductible and out-of-pocket accumulators appropriately. Find a Blue Cross of Idaho Provider