Medical Insurance - OUHSC Programs

OU Health Sciences Center offers two options for medical plans through Blue Cross and Blue Shield of Oklahoma to meet those needs and provide flexibility to you and your family. OU Norman employees can find Norman medical insurance information here.

Blue Cross and Blue Shield of Oklahoma Plan Overview

Blue Options PPO Plan

Blue Options is a preferred provider organization (PPO) plan, which gives you the flexibility to choose your provider and network at the time of service You do not need to select a primary care physician. Your choice of health care providers can affect the level of health care benefits (including co-payment and deductible amounts) – based on the network your provider is in. With the Blue Options plan, you can choose from two different networks, Blue Preferred and Blue Choice each time you need health care.

Or, you may choose to see providers that are not in a network (out-of-network). Most preventive care services for in-network providers are fully covered under the Blue Options plan, which means you will pay no co-payment or coinsurance for services such as well child and adult immunizations, routine exams, gynecological exams, mammograms and prostate specific antigen (PSA) tests. Blue Options members have nationwide access to contracting providers through the Blue Card Program when you or your covered family members live, work, or travel anywhere in the country.

Blue Edge HSA Plan

The Blue Edge HSA plan is a high-deductible plan that uses the Blue Choice network. With an HSA plan, a specific amount of money is deposited each benefit year in a health savings account (HSA). When you need any covered medical care, the first out-of-pocket costs you have can be paid from available funds in this account. The money paid from your health savings account is applied toward meeting your annual plan deductible or other co-payment or coinsurance amounts you may be responsible for.

The BlueEdge HSA has a notably higher deductible to satisfy each year. To help offset the higher deductible, money is put into a health savings account each year on your behalf, which can be applied to your deductible or other eligible out-of-pocket medical expenses. Note: If you have dependents on your plan, the entire family deductible of $3,000 for in-network coverage OR $5,000 for out-of-network coverage must be met before the plan assumes payments.

Plan Networks

Blue Cross and Blue Shield of Oklahoma have two networks, Blue Preferred and Blue Choice. Members in the Blue Options PPO plan have the option between the networks, while Blue Edge HSA plan uses the Blue Choice Plan. Depending on which network your provider is in will determine how much your out-of-pocket costs will be.

BLUE PREFERRED 
The Blue Preferred PPO network provides the biggest discount and pays your benefits at the highest level, which means you will have the lowest out-of-pocket costs when you use providers in the Blue Preferred PPO network. (note: OU Physicians are in the Blue Preferred Network)

  • Coinsurance: 90% / 10%
  • Individual Deductible: $500
  • Family Deductible; $1000 

  • BLUE CHOICE
    The Blue Choice PPO network will pay your benefits at the second highest level, although some aspects of coverage are the same with the Blue Preferred PPO and Blue Choice PPO networks.

  • Coinsurance: 80% / 20%
  • Individual Deductible: $1000
  • Family Deductible; $2000 

  • OUT-OF-NETWORK
    If you see out-of-network providers, you will receive no discounts and your benefits will be paid at the lowest allowed amount.

  • Coinsurance: 50% / 50%
  •  

    Choosing a Plan

    1. How to Choose a Plan

    What should I consider when choosing between the PPO Plan and HSA Plan options? 

    Premiums (rates) are not the only thing to consider when choosing a medical plan. The two medical plan options available in 2018 work in different ways – you should make your final enrollment decision based on your (and your family’s) needs. It’s important to have an understanding of how each plan works rather than making a decision based on cost alone.  We want you to be well informed and confident through the medical carrier transition.  Here are some helpful tips:

  • Reach out to the Blue Cross and Blue Shield customer service representatives at 855-649-9614 – they are there for you and can explain the differences between the PPO and HSA plans as well as help with any additional questions you might have.
  • Check Provider Networks--Look up your provider to see which network(s) they are a part of. Remember, out-of-network equals higher costs. Be proactive and help yourself stay healthy with preventive care services – covered at 100% on either plan option.
  • Log In to Blue Access for Members to submit claims, review you plan information and more. 
  • Budget Accordingly – Anticipate costs for the coming year. When budgeting, remember to compare your current premium costs to the 2018 premium cost. 
  • Choose Convenience--If you have non-emergency injuries, use an in-network urgent care rather than an emergency room.
  • 2. Plan Design

    Blue Edge HSA:

    Blue Edge HSA is a plan that features higher deductibles than traditional insurance. This plan is combined with a Health Savings Account through HSA Bank to allow you to pay for qualified out-of-pocket medical expenses on a pre-tax basis. A Health Savings Account (HSA) combines a health care plan with a tax-advantaged health savings account set up on your behalf when you enroll. Use the money in your account to pay for eligible health care expenses for you and your eligible dependents, or save it for future health costs. With an HSA plan, the entire deductible must be met before the plan will cover costs.

    How your plan and HSA work: 
    • As part of enrolling in the Blue Edge® HSA, you open a health savings account
    • You and/or your employer can contribute pre-tax dollars to your account. NOTE: The Health Savings Account is not fully funded at the beginning of the year. These contributions are made on a prorated basis per pay period. 
    • You can use the money in your HSA to pay for qualified health care expenses (including your deductible and coinsurance) for yourself and your eligible dependents. You can also use it to pay for qualified medical expenses that may not be covered under your medical plan, including dental and vision expenses
    • The HSA dollars you use go toward paying your annual deductible. Dollars you don’t use remain in your account  and earn interest

    If you leave your health plan, change jobs or retire, you take your HSA with you.You can learn more by visiting the HSA Bank Website

    Please refer to your plan documents, including specific information on your HSA, or contact your employer for more information on what’s covered and not covered by your plan. HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Contact a tax professional for information about your state.

    Blue Options PPO Plan: 
    Blue Options PPO plan gives you important choices. Each time you need care, you can choose your doctors, health care professionals and hospitals from our network, or you can choose to receive care and services from health care professionals outside of the network.

    How the PPO plan works:

    • Primary care physician (PCP): You don’t need to select a PCP. BCBSOK will work closely with you and your doctors to help coordinate your care.
    • In-Network Options: Choose between the Blue Choice and Blue Preferred networks to see in-network doctors or other health care professionals. Depending on the network your provider can impact your level of coverage and co-insurance, so be sure to review the details of each network and well as out-of-network information.
    • No-referral specialist care: If you need to see a specialist, you do not need a referral—just make the appointment and go. Pre-certification may be necessary for hospitalizations and some types of outpatient care.
    • Out-of-network: You also have the freedom to visit doctors or use hospitals that are not part of the Cigna network, but your costs will be higher, and you may need to file a claim.
    • Emergency and urgent care:  When you need care, you have coverage, 24 hours a day, worldwide.
    • Copays: With the plan, you’ll pay an annual amount (deductible) before your health plan begins to pay for covered health care costs. Once you meet your deductible, you pay a set amount (copay) or percentage of the cost (coinsurance) for your covered health care costs, and the health plan pays the rest. Again, this varies depending on which network your provider(s) are in.

    3. Cost Comparisons: Become a Smart Consumer

    There are several online resources via Blue Access for Members available beginning January 1, 2018, including:

    • Pharmacy Price Estimator
    • Healthcare Cost Estimator

    4. Out-of-State Coverage

    All BCBSOK members have nationwide access to contracting providers through the BlueCard® Program when you or your covered family members live, work, or travel anywhere in the country. Your benefits will generally be paid at the highest benefit level, since Blue Preferred PPO providers are mostly located in Oklahoma. You can search for BlueCard providers in the online provider directory at bcbsok.com.





    5. Pre-Existing Conditions

    OUHSC's medical insurance plans do not have pre-existing condition restrictions.

    Find a Provider

    Tobacco-Use Surcharge

    Tobacco users pay a surcharge for medical insurance. 

    Protect Your SSN with Health ID

    Because keeping your personal identity safe is a top priority at the university, you will use your Health ID instead of your Social Security number for all medical and dental transactions at the doctor's office and with insurance providers. Click here to learn more about your Health ID Number.

    Health Savings Account

    Members enrolled the HSA medical insurance plan will have a health saving account to which employees and employers can contribute pre-tax money. Employees will receive a debit card to use on healthcare costs not covered by your insurance plan. You can visit HSA Bank's website to manage your account.

    Retirees

    • Retirees under age 65 have the same Blue Cross and Blue Shield of Oklahoma medical insurance options as active employees.
    • Retirees age 65 and over are covered by the BlueCross BlueShield Traditional Indemnity plan. 

    Flexible Spending Accounts

    Did you know that health care and dependent care reimbursement accounts can decrease the amount of taxes you pay on your income? OU and ConnectYourCare offer a debit card with the healthcare reimbursement Flexible Spending Account (FSA). Get more information on the Flexible Spending Accounts page.

    ACA Marketplace

    The federal Affordable Care Act (ACA) continues to provide the Health Insurance Marketplace for 2017 and 2018. Find information about how the ACA Health Insurance Marketplace may affect OU employees here.