Benefits

University of Chicago Health Plan (HMO)

University of Chicago Health Plan (UCHP) is not formally organized as an HMO, but it works like one. UCHP doctors and facilities are affiliated with the University of Chicago Medical Center (UCMC). UCHP facilities are mainly located at UCMC.  You can compare UCHP benefits to the other medical plans to determine if it will meet your medical needs.

As long as your care is coordinated by your Primary Care Physician, UCHP generally covers 100% of the cost for approved care after you pay your required copayment. Coverage includes preventive care such as physicals, mammograms, gynecological exams, well-child care and immunizations, and prescription drugs.

You must use UCMC providers in order receive benefits. If you go to a doctor or hospital outside of UCMC for care without prior approval, you will not receive any benefits from the plan, except for emergencies. 

Effective 7/1/2015, CVS Minute Clinics nationally will provide urgent care services to UCHP members in accordance with UCHP Certificate of Coverage. Urgent Care Centers should be utilized for "urgent care" and not "emergency care". If you have an urgent care issue that can not wait for you to see your primary care provider (PCP), you can seek services at a CVS Minute Clinic. Please note, you should call your PCP for prior authorization and you must call your PCP within 24 hours and UCHP within 48 hours after your CVS Minute Clinic visit. All routine Primary Care Services, including vaccinations and immunizations, must be provided and coordinated by a UCHP PCP.

Your cost for the plan depends on the coverage you select and your income. Enrolling in the plan is limited to certain times or events during your employment.

Prescription Drugs

Participating Retail Pharmacy - Per prescription for up to 30-day supply

  • Generic - 100% after $8 Copayment
  • Preferred brand-name - 100% after $25 Copayment
  • Non-preferred brand-name - 100% after $45 Copayment

Mail Order -

Per prescription for up to a 90-day supply at DCAM only;

  • Generic - 100% after $10 Copayment
  • Preferred brand-name - 100% after $30 Copayment
  • Non-preferred brand-name - 100% after $60 Copayment

Per prescription for up to a 90-day supply at CVS/Caremark;

  • Generic -100% after $16 Copayment
  • Preferred brand-name - 100% after $50 Copayment
  • Non-preferred brand-name - 100% after $90 Copayment