Current Providers:

Medical Services: United Healthcare
Group Number: 702111
Customer Service: 1-800-382-2599
Website: MyUHC.com

Prescription Drugs: Express Scripts
Group Name:  WUSTLRX
Rx Bin: #003858
Customer Service:  1-877-880-1877
Website: Express-scripts.com

Washington University offers eligible employees up to five health plan options from which to choose from. Note: the options available to you depend on whether you are a faculty member, staff member, Clinical Fellow, Postdoctoral Appointee or union employee. See the applicable guide below for information regarding eligibility, rates and the options that may be available to you.

All five options provide coverage for the same medical services, are administered by UnitedHealthcare and include prescription drug coverage through Express Scripts. How much you pay out-of-pocket in premiums, deductibles, copays and/or coinsurance varies by option. The following table summarizes the in-network benefits under each of the five health plan options.

2022 Health Plan Options: IN-NETWORK BENEFITS

 EPOPOSHDHP PPOExcel PPOBasic PPO
Annual Calendar Year Deductible     
IndividualNoneNone$1,500$500$750
FamilyNoneNone$3,000$1,500$2,250
Annual Out-of-Pocket Maximum*     
Individual$1,500$1,500$3,000$2,000$3,250
Family$3,000$3,000$6,000$4,000$6,500
Copayments and/ or CoinsuranceYou payYou payAnnual deductible must be met before coinsurance applies. Then, you pay:Annual deductible must be met before coinsurance applies. Then, you pay:Annual deductible must be met before coinsurance applies. Then, you pay:
Office Visits: Primary care$25$2520%20%20%
Office Visits: Specialist$50$5020%25%25%
Virtual Visits/ Telehealth$25$2520%20%20%
Urgent Care Visits$35$3520%20%20%
Emergency Room Care$150 (waived if admitted)$150 (waived if admitted)20%20%20%
Lab and X-ray Services: Preventive$0$0$0$0$0
Lab and X-ray Services: Non-preventive10%10%20%20%20%
Lab and X-ray Services: Major radiologic diagnostic20%20%20%20%20%
Inpatient: Hospital, Rehab, Skilled Nursing  $500  $500  20%  20%  20%
Surgery: Inpatient$0$020%20%20%
Surgery: Outpatient$250$25020%20%20%
Maternity: Prenatal office visit$0$0$0$0$0
Maternity: Lab tests/ultrasound10%10%20%20%20%
Maternity: Inpatient delivery$500$50020%20%20%
Therapy Services$50$5020%25%25%
*Includes copays, deductibles and coinsurance

2022 Health Plan Options: WUDirect Benefits

The following table summarizes the in-network benefits if you use a WUDirect physician:
In-network annual deductible may apply.

Under WUDirect EPOPOSHDHP PPOExcel PPOBasic PPO
Office Visits:
Primary care
  $15   $15   10%   10%   10%
Office Visits: Specialist$25$2510%10%10%
Therapy Services*$25$2510%10%10%
Bariatric Surgery10%10%10%10%10%
Kidney Dialysis
Inpatient facility charges will apply
No cost to memberNo cost to member0% after deductible0% after deductible0% after deductible
Infertility
Lifetime benefit: $30,000 for medical and $15,000 for prescription drugs
20% up to lifetime benefit20% up to lifetime benefit20% up to lifetime benefit20% up to lifetime benefit20% up to lifetime benefit
Hip and Knee Replacement Inpatient facility charges will applyNo cost to memberNo cost to member10%10%10%
*Includes PT/OT Speech, ABA Therapy for Autism and Outpatient for Mental Health/ Substance Abuse Disorders.

Eligibility, Rates & Plan Comparisons

In some cases, employees who would not otherwise be eligible for benefits may become eligible for the university’s health plan under the Affordable Care Act (ACA).

Visit ALEX – Benefit Education Tool

Need Help? ALEX, a benefit education tool, is available to assist you with deciding which benefit plans are best for you. 
Walk through plans with this benefit education tool.

Enrollment Period

Eligible employees may enroll within 31 days after their date of hire, during the annual open enrollment (in November) and/or within 31 days (62 days for birth of baby) after a qualified family status change or life event.

Effective Date

Benefits eligible rehires and new hires become eligible for coverage on their date of rehire/hire. Changes made to benefit coverage due to a life event or job change into a benefits-eligible role will also be effective as of the date of the event. Changes made during the annual Open Enrollment period in November are effective January 1 of the subsequent year.

Prescription Drug Coverage

Express Scripts Logo

Prescription drug benefits are included as part of your health care package when you are enrolled in a university health plan. Learn More

Medical Coverage for International Business Travel through GeoBlue

GeoBlue Logo

Register at geo-blue.com
WashU Group Access Code: QHG99999WUBT

For questions about registration or medical coverage, call 1-888-412-6403 inside the U.S. or 1-610-254-5830 outside the U.S. More Information.

Health Care Benefit Notices

The university is required to provide you with important information regarding eligibility and enrollment, benefit coverage, COBRA rights, HIPAA privacy rules, and whether the university’s prescription drug coverage qualifies as creditable coverage for Medicare.

COBRA Insurance

You may be eligible for personalized continuation of coverage packet after your employment is terminated at the university. Learn More