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FEHB Plans

Get healthcare from doctors and hospitals in your community and customer service that puts you first.

Choose a Plan that Works for You

We offer three plans to meet your unique healthcare coverage needs. All three include prescription, emergency, maternity, and vision benefits. You’ll have access to nationally-recognized facilities, contracted hospitals and clinics in Utah. And if you need a specialist? No worries, go ahead and make an appointment—you don't need a referral.

Standard Option
New for 2019 - HDHP Option
High Option

Our Standard Option FEHB plan offers low-cost premiums and a low deductible. Our extensive network of providers is the same no matter which FEHB plan you choose.

Below, an asterisk (*) means the item is subject to the deductible.

This plan gives you the freedom to choose how you spend your healthcare dollars. With a higher deductible, lower premium, and many preventive care services covered 100%, this HDHP option may pair with an HSA or HRA that puts you in control of your healthcare spend.

For each month you’re eligible, SelectHealth will deposit $62.50 for Self Only, or $125.00 for Self Plus One or Self and Family per month in your HSA. Have questions or want to know more? Call, 844-345-FEHB (3342).

Below, an asterisk (*) means the item is subject to the deductible.

If you'd like more comprehensive benefits, our High Option FEHB plan includes no deductible, low copays and our same great network of providers.

Deductible

$250 Self Only, per year $500 per Self Plus One or Self Plus Family, per year

Deductible

$1,500 Self Only, per year $3,000 per Self Plus One or Self Plus Family, per year

Deductible

$0

Out-Of-Pocket Maximum

$5,500 per person, per year
$11,000 per Self Plus One or Self Plus Family, per year

Out-Of-Pocket Maximum

$5,000 per person, per year
$10,000 per Self Plus One or Self Plus Family, per year

Out-Of-Pocket Maximum

$5,000 Self Only, per year*
$10,000 per Self Plus One or Self Plus Family, per year*

Services Provided By A Hospital

Inpatient 15% per admission*

Outpatient 15% per admission*

Services Provided By A Hospital

Inpatient $150 per day up to $750 per admission*

Outpatient $150 per day*

Services Provided By A Hospital

Inpatient $250 per admission

Outpatient 10% per admission

Emergency Benefits

In-Area/Out-of-Area $200 copay*

Emergency Benefits

In-Area/Out-of-Area $200 copay*

Emergency Benefits

In-Area/Out-of-Area $175 copay

Note: This is a summary of the features of the SelectHealth Plan. Before making a final decision, please read the Plan’s Federal brochure RI 73-865. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.

 

Pharmacy Coverage

To see the drugs covered by your plan, log in to My Health or by clicking on the links below:

RxSelect 4 Tier PDL (Utah)

      Lookup Online

      Download PDF