UnitedHealthcare New Medical Insurance

Effective January 1, 2026 Northwestern University will transition to a new medical insurance provider called UnitedHealthcare (UHC). The university will no longer be offering plans from Blue Cross Blue Shield of Illinois (BCBSIL).

UHC's medical networks match BCBSIL’s at 99+%, meaning that very few postdocs will experience disruption with their current doctors when the change is made to UHC. Should you find that your current doctors are not in network with UHC, please refer to the document “Understanding Transition of Care – assisting your transition to “in network” providers – Application Form”.

Key differences between the two PPO plans:

• BCBSIL has a prescription out-of-pocket maximum that is separate from the medical services' out-of-pocket maximum, while UHC combines the prescription out-of-pocket maximum with that of the medical services. This could afford members a significant savings as drugs purchased under the UHC plan will count towards the combined medical/RX annual out of pocket maximum. Note that the monthly copays for both retail and in-network mail order pharmacy copays are slightly higher for UHC.
• Out-of-network care is, in general, slightly more expensive on the UHC plan (member pays 40% after deductible) than the BCBSIL Plan (member pays 20% after deductible). However, with such a robust PPO network of care providers, out-of-network utilization should be very limited. Postdocs are encouraged to check to see that the doctor that they're planning to visit is in network with UnitedHealthcare.

Key differences between the two HMO plans:

• UHC has no out-of-pocket maximum for prescription drugs while BCBSIL has a separate out-of-pocket maximum for prescriptions.
• There is no copayment for inpatient mental health treatment on the UHC plan, while BCBSIL has a $500 copay per admission.

Key general differences in both the HMO and PPO plan designs:

• While both carriers cover Telehealth, Virtual Care Services are not covered by BCBSIL for Medical or Behavioral Health; these are covered by UHC.
• The "match ratio" for currently utilized Mental Health providers that accept the UHC plan is only 56%, which will cause disruption for some select NU postdocs who currently utilize mental/behavioral health services.

UnitedHealthcare Choice Plus PPO Plan Enhancements:

• No Maximum Out of Pocket Prescription Drug amount
• No copays for Office Visits for people under 19yo
• No copay for Diagnostic tests
• FREE Virtual Care Visits
• Urgent Care Visits – deductible does not apply
• Mental Health - $25 copay per visit – not subject to deductible

UnitedHealthcare Navigate HMO Plan Enhancements

• No separate Maximum Out of Pocket for Prescription Drugs
• No copays for Office Visits for people under 19yo
• No Copay for Outpatient Surgery
• No Copay for Virtual Care Visits

UnitedHealthcare Perks

• 3 Visit Employee Assistance Program (EAP)
• $0 Copay Virtual Visits (HMO/PPO)
• $0 Kids Copay (HMO/PPO)
• Real Appeal Administration (Weight Loss)
• Smoking Cessation Quit4Life v
• Care Cash (HMO, PPO, $200/$500 benefit)
• UHC Rewards ($1,000 benefit)