2025 UnitedHealthcare Point of Service (POS) Plan

Plan Type
Medical

Under the The UnitedHealthcare Point of Service (POS) plan, costs are less when using providers in the plan’s network. Individuals can access doctors, hospitals, and providers outside of the network without a referral for an additional cost. The POS plan includes the Prescription Drug Plan.

 

Features
  • Highest contribution offered.
  • Choice Plus Network of providers
  • In-network preventive services e.g. annual exams, colonoscopies, and mammograms covered at 100%.
  • Prescriptions and copayment services e.g., office visits, telemedicine, and urgent care, are covered before deductible.
  • After meeting the annual deductibles, coverage begins for all other medical services.
  • After reaching the out-of-pocket maximums (OPMs), services are covered at 100%.
  • In-network preferred providers deliver coverage at the lowest cost followed by in-network non-preferred and out-of-network providers.
  • You will pay less for certain services that are performed at an independent facility, not associated with a hospital; see the Summary Plan Description for additional information. 
  • Out-of-network reimbursements are limited; rates are determined by our insurance carriers using data provided by Medicare. Review the Summary Plan Description for details.
  • Primary care physician (PCP) is not required but is highly recommended and does not introduce referral requirements.
  • Referral is not required to see a specialist.
  • 24/7 Nurse Line available to speak with a registered nurse about health issues or questions; available at no cost. Call 1-877-609-2273 for assistance.

Medical Services

To maximize benefits and minimize costs, consider using the following providers and resources:

Mental Health Services

Coverage Options
In-Network
In-Network (Tier 1)
In-Network (Tier 2)
Out-of-Network
Plan Design
Employee
$147.00
Employee & Children
$411.00
Employee & Spouse
$522.00
Family
$773.00
In-Network
Individual
$300
Family
$600
Out-of-Network
Individual
$1,500
Family
$3,000
In-Network
Individual
$3,200
Family
$6,400
Out-of-Network
Individual
$6,000
Family
$12,000
Physician Visits

Telemedicine (Offered through Teladoc)

In-Network
$10 copayment
Out-of-Network
NA

Telemental Health (Offered through Teladoc)

In-Network
$10 copayment
Out-of-Network
NA

Primary Care Physician (PCP)

In-Network
$25 copayment
Out-of-Network
40% after deductible

Preventive Care & Immunizations

In-Network
$0
Out-of-Network
40% after deductible

Specialists

In-Network
$30 copayment
Out-of-Network
40% after deductible

Tiered Specialists

In-Network (Tier 1)
$30 copayment
In-Network (Tier 2)
$60 copayment
Out-of-Network
40% after deductible
Emergency & Urgent Care Services

Urgent Care Center

In-Network
$30 copayment
Out-of-Network
40% after deductible

Emergency Room (No coverage for non-emergencies)

In- or Out-of-Network
$175 copayment (waived if admitted)
Maternity

Prenatal Care Visits

In-Network (Tier 1)
$30 copayment for the first visit, $0 for subsequent visits
In-Network (Tier 2)
$60 copayment for the first visit, $0 for subsequent visits
Out-of-Network
40% after deductible

Delivery

In-Network (Tier 1)
10% after deductible
In-Network (Tier 2)
20% after deductible
Out-of-Network
40% after deductible

Post-Partum Visits

In-Network (Tier 1)
$30 copayment
In-Network (Tier 2)
$60 copayment
Out-of-Network
40% after deductible
Inpatient Services

Medical & Surgical Procedures

In-Network (Tier 1)
10% after deductible
In-Network (Tier 2)
20% after deductible
Out-of-Network
40% after deductible

Mental Health

In-Network
10% after deductible
Out-of-Network
40% after deductible
Outpatient Services

Surgical Procedures

In-Network
$500 copay after deductible
Out-of-Network
40% after deductible

Laboratory

In-Network (Tier 1)
$20 copay
In-Network (Tier 2)
$40 copay
Out-of-Network
Not covered

Radiology (X-Ray)

In-Network (Tier 1)
$20 copay (Independent Facility)
Out-of-Network
Not covered
In-Network (Tier 2)
30% after deductible

Hi-Tech Radiology (MRI, CAT, etc.)

In-Network (Tier 1)
$20 copay (Independent Facility)
Out-of-Network
Not covered
In-Network (Tier 2)
30% after deductible

Mental Health

In-Network
$20 copayment
Out-of-Network
25% no deductible

Annual Eye Exam

In- or Out-of-Network
Not covered

Prescription Eyeglasses and/or Contact Lenses

In- or Out-of-Network
Not covered

Physical Therapy

In-Network
10% after deductible
Out-of-Network
50% after deductible

Speech Therapy / Occupational Therapy / Pulmonary & Cardiac Rehabilitation

In-Network
10% after deductible
Out-of-Network
50% after deductible

Chiropractic Care (20 visits per calendar year)

In-Network
$30 copayment
Out-of-Network
40% after deductible

Acupuncture (20 visits per calendar year)

In-Network
$30 copayment
Out-of-Network
40% after deductible
Additional Information

All benefits-eligible employees can elect coverage under the POS except those on a J-1 Visa.

Employees here on a J-1 Visa may not elect this plan. They may only elect the EPO plan or the J-1 Visa plan.

ID cards will be mailed to home addresses within three to four weeks following enrollment in or changes to medical coverage. Individuals can view ID cards on the provider’s website or app or within the CastLight app. A separate ID card is issued for the Prescription Drug Plan, and individuals can print or view them on the OptumRx website or app.

If there are any discrepancies between the information in this publication, verbal representations, and the plan documents, the plan documents always govern. Although Princeton intends to continue these benefits, the University reserves the right to amend or terminate these plans at any time.