UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)

UnitedHealthcare · 2026 plan year

Gold
Ind. deductible
$2,000
Family deductible
$4,000
Ind. OOP max
$8,600
Family OOP max
$17,200

Compare with other Gold plans in WY

Side by side: deductibles, out-of-pocket limits and copays.

More UnitedHealthcare plans in WY

Monthly premiums by age

Rating Area 3 — the lowest-priced of the 3 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$635$635
21$831$872
30$943$1,037
40$1,062$1,168
50$1,483$1,780
60$2,254$2,705
64 and over$2,492$2,990

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$15.00

Specialist

BenefitIn-network
Specialist Visit$40.00

Hospital

BenefitIn-network
Emergency Room Services$500.00 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)25.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services25.00% Coinsurance after deductible
Urgent Care Centers or Facilities$55.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs$350.00
Preferred Brand Drugs$60.00
Specialty Drugs$625.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services25.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$15.00

Other

BenefitIn-network
Substance Abuse Disorder Outpatient Services$15.00
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental25.00% Coinsurance after deductible
AcupunctureNot covered
Allergy TestingNot covered
Bariatric Surgery25.00% Coinsurance after deductible
Basic Dental Care - AdultNot covered
Basic Dental Care - Child25.00% Coinsurance after deductible
Chemotherapy25.00% Coinsurance after deductible
Chiropractic Care$20.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care25.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes Education$40.00
Dialysis25.00% Coinsurance after deductible
Durable Medical Equipment25.00% Coinsurance after deductible
Emergency Transportation/Ambulance$500.00 Copay after deductible
Eye Glasses for Children25.00% Coinsurance after deductible
Gender Affirming Care25.00% Coinsurance after deductible
Habilitation Services$40.00
Hearing AidsNot covered
Home Health Care Services25.00% Coinsurance after deductible
Hospice Services25.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)25.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy25.00% Coinsurance after deductible
Inpatient Physician and Surgical Services25.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$20.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - Child25.00% Coinsurance after deductible
Nutritional CounselingNot covered
Orthodontia - AdultNot covered
Orthodontia - Child50.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)25.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25.00% Coinsurance after deductible
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal CareNo charge
Private-Duty Nursing25.00% Coinsurance after deductible
Prosthetic Devices25.00% Coinsurance after deductible
Radiation25.00% Coinsurance after deductible
Reconstructive Surgery25.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility25.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services25.00% Coinsurance after deductible
Transplant25.00% Coinsurance after deductible
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging25.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 20 geographic areas.

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