UHC Gold Copay Focus+ $0 Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin, Dental + Vision, No Referrals)
UnitedHealthcare · 2027 plan year
Gold
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $8,500
- Family OOP max
- $17,000
Compare with other Gold plans in IN
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
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Monthly premiums by age
Rating Area 17 — the lowest-priced of the 10 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $532 | $532 |
| 21 | $695 | $730 |
| 30 | $789 | $868 |
| 40 | $888 | $977 |
| 50 | $1,241 | $1,489 |
| 60 | $1,886 | $2,263 |
| 64 and over | $2,085 | $2,502 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $20.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $55.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $750.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $1750.00 Copay per Day |
| Outpatient Surgery Physician/Surgical Services | $250.00 |
| Urgent Care Centers or Facilities | $30.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $3.00 |
| Non-Preferred Brand Drugs | 40.00% |
| Preferred Brand Drugs | $30.00 |
| Specialty Drugs | 50.00% |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $1750.00 Copay per Day |
| Mental/Behavioral Health Outpatient Services | $20.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 45.00% |
| Acupuncture | Not covered |
| Allergy Testing | 45.00% |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | 50.00% |
| Basic Dental Care - Child | 45.00% |
| Chemotherapy | $500.00 |
| Chiropractic Care | 45.00% |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | $1,750.00 |
| Dental Check-Up for Children | No charge |
| Diabetes Education | 45.00% |
| Dialysis | $300.00 |
| Durable Medical Equipment | 45.00% |
| Emergency Transportation/Ambulance | $750.00 |
| Eye Glasses for Children | 45.00% |
| Habilitation Services | $55.00 |
| Hearing Aids | Not covered |
| Home Health Care Services | 45.00% |
| Hospice Services | 45.00% |
| Imaging (CT/PET Scans, MRIs) | $300.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | $100.00 |
| Inpatient Physician and Surgical Services | No charge |
| Laboratory Outpatient and Professional Services | $10.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | 50.00% |
| Major Dental Care - Child | 45.00% |
| Nutritional Counseling | 45.00% |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 50.00% |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | 45.00% |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $500.00 |
| Outpatient Rehabilitation Services | $55.00 |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | 45.00% |
| Prosthetic Devices | 45.00% |
| Radiation | $150.00 |
| Reconstructive Surgery | $500.00 |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $55.00 |
| Rehabilitative Speech Therapy | $55.00 |
| Routine Dental Services (Adult) | No charge |
| Routine Eye Exam (Adult) | No charge |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | $1750.00 Copay per Day |
| Substance Abuse Disorder Inpatient Services | $1750.00 Copay per Day |
| Substance Abuse Disorder Outpatient Services | $20.00 |
| Transplant | $1,750.00 |
| Treatment for Temporomandibular Joint Disorders | 45.00% |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $10.00 |
Plan rules
Service area
This plan covers 36 geographic areas.
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