UnitedHealthcare

Ancestry considers you part of our family. That’s why we offer several medical plans featuring a range of coverage levels and costs, so you have the flexibility to choose the best plan for yourself and your family. Keep in mind that certain medical plans give you the option to contribute to a Health Savings Account (HSA), a tax-advantaged account that can help you save money.

Watch the videos below to understand more about the Health Savings Account (HSA) to determine if one of the HDHP medical plan options may be right for you.

How HDHP with HSA works
HDHP vs Traditional PPO
Comparing HSA and FSA

$500 Deductible
Provider Network
Options PPO Network (Utah)
Choice Plus PPO Network (outside of Utah)
HSA Eligible
No
Individual / Family HSA Funding by Ancestry
None
Preventive Doctor's Visit
Covered at 100%
in-network*
$1,500 Deductible with HSA
Provider Network
Options PPO Network (Utah)
Choice Plus PPO Network (outside of Utah)
HSA Eligible
Yes
Individual / Family HSA Funding by Ancestry
$750 / $1,500
Preventive Doctor's Visit
Covered at 100%
in-network*
$2,500 Deductible with HSA
Provider Network
Options PPO Network (Utah)
Choice Plus PPO Network (outside of Utah)
HSA Eligible
Yes
Individual / Family HSA Funding by Ancestry
$1,250 / $2,500
Preventive Doctor's Visit
Covered at 100%
in-network*

In-Network

$500 Deductible
Individual / Family Deductible
$500 / $1,000
Individual / Family Out-of-Pocket Max
$2,000 / $4,000
Plan Coinsurance
80%
Office Visit (Primary Care / Specialist)
$20 primary care physician / $40 specialist*
$1,500 Deductible with HSA
Individual / Family Deductible
$1,500 / $3,000
Individual / Family Out-of-Pocket Max
$3,000 / $6,000
Plan Coinsurance
80%
Office Visit (Primary Care / Specialist)
20% after deductible
$2,500 Deductible with HSA
Individual / Family Deductible
$2,500 / $5,000
Individual / Family Out-of-Pocket Max
$4,500 / $6,850
Plan Coinsurance
70%
Office Visit (Primary Care / Specialist)
30% after deductible

Retail Prescriptions

$500 Deductible
Generic (Tier 1)
$10 copay*
Preferred Brand Name (Tier 2)
$30 copay*
Non-Preferred Brand Name (Tier 3)
$60 copay*
$1,500 Deductible with HSA
Generic (Tier 1)
20% after deductible
Preferred Brand Name (Tier 2)
20% after deductible
Non-Preferred Brand Name (Tier 3)
20% after deductible
$2,500 Deductible with HSA
Generic (Tier 1)
30% after deductible
Preferred Brand Name (Tier 2)
30% after deductible
Non-Preferred Brand Name (Tier 3)
30% after deductible

Mail Order Prescriptions

$500 Deductible
Generic (Tier 1)
$25 copay*
Preferred Brand Name (Tier 2)
$75 copay*
Non-Preferred Brand Name (Tier 3)
$150 copay*
$1,500 Deductible with HSA
Generic (Tier 1)
20% after deductible
Preferred Brand Name (Tier 2)
20% after deductible
Non-Preferred Brand Name (Tier 3)
20% after deductible
$2,500 Deductible with HSA
Generic (Tier 1)
30% after deductible
Preferred Brand Name (Tier 2)
30% after deductible
Non-Preferred Brand Name (Tier 3)
30% after deductible
* Plan deductible does not apply.

Learn more about UHC benefits.

UnitedHealthcare Monthly Costs

See what both you and Ancestry contribute each month for the medical plans.

For more information, see the Plan Documents and Required Notices.

Wellness Program

The Wellness Program helps UnitedHealthcare members identify and minimize their health risks. Learn more about the Wellness Program. Learn how to access Rally.

Questions?

UnitedHealthcare

Medical
Plan/Group Number: 743256
Phone: 1-844-333-8019
Website

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