Overview
Take an active role in your healthcare coverage with one of WGU’s available medical coverage options:
- HDHP
- Informed Choice Health Plan (ICHP)
Our benefits program includes medical plan options with a range of coverage levels and costs so you can choose the one that’s best for you. These plans are administered by UHC. You can enroll as a new hire, during Open Enrollment, or if you have a qualifying life event. You may also view your premiums.
2025 Medical Plans
Take charge of your spending through lower premiums, higher deductibles, and a tax-free Health Savings Account (HSA) with contributions from Western Governors University that you own for life.
The ICHP
Administered by: Surest
Consider this plan if you prefer the predictability of office visit copays and lower deductibles, but with a significantly higher paycheck deduction.
Key Words to Know
Deductible:
The amount you pay before the plan begins to pay
Out-of-Pocket Costs:
Expenses you pay yourself, such as deductibles, copays, and the remaining amounts after plan coinsurance is paid
Out-of-Pocket Maximum:
The maximum amount you pay for covered services in a year (you may need to pay additional amounts if coverage is received from an out-of-network provider)
Copay:
An amount you pay for a covered service each time you use that service, which usually does not apply toward the deductible
Plan Comparison
How the WGU Medical Plans Compare
Before choosing which medical plan to enroll in, it's important to understand how they compare. The table provides a high-level comparison.
| The HDHP | The ICHP |
|---|---|
| What is different? | |
| Premiums, Deductibles, Prescription Drugs | |
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| HSA and FSA | |
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| What is the same? | |
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Behavioral Health Enhancement: Post Traumatic Stress Disorder Support
Western Governors University is proud to offer enhanced Post-traumatic stress disorder (PTSD) and behavioral health (BH) support, including coverage for Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR), and treatment of disorders that have been diagnosed as organic mental disorders associated with permanent dysfunction of the brain.
Visit the UHC website or call 800-244-6224 to learn more.
Medical Plans At-a-Glance
| The HDHP | The ICHP | |||
|---|---|---|---|---|
| Choice of Providers | UHC network. | |||
| Health Savings Account (HSA) ($4,300 Employee Only or $8,550 for Family annual limit.) If you are over age 55, you are able to contribute an additional $1,000. | Available with this plan. Refer to Health Savings section for details. | Not available | ||
| Healthcare FSA | Not available | Available for medical, dental, and vision | ||
| Limited Purpose FSA | Available for dental and vision expenses only | Not available | ||
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Calendar Year Deductible | ||||
| Individual (Note: only applies to Employee Only coverage under HDHP.) |
$2,000 | $4,000 | $0 | $0 |
| Family | $3,500 | $8,000 | $3,000 | $8,000 |
| Calendar Year Out-of-Pocket Maximum (Includes Deductible) | ||||
| Individual | $4,000 | $8,000 | $3,000 | $8,000 |
| Individual Within a Family | $7,000 | $16,000 | N/A | N/A |
| Family | $8,000 | $16,000 | $6,000 | $16,000 |
| You Pay | You Pay | |||
| Coinsurance | ||||
| Preventive Care | $02 | 40%1 | $0 | $100 copay/visit |
| Physician Office Visits | 20%1 | 40%1 | $10 - $65 copay/visit | $195 copay/visit |
| WGU Virtual Care | $55/visit until deductible is met; 20% thereafter | $10 - $65 copay/visit4 | ||
| Emergency Room | 20%1 | 20%1 | $375 copay | $375 copay |
| Inpatient Hospital Care | 20%1 | 40%1 | $150 - $2,500 copay/stay | Up to $7,00 copay/stay |
| Outpatient Surgery3 | 20%1 | 40%1 | $15 - $2,500 copay/visit | $15 - $2,500 copay/visit |
1 After deductible.
2 Deductible does not apply to in-network preventive services. (Deductible applies for out-of-network preventive services.)
3 Out-of-network treatment for dialysis is not covered.
4 Cost share applies to any other Telehealth service based on provider type. If you receive services in addition to office visit, additional copays may apply.
With advancements in technology, we have become comfortable with managing activities remotely – including virtual healthcare, primary care behavioral, and dermatology support. Whether you’re dealing with a routine illness or injury, or need access to counseling or mental health providers, WGU’s expanded virtual care options deliver cost-effective, around-the-clock access to consultations with board-certified providers via video, phone or app with our partners.
We often think of virtual healthcare for fast access to a physician, but you can use virtual care for primary care appointments, too. Board-certified doctors can help identify any potential health issues, discuss ways to improve your health, and even recommend follow-up care, if necessary. Virtual primary care helps you skip the drive and waiting to see a physician for your preventive care and wellness screening visits. Connect from just about anywhere via video or phone — 7 days a week, 365 days a year, including flexible hours.
If you are enrolled in a WGU medical plan, you and your enrolled dependents can get treatment for general illnesses, prescriptions for a range of medical conditions (subject to applicable state laws), dermatology support, primary care, and advice by live computer video or phone consultations for conditions such as:
- Sore throats
- Headaches
- Stomach aches
- Fevers
- Colds and flu
- Allergies
- Rashes
- Acne
- Shingles
- Bronchitis
- Urinary tract infections and more
If you're enrolled in the Surest plan: log into the Surest app for virtual care. If you're enrolled in the UHC plan, visit the UHC Virtual Visits page.
Keep your Insurance ID Cards Digitally
You have immediate access to your member ID cards and proof of coverage anytime via the UHC or Surest mobile app. View your ID cards on your mobile device to share them with your providers.
Need Help Deciding?
WGU has partnered with ALEX to provide an easy-to-use online tool to help you identify the medical plan option that may be best for you. Answer a few simple questions about your likely medical needs for the coming year and the tool will calculate estimated outcomes for each medical coverage option. Give it a try now! Go to http://start.myalex.com/wgu.
Find an In-Network Provider
Save money when receiving care from an in-network provider.
Important: Certain Medications at No Cost
Certain preventive medicines on UHC’s preventive drug list are covered under both the HDHP and ICHP at no cost. Examples: contraceptives, select vaccines, folic acid, and breast cancer prevention. For a complete list of medications covered under this list, visit the UHC website. In addition, some diabetic supplies, such as needles, lancets, and test strips are available to members at no cost when purchased on the same day as injectable insulin.
Covered by the HDHP?
Don’t forget — certain other common medications for chronic conditions are covered the same as they are under the ICHP. Examples: antidepressants, medications for diabetes, high blood pressure, high cholesterol, osteoporosis, and respiratory conditions. Under the HDHP, plan coverage for certain medications will apply right away, even if you have not met the plan deductible yet. Find a participating pharmacy, check drug coverage, arrange for home delivery, and compare prices on the UHC website.
High Deductible Health Plan (HDHP)
The HDHP pairs low-premium, high-deductible coverage with a tax-free Health Savings Account (HSA) that helps you save money and plan ahead for future medical expenses. This combination gives you more control over your money and rewards you for making healthy, cost-conscious choices.
Higher Deductible, You’ve Got This
Under the HDHP, on an annual basis, WGU contributes up to $1,000 for Employee Only coverage and up to $2,000 for Employee plus Dependents coverage, as long as you are contributing at least that much over the year. This means you will need to contribute a minimum of $38.46 per paycheck for an employee only plan and $76.92 per paycheck for employee plus dependent(s) plan.
- You can also earn up to $750 to your HSA by completing Preventive Activities in the Sonic Boom portal. Use or save your HSA contributions at your discretion.
- Lower per-paycheck costs allow you to redirect money you would pay in premiums to your HSA instead, so you have more money to use when you need care.
- Think of your HSA as a reserve to help cover your deductible. The 2025 in-network individual deductible is $2,000, and the in-network family deductible is $3,500. When you factor in all available WGU HSA contributions, your in-network deductible is pretty well covered!
- If you have a year with few medical expenses, then the accumulated HSA funds stay in your account for the future.
- Your overall out-of-pocket risk in any given calendar year is always limited by the out-of-pocket maximum.
How the HDHP Works
You pay the plan premium from your paycheck to have coverage.
Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.
Use your HSA to save money and plan ahead!
Contributing to your HSA is a great way to budget for deductibles and other out-of-pocket expenses while also saving money — your HSA contributions are tax-free!*
Keep in mind:
- The HDHP costs you less from your paycheck, so you may have extra money available to put in your HSA.
- You can only spend HSA money that’s actually been deposited into your account. If you don’t have enough money in your HSA when you need it, you can pay another way and reimburse yourself later so you take full advantage of your HSA’s tax savings.
- You will never forfeit any money left in your HSA — it rolls over year after year. If you know about future expenses or want to save for your health care costs in retirement, set aside a little extra each paycheck so your balance can grow over time.
- You can change your HSA contribution amount throughout the year as needed to keep up with any changes in your situation.
*Contributions are not subject to federal income tax. However, HSA contributions are currently subject to state income tax in CA and NJ. Consult with your tax advisor to understand the potential tax implications of enrolling in an HSA. Money in an HSA can be withdrawn tax-free as long as it is used to pay for qualified health-related expenses. If money is used for ineligible expenses, you will pay ordinary income tax on the amount withdrawn, plus a 20% penalty tax if you withdraw the money before age 65.
ICHP + LSA
The ICHP gives you access to the same broad coverage and free in-network preventive care as the HDHP because it leverages the same network of in-network providers. It’s designed to offer you a simpler healthcare experience, with a focus on greater clarity around costs of care. Consider how the ICHP’s features might fit your needs. Plus, you get access to a Lifestyle Spending Account that provides benefits to employees for completing wellbeing activities.
A broad network of doctors with transparency into quality of care
The ICHP makes it easy to spot high-quality providers in the broad UnitedHealthcare network. When you search for a provider, you’ll see a range of copays (flat fees for services) for the providers in your area. Providers with higher quality ratings have lower copays.
Predictable costs and access to a Healthcare Flexible Spending Account (FSA)
The Surest app makes it easy for you to understand what you’ll pay before you go to the doctor, so you’ll know in advance exactly what your cost will be. You can also make tax-free contributions to a healthcare FSA to pay eligible medical expenses.
No deductible before the plan begins to pay
The ICHP does not have a deductible, meaning you will be able to access care at predictable copays from your very first doctor’s visit.
24/7 digital experience
Surest’s app and member portal offer an integrated, seamless experience, making it easy to access your healthcare information whenever you need. The ICHP provides clear, upfront prices for the care that you need. You’ll pay an assigned price for care until you meet your annual out-of-pocket maximum.
How The ICHP Works
You pay the plan premium from your paycheck to have coverage.
Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.
Prescription Drugs
When you enroll in a Western Governors University medical plan, you automatically receive prescription drug benefits through CVS Caremark.
Prescription Drug Coverage At-a-Glance
All your pharmacy benefits will be available via CVS Caremark. You will have expanded options to receive pharmacy benefits through Costco, CVS, Kroger (Smith’s), Sav-On, and Walgreens, among others. Your medications can be delivered to your home via the CVS Caremark mail order program, too. Most pharmacy benefits will be enhanced or stay the same, backed by CVS Caremark’s commitment to cost transparency and implementing formulary strategies that drive down prices. Visit the CVS Caremark site for your specific plan (each plan's site is linked below) for more information:
| The HDHP | The ICHP | |||
|---|---|---|---|---|
| Pharmacy | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Retail Rx (up to a 30-day supply)2 | ||||
| Generic | $101 | 40%1 | $10 | 40% |
| Preferred | 35%1 | 40%1 | $40 | 40% |
| Non-Preferred | 50%1 | 40%1 | $80 | 40% |
| Mail Order Rx (up to a 90-day supply)2,3 | ||||
| Generic | $101 | Not covered | $20 | Not covered |
| Preferred | 35%1 | $80 | ||
| Non-Preferred | 50%1 | $160 | ||
1 After deductible.
2 Deductible does not apply to in-network preventive services. (Deductible applies for out-of-network preventive services.)
3 Out-of-network pharmacy supplies is not covered for Mail Order.
Check the formulary
See how medications are covered by logging in to your prescription account on the CVS Caremark website.
Save Money on Prescriptions
The cost of prescription drugs is rising faster than many other health care services and supplies. But there are ways for you to save.
Ask your doctor about generic medications.
Generic medications are generally just as effective as brand-name medications, but they typically cost between 80% and 85% less.
Use the home delivery feature.
If you take maintenance medication to treat a chronic condition — such as an allergy, heart disease, high blood pressure, or diabetes — the convenience and cost savings of the home delivery prescription programs through CVS Caremark will save you time and money.
Why use home delivery?
- Prescriptions are shipped to you for free — no waiting in line at the pharmacy.
- You save money with a reduced cost for a three-month supply.
- You can set up automatic refills.
Generic vs. Brand Name
Programs & Resources
Take advantage of these valuable programs and resources to better manage your health and financial well-being.
Omada® Diabetes Prevention Support
If you are enrolled in a WGU medical plan, you and your eligible dependents have access to Omada® Diabetes Prevention Support.
Omada® is a personalized program designed to help you reach your health goals—whether that’s losing weight or improving your overall health. It combines real human support with the latest technology so you can make lasting changes, one step at a time.
With Omada®, you will …
All at no additional cost to you:
If you or your covered adult dependents are enrolled in a WGU medical plan, are at risk for type 2 diabetes or heart disease, and are accepted into the program, you’ll receive the program at
no additional cost.
Travel Reimbursement Benefits
When providers are not available within a 60-mile radius of your home location for medical services, our UHC medical plans will cover up to $10,000 in total travel expenses (which includes a $50 daily lodging cap for an individual and up to $100 daily lodging cap if traveling with a companion) for employees and their dependents requiring travel for all procedures, including those related to reproductive and gender-affirming care. For more information and assistance filing a claim, HDHP plan participants contact UHC member services and Informed Choice plan participants contact Surest member services.
Whatever ‘healthy’ means to you, Omada® helps you get there by providing:
- An interactive program
- A wireless smart scale
- A personalized plan created for you
- A dedicated care team to help answer all your questions
- Weekly online lessons
- A professional health coach
Additional Support
Employees with WGU medical coverage have access to support resources for conditions like diabetes, COPD, asthma and other chronic health matters. One-on-one assistance is available to help you with:
- Locating online resources for your condition
- Understanding your condition, diagnoses, medications, triggers, and warning signs
- Establishing and following a personal care plan
- Setting health goals and improving healthy habits
- Hospital admissions
- Comparing treatment options
Log in to the UHC website to learn more about your diabetes management program, available to medical plan members who have been diagnosed with diabetes. Receive a smart touchscreen glucose meter that automatically uploads readings and provides personalized tips, as well as unlimited test strips and support from coaches.
Medical Plan Tools
Visit your medical plan website to find a doctor, compare costs, manage claims, and more.
Prescription Tools
Visit your prescription plan website to order or refill prescriptions, sign up for home delivery, and more.
HSA and FSA Tools
Visit your tax-advantaged account website to manage your HSA or FSA accounts online, use calculators, and more.
- HSAs and FSAs – Visit the HealthEquity website
Find a Doctor
Using in-network providers saves you money. If you are enrolled in a Western Governors University medical plan, find doctors in your plan network to save money.
Both the HDHP and ICHP use a national network called Choice Plus. Specifically in Utah, the network is called Options PPO.
- Search the Choice Plus Network
- Search the Options PPO Network (Utah only)
- Behavioral Healthcare Providers
- Know before you go. Before you visit any provider or facility, we recommend you call ahead to be sure they are in your plan’s network, as well as confirm their address, office hours, and that they are accepting new patients.
- Meet the provider in person. Ask to schedule an introductory appointment. This appointment can help you decide if the provider is a good fit for you.
- Expanded Travel and Lodging Benefits: When providers are not available within a 60-mile radius of your home location for medical services, our UHC medical plans will cover up to $10,000 in total travel expenses (which includes a $50 daily lodging cap for an individual and up to $100 daily lodging cap if traveling with a companion) for employees and their dependents requiring travel for all procedures, including those related to reproductive and gender-affirming care. For more information and assistance filing a claim, HDHP plan participants contact UHC member services and Informed Choice plan participants contact Surest member services.
Don’t have a personal doctor? You should. Here’s why.
- Better health. Getting the right health screenings each year can reduce your risk for many serious conditions. Preventive care is free under both the HDHP and the ICHP.
- A healthier wallet. Having a doctor you can call helps you avoid costly trips to the emergency room and decide when you really need to see a specialist.
- Peace of mind. Advice from someone you trust ... it means a lot when you’re healthy, but it’s even more important when you’re sick. Your personal doctor gets to know you and your health history and can help coordinate any care you need.
Money-Saving Tips
When you carefully consider the financial impact of your health care choices, you can help lower costs for yourself and the entire company. Get the most from your medical benefits by following these tips to be well and buy smart:
- Use in-network providers. They’ve agreed to charge only up to negotiated rates and bill your insurance company directly, which saves you money and time. Also, check with your insurance company to ensure that a service is covered before you receive care.
- Keep up with preventive care. It’s covered in full by all of our medical plans and can help detect and prevent potentially costly health issues early. You pay nothing for annual physicals, recommended immunizations, routine cancer screenings, and more when you see in-network providers.
- Use tax-free money to pay for eligible health expenses. Contributing to a Health Savings Account (HSA) or a Health Care Flexible Spending Account (FSA) is easy and saves you money. You can set aside before-tax dollars from your paycheck to use for out-of-pocket costs. Keep in mind that with an HSA, you can only spend contributions that have actually been deposited into your account. And with an FSA, you can only carry over up to $660 of unused money in your FSA to the next year; you will forfeit amounts above $660.
- Shop smart for prescriptions. Using generic alternatives will almost always save you money — and they’re just as effective as brand-name prescriptions. Also, try calling a few local pharmacies to compare prices before deciding where to fill a prescription. For your ongoing prescriptions, use the home-delivery service to save money and time.
- Take advantage of the Western Governors University Wellbeing program. It offers valuable resources to help you improve your health, which could prevent the need for costly care. Plus, if you are enrolled in the HDHP, you will have an opportunity to receive medical plan incentives! Not only that, you will have an opportunity to earn Boomer Bucks that you can redeem for merchandise in the Sonic Boom online store. And if you are enrolled in the ICHP, you have the opportunity to earn incentives for a ThrivePass Lifestyle Spending Account. If you are not enrolled in either of WGU’s medical plans, you can still participate and earn Boomer Bucks!
- Choose the right place to get care. Facilities charge different amounts for the same services, so think about your options when you or a family member needs medical attention. Use the guide below to help you save money and choose the most appropriate care for your situation.
| Telehealth | Doctor’s office | Urgent care clinic | Emergency room |
|---|---|---|---|
| Use it for | |||
| A common, non-emergency medical issue that can be diagnosed by phone or online | A condition that doesn’t need immediate attention and can wait until the next day | A condition that needs immediate care but is not life- or limb-threatening | A life-threatening or potentially crippling condition that needs immediate attention |
| Examples | |||
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| Cost | |||
| You pay: $ | You pay: $ | You pay: $$ | You pay: $$$ |
| Find it | |||
| Call your regular doctor or search for an in-network provider on your medical plan carrier’s website | Search for urgent care clinics near you or on your medical plan carrier's website | Call 911 or search online for the nearest hospital | |