National Medical Plans: Cigna and UnitedHealthcare
Here’s a look at the benefits provided under the Options A, B and C of the Medical Plan. Please note that your deductible and out-of-pocket maximum reset each Plan year.
Medical Comparison Chart
2024 Plan Information
| Option A | Option B | Option C |
|---|---|---|
| Individual Annual Deductible | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Family Deductible | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Individual Out-of-Pocket Maximum | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Family Out-of-Pocket Maximum | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Diagnostic and Preventive Care | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Most other services, including inpatient and outpatient hospital and specialist visits | ||
In-Network: Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required. Out-of-Network: Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required. | In-Network: Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required. Out-of-Network: Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required. | In-Network: Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required. Out-of-Network: Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required. |
| Cancer Support Program | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Bariatric Surgery | ||
In-Network: UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible. Out-of-Network: UHC: No coverage | In-Network: UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible. Out-of-Network: UHC: No coverage | In-Network: UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible. Out-of-Network: UHC: No coverage |
| Maternity | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
| Fertility Coverage (includes cryopreservation, artificial insemination, IVF, GIFT and ZIFT) | ||
In-Network: Out-of-Network: | In-Network: Out-of-Network: | In-Network: Out-of-Network: |
Out-of-network reimbursements are based on eligible expenses as determined by the Plan administrator. You are responsible for any payments required to the provider in excess of the reasonable and customary amount.
Amounts paid to out-of-network providers count toward the in-network and out-of-network annual deductible. The amount you pay toward your annual deductible is included in your out-of-pocket maximum.
For non-preventive health care services, including office visits, coinsurance will apply after you have met your annual deductible. That means you will pay a percentage of the cost of services (coinsurance) rather than a flat fee (copay). The amount you pay in coinsurance plus the annual deductible during the year will not exceed your annual out-of-pocket maximum.
Upon enrolling in the program within 60 days of a cancer diagnosis and meeting your annual in-network deductible, Morgan Stanley will cover 100% of the cost of cancer-related treatments and procedures provided by in-network doctors and facilities. This enhanced coverage applies to medical claim expenses only, which must indicate a cancer diagnosis. This does not apply to pharmacy claims. Regular engagement with a CSP nurse is required.
A lifetime maximum of $75,000 for fertility medical services and prescription drugs – combined with adoption and surrogacy reimbursements from the Firm and in- and out-of-network costs – applies to each household. The combined lifetime maximums apply across Plan administrators regardless of which carrier you choose, and include prior accumulation toward the fertility maximum and prior reimbursements from the Firm for adoption and surrogacy claims. Cryopreservation storage is limited to a 12-month period. Please contact Maven for further details.
Eligible expenses, otherwise known as Reasonable and Customary (R&C) charges, are determined by the health plan administrator. If you receive services from an out-of-network provider, you may be responsible for the amount billed in excess of the eligible expense.