This Anthem-administered plan lets you choose health care providers within a single statewide networkNetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services, giving you access to doctors and specialists across the Front Range.

You'll receive care at UCHealth facilities by physicians from the CU School of Medicine, UCHealth Medical Group and others. Your Primary Care ProviderPrimary Care Provider (PCP)A physician (medical doctor or doctor of osteopathic medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services manages your care, but you do not need a referralReferralA written order from your primary care provider for you to see a specialist or receive certain health care services for any covered service that cannot be performed by your primary care provider. This applies to our Anthem Exclusive and Kaiser plans.   to see a specialist.

No out-of-network coverage is available except for urgentUrgent CareCare for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care and/or emergency careEmergency CareA medical or behavioral health condition that must be treated at the emergency department of a hospital due to an illness, injury, symptom or condition severe enough to risk serious danger to your health (or, with respect to a pregnant woman, the health of her unborn child) if you didn’t get medical attention. See where and when to get care..

  Plan details

  Covered providers and medications

CU Health Plan - Exclusive Guest Membership

If you have dependents covered by this plan who live out-of-state during the 2025-26 plan year, you may enroll them in CU Health Plan - Exclusive Guest Membership for additional, temporary coverage in participating states. Guest MembershipGuest MembershipAn “away from home care” program that allows your dependent children to have coverage outside the CU Health Plan Exclusive service area and is available only in certain states.   coverage ends with the health plan year. To receive and maintain this benefit, you must apply for and enroll in this program during each Open Enrollment. See Anthem's instructions for applying or call Anthem Blue Cross Blue Shield at 1-800-735-6072 to get started.

Features & Considerations
Plan Type HMOHealth Maintenance Organization (HMO)A managed health care system designed to give you access to quality, cost-effective service while optimizing utilization and cost of service. With an HMO, such as the case of our CU Health Plan Exclusive, you must choose a primary care provider from a network of physicians, facilities and other providers affiliated to CU. Your primary care provider will manage and coordinate any care of most specialists you may need by providing you with a referral within the network.       - CU networkNetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services
Deductible

$350 per individual (Each member must meet their individual $350)

$750 family maximum (3+ members)
Out-of-Pocket Limits

$9,200/Individual; $18,400/Family 
Office Visit Primary care providerPrimary Care Provider (PCP)A physician (medical doctor or doctor of osteopathic medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services -  $30/visit
SpecialistSpecialistA physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent, or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has more training in a specific area of health care. -  $40/visit
Urgent CareUrgent CareCare for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care - $30/visit

Office visit copaysCopayment (copay)A fixed-dollar amount that you must pay out of your pocket at the time of service to a provider or a facility for a specific health covered service.  Copays do not apply to the deductible requirement. For example, an office visit may have a copay of $30 under the Exclusive Plan and $40 under the Extended.  You must pay the amount at the time of service. do not apply toward the deductible.DeductibleAn amount that you are required to pay before the plan will begin to reimburse for covered services.
Outpatient/Inpatient Services Outpatient Services: $100/visit, after deductible

Inpatient Services: $200/visit, after deductible
Emergency Care $250 copay (waived if admitted)
Prescription Drug Coverage (rx) 
Up to 30-day supply*

Tier 1 $10

Tier 3 $75

Tier 2 $50

Tier 4 $100


*Maintenance and specialty medications may be purchased at a CVS Network Retail Pharmacy. After three fills, CVS Retail Pharmacies, Costco, King Soopers, City Market or CVS Mail Order must be used for up to a 90-day supply.
*Specialty medications may be purchased at a retail pharmacy. After three fills, CVS Specialty Pharmacy must be used.

Access the CVS formulary to check your medication's coverage.
Mail Order Rx
Up to 90-day supply

Tier 1: $20

Tier 3: $150

Tier 2: $100

Tier 4: $75**


**30-day supply