Insurance Plan Comparison (UT Select and Academic Blue)

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1	Key Plan Differences (see the "Sources and Resources" Tab below for links to the BCBS and UT sources we used to draft this comparison)	UT Select	Academic Blue	What does this mean?	Why does this matter?	Specific Examples	UT Select Price Estimate (all costs calculated using the "Find a Cost" Tool on the BCBS Member portal for UT Select)	Academic Blue Price Estimate (all costs calculated using the "Find a Cost" Tool on the BCBS Member portal for Academic Blue)	Estimated Price Difference

2	Overall Deductable	For UT Health Network Provider: $350 Individual/$1,050 Family For In-Network $350 Individual/$1,050 Family For Out-of-Network $750 Individual/$2,250 Family	For In-Network: $350 Individual / $1,050 Family For Out-of-Network: $700 Individual / $2,100 Family	A deductable is a flat amount the member must pay before the insurer will make any benefit payments. The deductible is usually a set amount or percentage determined by the member’s contract and is set for a given period of time.	This matters because this is the amount of money you are on the hook for before your insurance kicks in. Some services will not require you to pay into a deductible first.
3	Out of Pocket Maximum	$8,150 Individual / $16,300 Family	In-Network: $6,600 Individual / $12,700 Family Out-of-Network: $13,200 Individual / $37,500 Family	The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. Network providers sometimes use out-of-network providers for some services (such as lab work).	This matters because this is the amount of money you could be on the hook for to pay for covered medical services. This is LESS for Academic Blue than for UT Select, however, UT Select has a coinsurance maximum and Academic Blue does not have a coinsurance maximum and also replaces several copays with coinsurance (see explaination below) which makes it much more likely that you would reach the Academic Blue out of pocket maximum before the UT Select out of pocket maximum.	N/A
4	Coinsurance Maximum	$2,150 / $6,450	No Coinsurance Maximum	This means that for UT Select, you can only be required to pay $2,150 (individual) / $6,450 (family) in coinsurance in a year. However, Academic Blue does not have a coinsurance maximum. This means that you will continue to pay coinsurance until you hit your out-of-pocket maximum for the year, which is $6,600 Individual / $12,700 Family (in-network) and $13,200 Individual / $37,500 Family (out-of-network).	This is one of the biggest differences between the two plans. Academic Blue relies more on 20% coinsurance payments than on single copays than UT Select (see examples in the rows below), and there is no coinsurance maximum for Academic Blue. This means that we could end up paying up to $4,450 (individual) / $6,250 (family) (the difference between the AB out of pocket maximum and the UT Select coinsurance maximum) MORE in coinsurance in a given year on Academic Blue than on UT Select. The average TA salary at UT is 15.7K a year, and the cost of living in Austin is 32K. $4.5 K MORE in health care costs would be devastating.	N/A
5	Will I pay taxes on this?	No	Yes UPDATE: After weeks of pressure from Underpaid at UT, the Graduate School has conceded that it is illegal to tax us on this benefit.	UT Select is a non-taxable employee benefit while Academic Blue is a "taxable premium credit." UPDATE: After weeks of pressure from Underpaid at UT, the Graduate School has conceded that it is illegal to tax us on this benefit.	We are not being given health insurance as employees on Academic Blue. We are being alloted a TAXABLE premium credit which will increase our yearly tax burden by hundreds of dollars.
6	Prescriptions/Treatment Classified as Specialty Drugs	UT SELECT: $50 (retail) $125m (mail/Smart90®)copay	20% co-insurance (i.e. the percentage YOU pay out of pocket until you meet the 6.6K out of pocket max) + smaller selection of available drugs.	Under UT Select, specialty drugs are a $50 copay. Under Academic Blue, specialty drugs are subject to 20% coinsurance, which means you pay 20% of their retail price.	Specialty Drugs are often used to treat complex or chronic medical conditions, such as physical, behavioral, or developmental conditions that may have no known cure, are progressive, and/or are debilitating or fatal if left untreated or under-treated. These include cancer medications, some medications for chronic conditions like MS, diabetes, etc.. These drugs often have a extremely high monthly costs, and if they are billed at 20% coinsurance (as they would be on Academic Blue) that would be compltely unmanageable on a UT graduate students' salary. In other words, getting sick and needing specialty drugs for treatment on Academic Blue would be a financial as well as a health emergency for UT graduate students. Check to see if your required medication is covered here and if it will be billed as a specialty medication: https://hr.utexas.edu/sites/hr.utexas.edu/files/Prime%20Formulary%20.pdf	If you or a colleague are in this situation and you would like to share the cost difference in your specialty medication on UT Select and Academic Blue for us to add to this chart, you can do so anonymously here: https://forms.gle/neu63KkqL
7						Lithobid	$6.20-$10 (30 days, depends on pharmacy)	$1,512 30-day retail
8						Eskalith (Lithium Carbonate 300 MG)	$3.23-$5.89
9						Adderall XR (5mg) Adderal XR (10 mg) Adderal XR (15 mg) Adderall XR (20 mg) Aderrall XR (25 mg)	$10
10						Nexium (esomeprazole MAgnesium)	$10
11						Nortriptyline	$3.52-$4.00
12	Diagnostic Services: Imaging, Lab work, etc.	$0 - $100 copay (deductable does not apply)	20% co-insurance AFTER you meet the deductable of $350 individual / $1,050 families (in other words, the percentage YOU pay out of pocket until you meet the 6.6K out-of pocket max for individuals or 12.7K for families)	This means that on UT Select you will pay either nothing or a $100 copay for diagnostic services such as bloodwork, x-rays, MRIs, lab work, etc.. On Academic Blue you will pay 20% coinsurance after meeting your $350 deductible. So, if you have a bill for an MRI that costs $1,765 total, you're on the hook for 20% of that, or $353.	Diagnostic services such as bloodwork, x-rays, MRIs, and lab work are important parts of both routine and specialty healthcare. For students with health conditions that require testing for a diagnosis or that require routine testing to monitor a condition or the track the progress of a chronic illness, this switch will, again, be financially devastating on a graduate student salary.	x-ray	$0	20% coinsurance of all x-rays ordered	20% coinsurance
13						bloodwork	$0	20% coinsurance of all tests ordered	20% coinsurance
14						MRI	$0 - $100 copay	$353 - $1184	Between $253 and $1084 MORE expensive on Academic Blue.
15						CT/PET Scan	$0 - $100 copay	$834	$734 MORE expensive on Academic Blue.
16	Outpatient Surgery	- Facility Fees (hospital stay): $100 co-pay (deductable does not apply), then 10% or 20% co-insurance. - Physician Fees: 10% coinsurance for a UT Health Network provider or 20% coinsurance for an in network provider.	Facility Fees (hospital stay): and Physician Fees: 20% co-insurance AFTER you meet the deductable of $350 individual/$1,050 families (i.e. the percentage YOU pay out of pocket until you meet the 6.6K out-of pocket max for individuals or 12.7K for families)	This means that on UT Select you will pay a $100 copay for the initial visit and then for any additional services performed you will pay 10% coinsurance for a UT Health Network provider or 20% coinsurance for an in network provider. The deductable does not apply here. On Academic Blue you will pay 20% co-insurance AFTER you meet the $350 deductable both for the facility fee and for the physician fees until you meet the 6.6K (individual) or 12.7K (family) out of pocket deduction.	As you can see in the specific examples we looked up using the Blue Cross Blue Shield "Find a Cost" Tool for both UT Select and Academic Blue, costs for these procedures on Academic Blue are hundreds of dollars more expensive than on UT Select. Again, for a graduate student making an average of 15.5K in a city where a living wage is 32K, this would be devastating.	Septoplasty (fixing a deviated septum)	$913-$1233	$1,164 - $2,430
17						Tonsillectomy	$578 - $1559	$778 - $2,441	Between $200 and $882 MORE expensive on Academic Blue.
18						Myomectomy (removing uterine fibroids)	Fibroid Removal Laparoscopic $1212-1559	$1,658 - $3,415
19						Vasectomy	$88-148	$368 - $428	$280 MORE expensive on Academic Blue.
20						Laparoscopic cholecystectomy (gallbladder removal)	can't find...	$1,307 - $6,030
21						Apendix Removal (Laparoscopic)	$1,559	$1,856 - $1,917	Between $297 and $358 MORE expensive on Academic Blue.
22						Breast Biopsy	$462-708	$665 - $944
23						Abdominal Hernia Repair	$1126-1559	$1,326 - $2,435	Between $200 and $876 more expensive on Academic Blue.
24	Pregnancy	Office Visit: $20 copay, then coinsurance Childbirth/delivery professional services: 10% coinsurance at UT Health Provider and 20% coinsurance for in-network provider Childbirth/delivery facility services: $100 copay per day and then 10% or 20% coinsurance	Office Visit: $20 copay Childbirth/delivery professional services and Childbirth/delivery facility services: both 20% coinsurance after the deductable	This means that for both UT Select and Academic Blue, an Office Visit will be a $20 copay. However, costs for the actual delivery and health care are much higher on Academic Blue. On UT Select, you will pay 10% coinsurance for a UT Health Provider for delivery and a $100 daily copay for facility services, plus 10% coinsurance (UT Health Network) or 20% coinsurance (in network provider) for facility services. On Academic Blue you will pay the full deductable and then you will pay 20% coinsurance for both delivery and facility services.	As you can see in the specific examples we looked up using the Blue Cross Blue Shield "Find a Cost" Tool for both UT Select and Academic Blue, costs for these procedures on Academic Blue are hundreds of dollars more expensive than on UT Select. Again, for a graduate student making an average of 15.5K in a city where a living wage is 32K, this would be devestating. Graduate students are adults who are starting families, and gradaute students who give birth should be able to afford the necessary health care to have a safe delivery. We should not have to choose between our studies and the health of our families.	Office Visit	$20 copay	$20 copay	$0
25						Vaginal Delivery	$1,459	Vaginal Delivery without Complications: $2,424 - $3,344	Between $956 and $1885 more expensive on Academic Blue.
26						C-Section	$1,459	C-Section Delivery without complications: $2,664 - $3,714	Between $1,205 - $2,255 more expensive on Academic Blue.
27						Post-Delivery Care		Post-Delivery Care: $1,215 - $3,808
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31	Specialist Visit	$35 co-pay (deductable does not apply)	$40 copay (deductable does not apply)	The cost to see a specialist will go up $5.	This might not seem like a lot, but if you see a specialist (like a therapist) weekly or even monthly, this will add up quickly. Let's say you see a psychiatrist weekly for a year, so around 50 visits. On UT Select you will pay $1,750 total in copays. On Academic Blue you will pay $2000. That's a difference of $250, which, again, when you don't make a living wage is a significant amount of money.	Dermatologist	$35 copay	$40 copay (no limitations)	$5 more per visit on AB
32						Allergist
33						Infectious Disease Doctors
34						Obstetrician/gynecologists
35						Endocrinologist
36						Gastroenterologists
37						Nephrologists
38						Cardiologist
39						Urologists
40						Pulmonologists
41						Otolaryngologists
42						Neurologists
43						Psychiatrists
44						Oncologists
45						Radiologists
46						Rheumatologists
47						General surgeons
48						Orthopedic surgeons
49						Cardiac surgeons
50						Anesthesiologists
51	Hospital Stay	10% coinsurance with a UT Health Network Provider OR $100 copay per day, then 20% co-insurance for any additional services (after deductable is met) for an in-network provider.	20% co-insurance AFTER you meet the deductable of $350 individual/$1,050 families (i.e. the percentage YOU pay out of pocket until you meet the 6.6K out-of pocket max for individuals or 12.7K for families)	This means that on UT Select you will either pay 10% coinsurance for a UT Health Network Provider, or, you will pay a $100 copay for the initial visit and then for any additional services performed you will pay 20% coinsurance for an in network provider. On Academic Blue you will pay 20% co-insurance AFTER you meet the $350 deductable both for the facility fee and for the physician fees until you meet the 6.6K (individual) or 12.7K (family) out of pocket deduction.	Again, this will be more expensive which is an added burden for gradaute students already struggling to make ends meet.
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	A	B	C	D	E	F	G	H	I	J	K	L	M
1	SOURCES AND RESOURCES All data for this chart was taken from the UT Select and Academic Blue Plan Overviews listed on the UT Graduate School Website and the Blue Cross Blue Shield of Texas (BCBS) websites, as well as the "Find a Cost" Tool on the BCBS member portal. Because you can only use the "Find a Cost" Tool for the plan you’re on, we have been crowdsourcing comparisons between cost estimates for different procedures between students currently on the two different plans. If you’ve looked up any specific treatment, procedures, or medications and want us to add them to this comparison chart, please fill out the survey linked below and we will make that addition! UT Select Plan Overview: https://drive.google.com/file/d/1nKYvC9SlIA2ZCtl_k_ct42aAH-l6lhq1/view?usp=sharing Academic Blue Plan Overview: https://drive.google.com/file/d/1UgWVcPLzcE-Exdirvxx-Cb25WUGdE49h/view?usp=sharing BCBS Member Services Find a Cost Tool: https://bit.ly/3vw6URf Submit a cost range for a specific procedure: https://forms.gle/neu63KkqL You can read our Open Letter to the Gradaute School for a comprehensive summary of our concerns about this switch here: http://bit.ly/InsuranceOpenLetter You can sign our petition to delay the implementation of this switch here: http://bit.ly/gradhealthpetition Please don't hesitation to email us with questions or concerns at underpaidatut@gmail.com.
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