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UHC Gold-X Value HSA (Off-Exchange Only)

UnitedHealthcare
by UnitedHealthcare
2026 health insurance plan
Monthly Premium

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GoldHMOHSA eligible
Deductible · ind / family $3,400 / $6,800
Max out-of-pocket · ind / family $4,400 / $8,800
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Estimated yearly cost

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Coverage details

Deductible · individual $3,400 /yr
Deductible · family $6,800 /yr
Max out-of-pocket · individual $4,400 /yr
Max out-of-pocket · family $8,800 /yr
Includes child dental Yes
Includes adult dental No

Benefit details and out-of-pocket costs

Doctor visits

Preventive care & screenings No charge
Primary care visit Not Applicable
Specialist visit 20.00% Coinsurance after deductible

Hospital & emergency

Emergency room 20.00% Coinsurance after deductible
Inpatient facility 20.00% Coinsurance after deductible
Inpatient physician 20.00% Coinsurance after deductible

Prescription drugs

Tier 1 · Generic $3 Copay after deductible
Tier 2 · Preferred brand 25.00% Coinsurance after deductible
Tier 3 · Non-preferred brand 30.00% Coinsurance after deductible
Tier 4 · Specialty 45.00% Coinsurance after deductible

Plan documents & tools

* Figures shown are only for in-network medical costs.

** Please check with the insurance company if copay and coinsurance rates are before or after the deductible.

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