Carnegie Mellon provides many different health plans to its domestic faculty and staff. The plan that's right for you depends on:
- the current/anticipated health needs of you and your dependents,
- the doctors and facilities that you prefer and are in your area,
- the monthly contributions required for each option.
Selecting the Right Plan For You:
- Select the carrier/network that includes the doctors and facilities you prefer.
- Select the type of plan that meets your needs.
- If selecting a PPO, select the level of coverage that meets your needs.
- Determine which, if any, dependents you will cover.
Medical Insurance Carriers
We offer medical plans through three carriers: UPMC, Highmark and HealthAmerica. Providers who are part of the network agree to accept the plan's rate as payment in full, and will not bill you for additional payment. You will save money when you use in-network providers. If you have providers that you prefer, determine which insurance plans they accept; many accept multiple insurances.
Types of Medical Plans
We offer several types of medical insurance plans:
- Preferred Provider Organization (PPO):
These plans provide a higher level of coverage when you use in-network providers. The deductible and out-of-pocket maximum are tracked separately for in-network and out-of-network services.
- Health Maintenance Organization (HMO):
HMOs involve few out-of-pocket costs, with low co-pays and no co-insurance or deductible. However, care must be received by in-network providers, and you must select a primary care physician.
- High Deductible PPO w/ Health Reimbursement Account (HRA):
These plans pair a PPO plan with a high deductible with a university-funded HRA account to help pay for medical services before the PPO deductible is met. Unused funds in the HRA may be carried over, up to three years worth of contributions.
- Comprehensive (Indemnity) Plan:
This plan provides the same level of coverage regardless of whether the provider participates in the plan or not. However, out-of-network providers may bill you for the cost of their services in excess of the plan's payment rate.