SCU offers five medical plan options, allowing you to choose the plan that’s best for you and your family. A brief description of each plan is included below.
If you opt to waive medical coverage, Santa Clara University offers an incentive payment of $150 per month. You must fill out the Health Insurance Waiver and provide proof of coverage through another plan.
|
2024 MEDICAL PLANS |
Kaiser |
Aetna AWH |
Aetna |
Aetna |
| Annual Deductible | ||||
| Individual | None | None | None | $2,000 / $4,000 |
| Individual within Family | None | None | None | $3,200 / $4,000 |
| Family | None | None | None | $4,000 / $8,000 |
| Annual Out of Pocket Maximum | ||||
| Individual | $1,500 | $2,000 | $2,000 | $4,000 / $8,000 |
| Family | $3,000 | $4,000 | $4,000 | $8,000 / $16,000 |
|
Medical Services |
||||
| Primary Care Visit | $20 copay | $20 copay | $20 copay | 10% / 30% |
| Specialist Office Visit | $20 copay | $20 copay with PCP Referral | $20 copay with PCP referral | 10% / 30% |
| Basic X-ray and Laboratory | No charge | No charge | No charge | 10% / 30% |
| Inpatient Hospital | $250 copay per admission | $250 copay | $250 copay | 10% / 30% |
| Emergency Room | $50 copay | $100 copay | $100 copay | 10% / 10% |
| Urgent Care | $20 copay | $20 copay | $20 copay | 10%/30% |
| Chiropractic | $15 copay per visit to 30 visits per year |
$15 copay per visit to 20 visits per year |
$15 copay per visit to 20 visits per year |
10% / 30% |
| Hearing Aid | $2,500 per device, 2 devices every 3 years | 20% with $4,000 benefit maximum every 2 year | 20% with $4,000 benefit maximum every 2 year | 10% / 10% |
| Prescription Drugs | After Deductible | |||
| Generic / Tier 1 | $10 copay | $10 copay | $10 copay | $10 copay / Not covered |
| Formulary / Tier 2 | $25 copay | $25 copay | $25 copay | $30 copay / Not covered |
| Non-Formulary / Tier 3 | $25 copay | $50 copay | $50 copay | $50 copay / Not covered |
| Specialty/ Tier 4 | 20% coinsurance up to $200 Prescription | 20% up to $200 Copay | 20% up to $200 Copay | 30% up to $300 maximum / Not covered |
| Per Pay Period Employee Contribution | ||||
| Employee Only | $36.84 | $8.50 | $57.54 | $86.82 |
| Employee + 1 | $205.37 | $89.91 | $244.36 | $295.45 |
| Employee + Family | $309.77 | $169.55 | $370.97 | $468.81 |
Additional Resources