Why a UnitedHealthcare Copay Focus plan might be right for you

UnitedHealthcare Individual & Family ACA Marketplace plans is expanding the number of states and counties Copay Focus plans are offered in for 2025. These plans offer coverage with a $0 medical deductible.¹ Get the details on what the Copay Focus plan is and how it works.

What is a Copay Focus plan?

A Copay Focus plan is designed to help you know exactly what your eligible care costs before you get care. You’ll have flat-rate copays, usually around $15 or $30 depending on the health care service. Let’s learn more about how Copay Focus plans work.

First, get to know these essential health insurance terms

Premium: The amount you pay for your ACA health insurance coverage every month.
Deductible: The amount you must spend on care covered by your plan before your health plan begins to pay.
Copay: A set dollar amount you pay when you get care covered by your plan.
Network: The providers and facilities that are contracted to provide care for people with your health plan. Your plan may only pay for care in your plan's network.

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How does the Copay Focus plan work?

A Copay Focus plan may be a great choice for those who like to know their eligible care costs up front. Here are important details of the Copay Focus plan:

Premiums

This plan has a higher monthly premium than some plans. It’s designed that way so you can pay a low flat-rate copay when you need eligible care. You may also qualify for subsidies that can help lower the cost of your monthly premium. We can help estimate your costs and savings during the enrollment process.

$0 medical deductible

With a $0 deductible, you won’t have to worry about paying large out-of-pocket costs to reach a deductible before your plan starts paying – you’ll have predictable costs right from the start for eligible services.

Copays for care

You’ll pay a predetermined copay (usually $15 or $30). This will help you know what your eligible care costs are before you get care. Knowing your estimated cost makes it easier to budget for you and your family’s health care.

Choosing in-network providers

By choosing a network provider, hospital, clinic or pharmacy, you’ll be paying UnitedHealthcare’s negotiated rates for eligible care. You’ll only be responsible for your pre-determined copay. If you choose care that is not in the network, you may be responsible for paying out-of-pocket for your care. To help you find network providers who meet your needs, UnitedHealthcare has digital tools to estimate costs and find nearby network providers, so you’ll have a better sense of your costs before you get care.

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Copay Focus plan benefits

A Copay Focus plan from UnitedHealthcare has benefits that are designed to keep you healthier, like:

$0 preventive care³
$0 virtual urgent care²
$8 or less tier 2 (preferred generic) prescription medications²
Up to $150 in rewards²

Plus, extras like

$0 delivery fee for a 3-month supply of most maintenance prescriptions²
20% off Walgreens brand health and wellness products²
$0 digital fitness membership from One Pass Select™²

More resources

Open enrollment for 2025 Individual & Family ACA Marketplace plans is November 1, 2024 through January 15, 2025. Enroll now.

Footnotes

Copay Focus plans offer access to coverage with a $0 medical deductible and copays for many frequently used benefits. A deductible may apply for some prescription drug benefits. For cost shares and complete details of coverage, contact your broker or the company.
The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more.
Preventive care services are covered as recommended by the Affordable Care Act (ACA) of 2010.

Disclaimers

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, IN, KS, LA, MO, NE, NJ, TN, and WY; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; UnitedHealthcare of Wisconsin, Inc., and UnitedHealthcare Plan of the River Valley in Iowa. Administrative services provided by United HealthCare Services, Inc. or their affiliates.

The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more. By responding to this offer, you agree that a representative may contact you.