What’s Staying the Same for 2024

Medical Plan Features/Programs

Medical Faculty Associates Benefit Coverage Tier

The GW PPO and HSP medical plans include a separate benefit coverage tier for Medical Faculty Associates (MFA). When GW medical plan participants see an MFA provider*, they receive lower copayments and lower coinsurance, helping your medical expense dollars go further because a greater portion of your care will be covered by the Plan. GW employees also have a dedicated phone number to schedule appointments at: 202-677- 6000.

*The MFA tier applies to professional charges by MFA providers, MFA behavioral health providers will continue to be out of-network.

Real Appeal

Real Appeal is a virtual weight loss support program offered through both the GW HSP and GW PPO. (You must be a UHC plan participant to join.) Members must have a body mass index (BMI) of 23 or more to participate. Weekly online coaching sessions and tools, such as a Program Success Guide, Nutrition Guide, fitness DVDs and resistance bands, are included.

If you are currently enrolled in a UnitedHealthcare medical plan through GW, you may enroll at any time after meeting BMI eligibility requirements. If you are newly electing UnitedHealthcare for 2024 Open Enrollment, you may enroll beginning January 1, 2024. Visit gwu.realappeal.com for more information.

UHC Virtual Visits

Virtual Visits will remain a health plan feature for 2024, allowing UHC members to connect with a doctor via mobile device or computer—24/7, no appointment needed. Get timely care, including diagnosis and prescription, and pay less out-of-pocket. To access a UnitedHealthcare Virtual Visit provider, log on to www.myuhc.com or download the UHC App. Find instructions on how to access the additional virtual visit providers in the FAQ section on myuhc.com under related links for additional information.

Telemental Health

Telemental Health is available through your UHC medical benefit. The service uses secure, video-calling technology to provide real-time access to a behavioral health professional, and features a network of over 3,000 providers in all 50 states. Learn more or schedule a visit at myuhc.com.

Freestanding Imaging and Labs Preferred Network

A freestanding network facility performs outpatient services and submits claims separately from any hospital affliation, and may be a lower cost option. GW offers a preferred network,* including a lower coinsurance, for usage of freestanding facilities in lieu of hospitals for lab tests, radiology services, major diagnostics and other services. LabCorp and Quest Diagnostics are GW’s preferred vendors for lab work. The cost for visiting a GW-preferred network facility will remain the same for 2024:

GW HSP: 20 percent coinsurance after deductible
GW PPO: 20 percent coinsurance after deductible

Search for an outpatient center or laboratory on myuhc.com. Choose "Freestanding Facility" to help reduce out-of-pocket costs.

* In-network freestanding facilities and GW Hospital

Prescription Plan Features/Programs

Mandatory Maintenance Choice – All Access with Opt-Out

Under the Maintenance Choice program, the number of 30-day fills for maintenance prescriptions at a retail pharmacy (including CVS) is limited to three. After their third 30-day fill members will be prompted to either move their prescription to CVS or contact customer care to opt out and continue filling at their local pharmacy. Through this program, participants gain access to delivery offerings:

On-Demand Delivery – Four-hour delivery offered within 10 miles of any CVS Pharmacy store, for a small fee.
One- to Two-Day Delivery – Delivery provided by USPS within 1-2 days, at no extra cost to the member.

PrudentRx available via the GW PPO Pharmacy Benefit

PrudentRx for specialty medications will continue to be included in the GW PPO Pharmacy Benefit. This program is designed to lower your out-of-pocket costs by assisting you with enrollment in drug manufacturers discount copay cards/assistance programs. When enrolled in PrudentRx, your out of pocket cost will be $0 for medications included on the PrudentRx exclusive specialty drug list, which is updated monthly and posted on the Benefits website.

If you opt out, you will be responsible for the 30% coinsurance. Payments made by you for a medication that does not qualify as an essential health benefit, will not count toward your deductible or out-of-pocket maximum.

How to Enroll:
After enrolling in the GW PPO plan, you will be contacted via phone to enroll in PrudentRx at the time of your first specialty fill. You must complete any additional enrollment steps with PrudentRx to receive the $0 benefit when applicable.

IMPORTANT: Members must enroll in the PrudentRx program to access $0 copay benefits. Formulary exclusions will supersede this list.

If a participant’s specialty medication is not on the PrudentRx list, then the brand formulary or brand non-formulary plan design will apply.

For additional information, visit https://hr.gwu.edu/prudent