Medical Insurance

Marquette offers three medical care options to best fit your needs: CPHP, AHDHP or EHDHP. Monthly premiums are determined by the coverage selected: employee only, employee + spouse, employee + child(ren) and family. All medical care options are identical in the type of covered services provided, the national provider network, and coverage for wellness and preventive care at 100%. The only differences between the plans are premiums, deductibles, co-pays and out-of-pocket maximums.

The CPHP has the highest monthly premiums but includes a lower deductible and out-of-pocket maximum. The EHDHP has the lowest monthly premiums but includes a higher deductible and out-of-pocket maximum. The AHDHP falls in between these two plans. Together, the deductible, coinsurance and co-pays make up the out-of-pocket maximum. Once you reach the out-of-pocket limit, the plan pays 100% of covered services for the remainder of the year. 

Eligibility

You are eligible for this benefit on the first of the month following your date of hire/change in status.

The Plan classifies an employee as an “eligible employee” when that person has a minimum of a 9-month continuous assignment and:

  • Is regularly scheduled to work for Marquette for at least 20 hours per week or has an academic appointment for a minimum of 6 credits hours in two consecutive academic year semesters;  or
  • Is covered under a Collective Bargaining Agreement with the Plan holder that specifies a different definition of health care benefit eligibility.

Medical Plan Resources

There are many other medical resources and services available to you. For example, you have access to talk with a provider virtually through Teladoc. You can also talk with a Plan Advisor at UMR for information about your claims, using a premium designated provider (PDP), seeking care for a specific illness or condition, and more.

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Care, Disease and Maternity Management and Nurseline

UMR Care Management is a staff of experienced, caring nurses (RNs) who help you get the most out of your health plan benefits. They work with you, your doctors and other medical advisers to get the services that best meet your needs. Their expert nurses can guide you before, during and after your medical care. They will listen to your concerns, answer questions and explain your options.

Whether you’re having a baby, have an emergency hospitalization or need non-emergency care, the UMR nurses are there for you. For example, we can assist you during a hospital stay, after you are released and with your home care. You can concentrate on getting well knowing your care management nurse will review your progress with your doctor. As an added bonus, our services can save you money and prevent delays in your medical claim processing.

More details on these programs can be found by clicking on these resources:

Care Management

Disease Management

Maternity Care

Nurseline

Plan Advisor

Plan Advisor is a service available to all Marquette members – just call the number on the back of your UMR ID card. Help for a number of services is just a call away.

  • Member customer service with emphasis on first call resolution
  • General customer service for medical services and claims questions
  • Navigation and assistance establishing a primary care physician (PCP), based on preferences
  • Provider appointment scheduling, transferring care or moving medical records
  • Telemedicine promotion and registration assistance
  • Network steerage – guiding and encourage members to use premium designated providers (PDPs); the highest quality, most affordable provider for their needs
  • Education on disease management, maternity and care management programs available to members
  • Education and navigational help using umr.com and the digital tools and resources
  • Member reminders

More details about Plan Advisor

Premium Designated Providers (PDPs)

Need help in selecting a new doctor, outpatient facility or hospital? Let UMR help you find providers with a blue dot, indicating they provide high quality results and lower costs to you.

Tier 1 providers include those who have consistently followed quality standards that were developed by doctors for doctors, so they know what type of care works. With these providers, you’re more likely to get the care you need the first time, at the right place. That means:

  • Fewer complications
  • Fewer do-over surgeries
  • Fewer unnecessary lab tests, MRIs and medications

Choosing Tier 1 providers helps you manage your health care dollars. Choose providers with the Tier 1 symbol — a blue dot — next to their name to get high quality* care and pay less. Call the number on the back of your UMR member ID card to get connected to a Tier 1 provider near you. Or search for one by logging in to umr.com on your computer or mobile device.

More Searching for a Provider resources:

Premium Designated Providers (PDPs)

Premium Designated Providers FAQs

Provider Search

Teladoc

Teladoc is the first and largest provider of telehealth medical consults in the United States, giving you 24/7/365 access to quality medical care through phone and video consults. Teladoc should be used when you need immediate care for non-emergency medical issues. It is an affordable and convenient alternative to urgent care and ER visits. If you haven’t already done so, you can set up your account by phone, web or mobile app.

  • Online: Go to Teladoc.com and click "set up account."
  • Mobile app: Download the app and click "activate account."
  • Call Teladoc: Teladoc can help you register your account over the phone.
    Call 1-800-Teladoc (1-800-835-2362).

Teladoc - Cost of Care

Teladoc - FAQs

Teladoc - Getting Started

Cost of Services

General medical cost (e.g., cold, flu, allergies, strep throat, etc.):

  • CPHP – $10 co-pay
  • AHDHP and EHDHP – $49 charge (subject to deductible/coinsurance)

Dermatology cost:

  • CPHP – $10 co-pay
  • AHDHP and EHDHP – $85 charge (subject to deductible/coinsurance)

Mental health care cost:

  • CPHP – $10 co-pay
  • AHDHP and EHDHP – $90/therapist, $220/psychiatrist first visit, $100/psychiatrist ongoing visits (subject to deductible/coinsurance) 

Do's and Don'ts from UMR (a fun little read)

Transparency in Coverage Rule

 On November 12, 2020, the Departments of Health and Human Services, Labor and the Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create a member-facing price comparison tool and post publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services, including prescriptions drugs. Data in machine-readable files will be updated monthly.

Beginning July 1, 2022, through UnitedHealthcare, UMR and HealthSCOPE Benefits will create and publish the Machine-Readable Files on behalf of Marquette University. To link to the Machine-Readable Files, please click on the URL provided: https://transparency-in-coverage.uhc.com/. These Machine-Readable Files will be posted in a more consumer-friendly format in 2023 and 2024.