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Medical & Prescription Coverage

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Available Medical Plans (Both Networks available on all plans)

Traditional Value STAR
Deductible PPY
$500 / $1,500 $1,250 / $3,750 *$1,500 / $3,000
Based on how you are enrolled
Out of Pocket Maximum
$5,000 / $10,000 $5,000 / $10,000 $5,000 / $10,000
Coinsurance 80% / 20% AD 80% / 20% AD 80% / 20% AD
Visit Co-Pays
Primary / Specialist
$30 / $40 $25 / $35 80% / 20% AD
Preventive Covered 100% Covered 100% Covered 100%
Generic / Preferred /
Non-Preferred / Specialty
$15 / 35% / 50% / 50% $250 Deductible Per Person
$7 / 20% / 35% / 35%
80% / 20% AD

For more details, see plan summary:
Advantage/Summit Traditional Plan
Advantage/Summit Value Plan
Advantage/Summit STAR Plan

Medical Premiums


Summit (generally non-Intermountain Health providers & rural Intermountain hospitals.)
University of Utah                                                     Ogden Regional

St. Marks                                                                     Huntsman Cancer Institute
Lone Peak Hospital                                                   Holy Cross Hospital - Jordan Valley (Jordan Valley Hospital)
Primary Children's                                                     Holy Cross Hospital - Salt Lake (Salt Lake Regional)

Advantage (generally uses providers largely around Intermountain Health facilities)
Intermountain Medical Center                                McKay Dee

LDS Hospital                                                               Riverton
Alta View                                                                     American Fork
Primary Children's

Please see herefor a complete network list of hospitals.

If you have dependents living out of state, you need to contact PEHP to let
them know prior to receiving medical care for non emergencies.

PEHP Value Providers
See healthcare providers with the lowest out-of-pocket costs.

Traditional and Value Plans: $10 office co-pay
The STAR Plan: 25% discount on what you would normally pay an in-network provider
Click here to find current PEHP Value Providers!

You can get CASH BACK on certain procedures, testing and scans for using PEHP Value Providers, see below to learn how to get started!
PEHP Cost Tools

E-Care/ Telemedicine
Visit a doctor online anytime, anywhere.

Intermountain Connect Care is available on all networks
Intermountain Connect Care
University of Utah Health Virtual Visits available on Summit network only
University of Utah Healthcare Virtual Visits

Traditional and Value Plans: $10 per visit
STAR HSA Plan: $49 per visit or $10 per visit after deductible

Need ID Cards? Print your ID Card from PEHP's website!
How to Print ID Cards from PEHP

If you use a specialty medication, you may be eligible for Express Scripts SaveOn program!
By enrolling in the available manufacturer assistance program and consenting to SaveOnSP monitoring your pharmacy account, your final cost will be as low as $0. Please call 1-800-683-1074 to participate.
SaveOn Medication List

CRX International
Get brand-name maintenance medications at huge SAVINGS.
Visit CRX International to find which prescriptions are eligible and to enroll!
*Must be on the Traditional or Value plan to be eligible for CRX Savings!

Video: PEHP Member Guide

Video: Know Before You Go – take a few extra simple steps beforehand to assure you get the right care, at the best value, and avoid unnecessary large bills.)

PEHP Flex Spending Reimbursement Form
Prescription Reimbursement or COB Reimbursement Form

Glossary of Health Coverage and Medical Terms
2023-24 Traditional Plan Summary of Benefits & Coverage (SBC)
2023-24 Value Plan Summary of Benefits & Coverage (SBC)
2023-24 STAR (QHDHP) Plan Summary of Benefits & Coverage (SBC)