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Gold Health Plan

REGIONAL HEALTH PLANS

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U-M Health Regional Gold Plan

U-M Health’s Regional Gold Plan is a PPO, which pairs optionally with a health care Flexible Savings Account (FSA).

Is it right for me?

  • Team members who prefer a traditional plan design and generally have higher utilization of health care services (ex: annual physicals, doctor visits, recurring prescriptions), or those who value paying less in copays and deductible by accepting higher premiums compared to the Silver Health Plan, may be good fits for the Gold Health Plan.
  • Team members planning to have procedures, or other care items which are subject to deductible and coinsurance in Tier 2 (outside of U-M Health facilities), will have the greatest Tier 2 coverage under the Gold Health Plan.

Gold Health ONLY Plan Benefits at a Glance (BAAG)

Gold Plan RxBenefits Only Plan Summary_Sparrow Team Members


Gold Health Plan (PPO) Overview:

  • Annual deductible (2026 listed):
    • $0 for team member only coverage within U-M Health Network
    • $0 for team member plus spouse, child(ren), or family coverage within U-M Health Network
  • Coverage requirements:
    • Enrolled members pay copays for listed medical services including prescriptions and doctor visits, except for preventive services which are fully covered in network (ex: Annual physical exam, well child visits).
    • Covered services without copays listed are subject to the deductible. $0 deductible in Tier 1; Deductibles in Tier 2 are embedded, meaning individual deductibles apply. Tier 2 deductibles must be met before the plan pays for services with no copay; co-share applies after the deductible is met. Co-share varies between network tiers.
    • Our Gold and Silver Plans have embedded deductibles: individual deductibles apply
  • Enrollment requirements:
    • Team members covered by a high-deductible health plan (HDHP) may not enroll in a non-HDHP (our Silver or Gold PPO Plans) or make or receive FSA contributions
      • Non-HDHP coverage includes Medicare, Medicaid, Tricare
      • Team members enrolled in the Gold Health Plan should not make or receive HSA contributions, but can participate in the health care FSA
    • FSA contribution limits (2026 listed):
      • $3,300

Contributions are pre-tax, and FSA funds can be used on eligible items. FSA funds do not rollover year after year, but there is a 2 ½ month grace period where you can incur expenses from Jan. 1 to March 15 of the following plan year to use up unspent funds.

  • Eligible expenses: Eligible expenses include out-of-pocket expenses related to doctor visits, prescription medications, dental/vision exams and much more!
  • F.S.A. card: WEX debit card tied to individual healthcare FSA accounts will be issued.  Team members can request additional cards from the vendor.
  • Employer contribution: There are no FSA employer contributions; all funds are team member contributions only.
  • Additional FSA resources linked below the pharmacy information.


Gold Plan Pharmacy Benefit Manager information (RxBenefits):


Additional F.S.A. Resources:

More on Flexible Spending Accounts


Wex Contact Information:

Contact Wex for questions about debit cards (including requesting new cards), mobile app/website support, etc.

866-451-3399

customerservice@wexhealth.com

Benefits Account Login | Benefits Administration Acct Login | WEX Inc. Login

Important Compliance Note:

Team members electing FSA benefit options are responsible to manage compliance with IRS FSA rules.