Medical Plans Overview

Choosing a medical plan is a personal decision based on your coverage needs and the people you cover. No matter which Pandora medical plan you choose, you can count on having the coverage you need (like 100% covered preventive care) and more.

What will I pay?

See what you'll pay for medical coverage through Pandora.

What to consider when choosing a plan

  • Your paycheck vs. your visit costs—lower premiums can come with higher deductible/coinsurance. Review the paycheck costs for each plan.
  • How often you expect to use care (ongoing conditions, specialist visits, therapy, planned procedures)
  • Prescription needs, especially if you take ongoing brand or specialty medications
  • Whether your preferred providers are in-network (and how easily you can switch if needed)
  • Whether you want a Health Savings Account (HSA) or prefer copays that are more predictable at the point of care.

Start your provider search with Garner

Garner Health is your first stop for all your healthcare provider needs. Follow these simple steps to get started:

  1. Download the app via App Store or Google Play.
  2. Enroll in the app and create your free account and set up direct deposit.
  3. Save or mark your chosen provider as your Top Provider in the app before your visit.
  4. If you have an eligible expense, follow the in-app steps to submit a claim so that you can receive reimbursement through direct deposit (see HSA note below). Remember, your provider must be marked as a Top Provider before your appointment to qualify for reimbursement.

Medical plan options (effective 8/1/26)

UnitedHealthcare Gold Choice Plus plan

This plan gives you the flexibility to see the providers you want while structuring costs with copays for office visits and more predictable costs for many common services. This plan also offers lower paycheck deductions than the UHC Platinum Choice Plus.

  • In-network deductible: $250 (employee-only)/$500 (family)
  • In-network out-of-pocket max: $2,000 (employee-only)/$4,000 (family)
  • In-network Primary Care Provider or specialist visits: $25 copay
  • Emergency room: $100 (waived if admitted)
  • Garner Health Reimbursement: $250 (employee)/$500 (family)

UnitedHealthcare Platinum Choice Plus plan

This plan offers flexibility to see the providers you want, but it features higher deductible and paycheck costs than the UHC Gold Choice Plus plan. It also structures costs with copays for office visits and more predictable costs for many common services.

  • In-network deductible: $1,000 (employee-only)/$2,000 (family)
  • In-network out-of-pocket max: $6,000 (employee-only)/$12,000 (family)
  • In-network Primary Care Provider visits: $25 copay
  • In-network specialist visits: $40 copay
  • Emergency room: $150 (waived if admitted)
  • Garner Health Reimbursement: $1,000 (employee)/$2,000 (family)

UnitedHealthcare Silver Choice Plus with HSA

This plan is a good fit if you want lower per-paycheck costs and like the idea of building savings in a Health Savings Account (HSA). You’ll pay more out of pocket when you use care until you meet the deductible.

  • In-network deductible: $2,000 (employee-only)/$4,000 (family)
  • In-network out-of-pocket max: $5,000 (employee-only)/$10,000 (family)
  • After deductible: 20% coinsurance for many services (including office visits)
  • Pandora HSA contribution: $750 (employee-only)/$1,500 (family)
  • Garner Health Reimbursement: $1,000 (employee-only)/$2,000 (family) (HSA rules apply—see Find the Right Provider for more information).

Skip the wait with $0 telehealth visits

Need care fast? With 24/7 virtual visits, you can connect with a provider by phone or video—anytime, anywhere—and pay nothing for your visit through your UnitedHealthcare plan.

Medical plans at a glance

Key featureUHC Gold Choice PlusUHC Platinum Choice PlusUHC Silver Choice with HSA
In-network deductible
(employee-only/family)
$250/$500$1,000/$2,000$2,000/$4,000
In-network out-of-pocket max
(employee-only/family)
$2,000/$4,000$6,000/$12,000$5,000/$10,000
Preventive care, screening, immunizations (in-network)$0$0$0
Office visits 
(in-network)
Primary Care Provider: $25
Specialist: $25
Primary Care Provider: $25
Specialist: $40
Deductible, then 20%
Diagnostic testing (in-network)X-ray and bloodwork: $0
Imaging (CT/PET scans, MRI): 10% coinsurance
X-ray and bloodwork: $0
Imaging (CT/PET scans, MRI): 20% coinsurance
X-ray and bloodwork: 20% coinsurance
Imaging (CT/PET scans, MRI): 20% coinsurance
Behavioral health (outpatient)
(in-network and out-of-network)
$25 per visit$25 per visitDeductible, then 20%
Emergency room
(in-network)
$100 (waived if admitted)$150 (waived if admitted)20%
Childbirth (in-network) Office visits: $0
Delivery professional services: 10% coinsurance
Delivery facility services: 10% coinsurance
Office visits: $0
Delivery professional services: 20% coinsurance
Delivery facility services: 20% coinsurance
Office visits: $0
Delivery professional services: 20% coinsurance
Delivery facility services: 20% coinsurance
Pandora fundingGarner Health Reimbursement: $250 (employee) / $500 (family)Garner Health Reimbursement: $1,000 (employee) / $2,000 (family)HSA contribution: $750/$1,500
Garner Health Reimbursement: $1,000 (employee) / $2,000 (family)

Notes: Amounts shown are for in-network care. Some services may be subject to the deductible, copays, or coinsurance—see the Summary of Benefits and Coverage (SBC) for details.

This is a high-level snapshot. For full details (including what services are subject to the deductible, copays, or coinsurance), review the SBCs during enrollment.

Medical for Hawaii employees

If you’re based in Hawaii, your medical coverage options are different from the mainland plans. Hawaii employees are covered through HMSA (CompMED). All other benefits aside from medical are the same for Hawaii employees.

Hawaii plan highlightWhat you pay (in-network)
Annual deductible$0
Out-of-pocket max (medical)
(employee-only/family)
$2,500/$7,500
Out-of-pocket max (prescription drugs)
(employee-only/family)
$3,600/$4,200
Preventive careNo charge for in-network preventive care (including annual preventive exam and recommended screenings)
Doctor/specialist visits$14 copay per visit
Urgent care$14 copay per visit
Emergency room20% coinsurance
Ambulance20% coinsurance (ground or interisland air)

Network + referrals: You’ll pay less when you use participating (in-network) providers, and you don’t need a referral to see a specialist.

To search providers, visit HMSA or call (800) 776-4672.

Note: This is a high-level summary for Hawaii employees. For complete plan details, review the HMSA Summary of Benefits and Coverage (SBC) and Guide to Benefits.

Contacts and resources