You must complete a Domestic Partner Affidavit to enroll a domestic partner. If you wish to enroll a child of your domestic partner, you must first enroll your domestic partner. You must then complete a Child of Domestic Partner Declaration for each child you enroll.

Health Plans General Information

View 2021 Premium Rates (PDF)          View 2021 Summary of Benefits and Coverage (PDF)

Imputed Income
Dependents you cannot claim on your federal income tax return are referred to as “non-tax-qualified dependents.” The IRS considers the University’s contribution toward insurance coverage for a non-tax-qualified dependent (such as a domestic partner or the child of a domestic partner) as your imputed income. Imputed income increases your taxable gross income, and is subject to federal and state income taxes and FICA (Social Security and Medicare) taxes.

Learn more by reviewing this Imputed Income flyer (PDF).

Contact Information: University of Arizona Alternative Plans
Provider Customer Service Group Number
UnitedHealthcare (800) 357-0971 730610
Delta Dental Plan of Arizona  (800) 352-6132  4602 
Total Dental Administrators (888) 422-1995  680110 
Avesis, Inc. (800) 828-9341 1101-2182

General questions or requests for assistance can be directed to the help line at  (877) 481-6781 or Ginnet Ahumada at

Medical Insurance

The UA Alternative Medical Plan is a UnitedHealthcare HMO. If you elect this plan, OptumRx will be the provider for pharmacy benefits. Enrollment is automatic.

Annual Deductible: $400/couple or family

UA Alternative Plan (Domestic Partners) Medical Copays, 2020
Service 2019
Routine Preventive Health Care $0
Office Visit
 - Primary Care Physician (PCP) $20
 - Mental Health Provider $20
 - Therapist (occupational, physical, respiratory, speech) $40
 - Chiropractor $40
 - Other Specialist $40
Hospital & Outpatient Services
 - Urgent Care $75
 - Emergency Room $200
 - Radiology (CAT, MRI, PET) $100
 - Outpatient Services $50
 - Inpatient Hospital Services $250

Save Money with Virtual Visits!

UnitedHealthcare offers a Designated Virtual Visit Network, designed for diagnosis and treatment of minor medical conditions. You can access a physician using your computer or smartphone for a real-time consultation at no cost (prescriptions have the normal copay). To find out more, log into or the UnitedHealthcare Health4Me app available from Google Play or the Apple App Store. You can also call the phone number on the back of your insurance card for assistance.

UA Alternative Plan (Domestic Partners) Prescription Drug Copays, 2018

Quantity Generic Preferred Brand Name Non-Preferred Brand Name
Retail 30 Days $10 $35 $60
Retail 90 Days N/A N/A N/A
Mail Order 90 Days $25 $87.50 $150

Medical Plan Information

Certificate of Coverage

Prescription Drug List 

Summary of Benefits and Coverage Nondiscrimination Addendum

Temporary Benefits Changes for COVID-19

Provider Search: Select “UnitedHealthcare Choice Plus” as your plan.

Dental Insurance

The UA Alternative Dental Plan offers a choice of coverage through Total Dental Administrators or Delta Dental.

Dental Plan Comparison

Total Dental AdministratorsPre-Paid Plan

  • Restricted to selected Primary Dental Providers
  • Reduced costs for services (co-payments)

Total Dental Administrators Plan Summary

Provider Search

Delta Dental—Preferred Provider Organization (PPO)

  • May see any licensed dentist
  • Preventive services not subject to annual deductible
  • Restorative services subject to annual deductible, then plan pays a percentage of post-deductible expenses for basic and major restorative services.

Delta Dental Summary of Benefits

Provider Search

Vision Insurance

The UA Alternative Vision Plan is offered through Avesis

You may choose from a participating network provider or non-provider.

  • Participating network providers are contracted with Avesis to provide services at a reduced rate for Avesis members.
  • Co-payments, deductibles, or coinsurance fees may be charged when services are used.
  • When using out-of-network providers, you must pay the provider and submit an itemized statement to Avesis for reimbursement of covered expenses.

Plan Summary

Provider Search