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  1. Associate
  2. Medical Plans
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Our Medical Plans

The best insurance is the kind you understand. Learn more about the payment details and costs for both plans.

Payment Details

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Annual Deductible Individual: $1,500
Individual +1: $3,000
Family: $3,000
Individual: $1,250
Individual +1: $2,500
Family: $2,500
Paycheck Contributions
(Annual salary <$70K)
Individual: $29.25
Individual +1: $58.12
Family: $84.55
Individual: $45.67
Individual +1: $90.90
Family: $132.60
Paycheck Contributions
(Annual salary ≥$70K)
Individual: $43.29
Individual +1: $86.17
Family: $126.36
Individual: $64.44
Individual +1: $128.38
Family: $188.25
Contributions from Blue Cross
(Annual salary <$70K)
Individual: $1,125
Individual +1: $2,250
Family: $2,250
Individual: $400
Individual +1: $800
Family: $1,000
Contributions from Blue Cross
(Annual salary ≥$70K)
Individual: $750
Individual +1: $1,500
Family: $1,500
Individual: $400
Individual +1: $800
Family: $1,000
Net Deductible: the remaining balance of your deductible after using Blue Cross contributions
(Annual salary <$70K)
Individual: $375
Individual +1: $750
Family: $750
Individual: $850
Individual +1: $1,700
Family: $1,500
Net Deductible: the remaining balance of your deductible after using Blue Cross contributions
(Annual salary ≥$70K)
Individual: $750
Individual +1: $1,500
Family: $1,500
Individual: $850
Individual +1: $1,700
Family: $1,500
Out-of-Pocket Maximum Individual: $5,000
Individual +1: $10,000
Family: $10,000
Individual: $3,000
Individual +1: $6,000
Family: $6,000

 

How to Determine Your Net Deductible

A Blue Cross-funded account is automatically paired with each medical plan to help offset a portion of your annual deductible.

Example:

Pat needs family coverage and has an annual salary of less than $70,000.

Based on the rates in the chart above, see how Pat would find the Net Deductible for each plan.

  PPO Plan HMO Plan
Annual Deductible $3,000 $2,500
Subtract Contributions by Blue Cross $2,250 $1,000
Net Deductible $750 $1,500

Medical Services Costs

Co-insurance/­Copayments

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Your Cost You must meet the deductible amount first; then you’ll only pay 10% co-insurance (when required) $25-$150 copayments (specific services subject to deductible)

Medical

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Preventive Care $0, no deductible $0, no deductible
Emergency Room (ER) Deductible, then $150 copay1 $150 copay, no deductible1
Urgent Care Deductible, then co-insurance $35 copay, no deductible
PCP Visit Deductible, then co-insurance $25 copay, no deductible
Specialist Visit Deductible, then co-insurance $35 copay, no deductible3

Hospital Care

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Inpatient/­Outpatient Deductible, then co-insurance2 Deductible, then $01

Mental/Behavioral Health or Substance Use Disorder

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Inpatient Deductible, then co-insurance2 Deductible, then $0
Outpatient Deductible, then co-insurance $25 copay, no deductible

Pregnancy Care

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Prenatal $0, no deductible $0, no deductible
Postnatal Deductible, then co-insurance $0, no deductible
Inpatient (including delivery) Deductible, then co-insurance Deductible, then $0

Telehealth

  Blue Care Elect Saver—Choice (PPO) Network Blue New England Deductible (HMO)
Minor medical care Deductible, then co-insurance for medical care $25 copay for medical care
Therapy Deductible, then co-insurance for therapy $25 copay for therapy
Psychiatry Deductible, then co-insurance for psychiatry $25 copay for psychiatry

1. Copay waived if admitted or for observation stay.

2. Prior authorization required.

3. Under this plan, you are required to select a PCP and will need a referral from your PCP to see a specialist.

4. Changes and cost-sharing limitations and/or exceptions may apply. For more information, review the overview of benefits and coverage under each medical plan option.

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