How does my prescription coverage work when enrolled in a High Deductible Health Plan?
When enrolled in the High Deductible Health Plan, you can expect to pay the negotiated price for your prescriptions, that are not on the Preventative Drug List, until your HDHP annual deductible is met.
Coverage highlights of the High Deductible Health Plan (HDHP)
You probably noticed that the High Deductible Health Plan (HDHP) has a higher deductible and lower monthly premiums than a typical health plan like the university’s 85/60 PPO plan. If you would typically choose your health plan by premium cost, be sure you understand the tradeoff for a lower monthly premium.
The HDHP requires you or your family to pay the full cost of your health care, including your medications, until you reach a fixed dollar amount. This is called your plan’s annual deductible.
What is default status and what does it mean for me?
New Employees have 31 days to enroll from their date of hire. If you do not select a plan within that time, you default into "refused coverage" status and you cannot select a plan until open enrollment, or until a qualifying life event occurs. Simply put, TAKE ACTION! Review your benefits offerings and select a plan that works for you and your family.
Coverage highlights of the 85/60 plan
On the Medical Mutual plans, your medical premium includes prescription and vision benefits. The 85/60 health insurance plan offers a lower deductible, but a higher monthly premium. The plan covers preventive annual exams, immunizations, and preventive screenings at no cost to the employee. Other in-network inpatient, outpatient, and diagnostic services are covered at 85% after the deductible is satisfied. Out-of-network coverage for these services is covered at 60% after the deductible has been satisfied.