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)
- Preventive care is covered 100% with in-network providers
- Lower monthly premiums
- Deductibles:
- KSUFA deductible for in-network providers: $3,400 for single coverage and $5,400 for family coverage.
- AFSCME deductible for in-network providers: $3,400 for single coverage and $5,400 for family coverage.
- Non-bargaining deductible for in-network providers: $3,400 for single coverage and $6,000 for family coverage.
- No Coinsurance for in-networ
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
- Preventive care is covered 100% with in-network providers
- Higher monthly premiums
- Deductible for in-network providers: $300 for single coverage and $600 for family coverage.
- Coinsurance for in-network providers: 15%
- Office co-pays for non-preventive healthcare services:
- $15 for primary care doctors
- $30 for specialists
- Co-pays do not go toward meeting your deductible
- Out of Pocket Maximum for in-network providers
- $1,500 for single coverage ($1,200 KSUFA)
- $3,000 for family coverage ($2,
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If I opt-out of Kent Coverage, then lose insurance, what then?
If you opted out and later lost insurance coverage, you can enroll in Kent State's plans under a Qualifying Event. A qualifying event is a major life event such as loss of insurance coverage, birth, adoption, marriage, and/or divorce. Qualifying life events may make you eligible to enroll in benefits or make changes to your benefits outside of the annual open enrollment period. Just email benefits@kent.edu within 31 days of the qualifying event to enroll or make any necessary chang