The Medical Plus Plan is a preferred provider organization (PPO) plan that provides protection against major health care costs and provides full preventive care benefits. It has a higher deductible than traditional medical plans but offers you an opportunity to contribute to a health savings account (HSA). The HSA allows you to save tax-deductible money in a special bank account to help you pay eligible out-of-pocket health care expenses. Funds in your HSA continue from one year to another.
$2,700 You + 1*
$3,350 You + 2 or more**
$6,850 You + 1*
$7,500 You + 2 or more**
* Individual + 1 - the aggregate deductible and aggregate out-of-pocket maximum will apply. This means that any combination of family members' expenses can satisfy the aggregate deductible and out-of-pocket maximum.
** Individual + 2 or more - the aggregate deductible will apply. This means that any combination of family members' expenses can satisfy the aggregate deductible. The out-of-pocket maximum for any individual each year is $6,850. Once an individual has reached this amount, the out-of-pocket max will be considered met for that individual. The balance of the family deductible must be reached by other covered family members for the out-of-pocket max to be considered met for all enrolled family members
Preventive Care Guidelines
Routine physical exams, well-child visits and sports physicals
In-network: Covered in full
Out-of-network: Deductible then 35%
Cancer screenings: mammograms, PAP smears, colonoscopies, prostate PSA screenings and more
General blood tests: cholesterol, triglycerides, thyroid and more
Other: bone density studies, type 2 diabetes and sexual health screenings
In-network: Deductible, then 15%
Out-of-network: Deductible, then 35%
Medical Plan deductible applies
Retail pharmacy, specialty drugs and mail-service:
15% after medical deductible.
Certain preventive generic prescription drugs for the prevention or recurrence of heart disease are covered in full and not subject to the annual deductible. These include medications for high cholesterol, high blood pressure and cholesterol, high blood pressure and diabetes.
Deductible, then 15%
Note: Emergency room care is always covered at the highest benefit level, regardless of whether or not the hospital is part of the BlueCard PPO network. However, if you receive emergency care at a non-preferred hospital, you may be responsible for any amount that exceeds the allowed cost.
Search for a Preferred Provider in the Premera Find a Doctor tool.
Benefits for routine vision exam, one per calendar year, is covered in full up to the allowable charge – no deductible.
Benefits for vision hardware or contact lenses:
You are no longer eligible to contribute to an HSA if any of the following apply during the plan year:
If you are receiving VA benefits for a service-connected disability, and are currently not on TRICARE, you may be eligible to contribute to an HSA.
*For more detailed information, refer to IRS Publication 969, "Health Savings Accounts and Other Tax-Favored Health Plans," which you can download from the IRS web site or order by calling 800-TAX-FORM.
Your HSA is offered through HSA Bank, an independent provider of health savings account products and services. It's an account you own, which allows you to save for health care expenses. Keep the money in your account to earn interest, pay for future health care expenses or use the money to pay for current expenses.
To determine your eligibility for an HSA, refer to the "Am I Eligible for an HSA?" accordion.
Contribution limits for 2019 for individuals 55 and older
With an HSA, you can contribute as much money as you want, up to the yearly maximum.
*Catch-up contributions can be made any time during the year in which the HSA participant turns 55.
Note: Maximums are adjusted for inflation annually by the IRS.
Using Your Funds
The money in your HSA is yours to keep. You take the money with you. And, you don't have to use the money by a certain date. The longer you leave money in your account, the more interest it will earn.
In general, your HSA can be used for:
Your HSA may not be used for over-the-counter drugs, unless you have a written prescription from your provider.
For more information about your health savings account, please read HSA Bank Annual IRS Contribution Limits or Standard HSA Rates & Fee Schedule.
Investing your health savings account
You can increase the potential future value of your health savings account by investing money from your account in mutual funds. Your account with HSA Bank gives you access to investing with TD AmeriTrade or Devenir Financial. There's no minimum HSA balance required, so you can choose how much you want to invest, none, some or all of the money in your Health Savings Account.
TD AmeriTrade offers self-directed investing with access to stocks, bonds and over 11,000 mutual funds. Devenir Financial offers managed accounts with access to a variety of mutual funds. Please note, there may be transaction fees or annual fees associated with these accounts.
For more information about investment options, visit HSA Bank.
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