September 2018: Get the scoop on the new medical plan option for 2019

Get the scoop on the new medical plan option for 2019

You saw in the Open Enrollment Sneak Peek email that we had a new medical plan option coming in 2019.

The new medical plan option will be offered through Texas Health Aetna. The name of the plan is Texas Health Aetna Select Plan 3000. Check out the information below for details to find out what’s the same and what’s different between all five plan options.

The biggest differences for this plan option are that it has the:

  • Highest deductible amount ($3000 for individual, $6000 for family)
  • Requirement that the high deductible has to be met before the plan will pay for any prescriptions OR health care ($3000 for individual or $6000 for family), other than preventive care and Telehealth (Texas Health ER Doc).
  • No co-pays for office visits or specialists. You pay 100% of the cost until you meet the deductible  ($3000 for individual or $6000 for family). Then, you pay 10% of the cost and the plan pays 90%.
  • Lowest out-of-pocket maximum
  • Lowest premiums
  • Ability for employees in the plan to set up a personal Health Savings Account, or HSA. Texas Health is NOT offering an HSA, and those interested may refer to their bank or financial advisor. Employees cannot be enrolled in both a Flexible Spending Account (like our Health Care Flexible Spending Account) AND a Health Savings Account.

 The plan is similar in that it has the same:

  • Network as the Texas Health Aetna Select Plan 1000
  • Covered medical expenses and exclusions as the other plan options

(Click the images for a larger view)

Medical Plan Details Rx Plan Details

 

 

If you enroll in the new Texas Health Aetna Select Plan 3000, you are eligible to enroll in a Health Savings Account on your own. We cannot advise you on how to do this or how much to elect, but here is some helpful information. Please contact your bank or financial advisor to get advice.

What is a Health Savings Account?

A type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. By using untaxed dollars in a Health Savings Account (HSA) to pay for deductibles, copayments, coinsurance, and some other expenses, you can lower your overall health care costs. HSA funds roll over year to year if you don’t spend them. An HSA may earn interest, which is not taxable.1

Who can enroll in an HSA?

To be eligible to enroll in an HSA, you must:

  1. Be covered by qualified high deductible health insurance plan, like the Texas Health Aetna Select 3000 option;
  2. Not be covered under other health insurance;
  3. Not be enrolled in Medicare;
  4. Not be another person’s dependent2; and
  5. Not have elected health care FSA account

How much can I contribute?

$3,500 for an individual, or $7,000 for a family3

1 https://www.healthcare.gov/glossary/health-savings-account-hsa/
2
http://www.hsacenter.com/how-does-an-hsa-work/frequently-asked-questions/
3
https://www.irs.gov/pub/irs-drop/rp-18-30.pdf