Benefits 101

Choose your plan

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Find the right plan for you

Your have many options to help you tailor your coverage to the level of care that you need.

 

Keep in mind when choosing your plans

  • Most plans have a deductible – the amount of money you pay out of your own pocket before your plan beings to share the cost of medical expenses with you.
  • After you’ve met your deductible, you only pay a small percentage of the cost of care, called coinsurance.
  • There is a limit to how much you pay out of your own pocket each year, called your out-of-pocket maximum.
  • Provider networks include the doctors, labs, hospitals and other facilities that have agreed to provide us with discounted rates for care. Going to an in-network provider will always save you money. The networks vary based on which plan you choose, so look at the plans to see which one best fits your needs.

 

We offer three new plans administered by Aetna:

Memorial Hermann ACO

  • This provider network is made up of ONLY Memorial Hermann doctors and facilities. If you are interested in seeing only Memorial Hermann doctors, this plan might be for you.
  • This plan offers prescription drug benefits through Express Scripts. Generic drugs for high blood pressure, high cholesterol, asthma, or diabetes (including injectable insulin) are available at no cost to you. You will need to purchase 90-day supplies through Express Scripts or through an Express Scripts retail pharmacy partner to take advantage of this offer.
  • You can have a Flexible Spending Account with this plan. You can set aside up to $2,750 in your FSA for eligible medical expenses, or up to $5,000 for your dependent day care expenses.

High Deductible Health Plan (HDHP)

  • This plan offers you a trade-off: You’ll pay lower premiums each month, but you will have a higher deductible to meet before the plan begins paying for medical and prescription services. If you want to be able to manage your medical spending more closely, this could be the plan for you.
  • The HDHP offers prescription drug benefits through Express Scripts, but it does not include any copays or any no-cost prescriptions. The cost of the prescriptions are combined with medical plan costs to create one annual deductible of $5,000/individual or $10,000/family. Once you have met your combined medical and prescription deductible, all charges are then paid at 100%. That includes medical as well as prescription costs.
  • This plan allows you to sign up for a Health Spending Account (HSA) to help cover your out-of-pocket expenses. Every pay period, a portion of your check will be deposited pre-tax into an interest-bearing HSA. You will receive a debit card so you can use your saved funds on expenses such as your deductible, co-payments for medical care and prescription drugs, or vision and dental care bills.  

Choice POS II

  • This plan offers a broad network, extending beyond Memorial Hermann facilities and doctors. If you love your doctors but can only find coverage for them in this network, this is the plan for you.
  • This plan offers prescription drug benefits through Express Scripts. Generic drugs for high blood pressure, high cholesterol, asthma, or diabetes (including injectable insulin) are available at no cost to you. You will need to purchase 90-day supplies through Express Scripts or through an Express Scripts retail pharmacy partner to take advantage of this offer.
  • You can have a Flexible Spending Account with this plan. You can set aside up to $2,750 in your FSA for eligible medical expenses, or up to $5,000 for your dependent day care expenses.

All of these plans come with prescription drug coverage through Express Scripts and no-cost preventive health visits.

Still need help deciding?

Call Benefits Outlook at 866-222-KISD (5473) to get personalized guidance before you enroll.

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