Health insurance coverage helps you and your family access routine and preventive health care at a reasonable cost and protects against the catastrophic costs of major illness or injury. Employees can choose between the HealthPartners High-Deductible Health Plan (HDHP) with HSA or the HealthPartners PPO Health Plan. Both plans use the Open Access Choice PPO Network and provide comprehensive coverage. The Open Access Choice PPO Network gives you the care and service you need, at your convenience. With more than 650,000 providers, you have access to one of the country’s largest networks.<\/p>\n\n\n\n
Macalester employees with a 0.50 FTE or higher are eligible for coverage. Employees may add spouses, registered domestic partners, dependent children up to age 26, as well as other legal dependents. All plan participants must have the same level of coverage, either the HDHP plan or the PPO plan.<\/p>\n\n\n\n
A High Deductible Health Plan (HDHP) is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. High deductible health plans are a form of catastrophic coverage intended to cover for catastrophic illness. Participation in a qualifying HDHP is a requirement for Health Savings Accounts (HSA) and other tax-advantage programs.<\/p>\n\n\n\n
A Preferred Provider Organization (PPO) is a health insurance plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. The PPO plan has lower deductibles than the HDHP and participants will pay co-pays for most services. Participants in the PPO plan may elect to participate in a healthcare flexible spending account to set aside funds on a pre-tax basis for qualified expenses.<\/p>\n\n\n\n
Plan Service\/Feature<\/strong><\/th>| PPO | In\u2010network services<\/th> HDHP with HSA | In\u2010network services<\/strong><\/th><\/tr><\/thead> Annual Deductible<\/strong><\/td> | $500\/person; | $1,000\/family<\/td> $3,500\/person; | $7,000\/family<\/td><\/tr> Preventive Care Services<\/strong> | Routine Health Exams, Cancer Screening, Eye and Hearing Exams, Immunizations, Prenatal & Postnatal Services, Well Child Care<\/td> 100 % of charges incurred<\/td> | 100% of charges incurred<\/td><\/tr> | E-日韩精品s<\/strong> | Virtuwell<\/td> The first 3 visits free, then | $10 co-pay per visit thereafter<\/td> Deductible, then 100%<\/td><\/tr> | Convenience Clinics<\/strong> | MinuteClinic<\/td> $10 co-pay, then 100%<\/td> | Deductible, then 100%<\/td><\/tr> | Allergy Injections<\/strong><\/td> | No out of pocket cost<\/td> | Deductible, then 100%<\/td><\/tr> | Primary Care Office 日韩精品s<\/strong> | MD 日韩精品s (includes ancillary services received in provider\u2019s office and palliative care)<\/td> $30 co-pay, then 100%<\/td> | Deductible, then 100%<\/td><\/tr> | Behavioral Health\/ | Substance Abuse<\/strong> Outpatient<\/td> $30 co-pay, then 100%<\/td> | Deductible, then 100%<\/td><\/tr> | Specialty Office 日韩精品s<\/strong> | Chiropractic, Physical Therapy, Speech Therapy, Occupational Therapy, Acupuncture, etc.<\/td> $50 co-pay, then 100%<\/td> | Deductible, then 100%<\/td><\/tr> | Urgent Care 日韩精品s<\/strong><\/td> | $50 co-pay, then 100%<\/td> | Deductible, then 100%<\/td><\/tr> | Emergency Room 日韩精品s<\/strong> | Coverage for emergency conditions only<\/td> $100 co-pay, then 100%<\/td> | Deductible, then 100%<\/td><\/tr> | Ambulance Services<\/strong><\/td> | 80% of charges incurred<\/td> | Deductible, then 100%<\/td><\/tr> | Inpatient Hospitalization<\/strong><\/td> | 80% of charges incurred<\/td> | Deductible, then 100%<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n | *For the PPO plan, in most cases, both the co-pay and Coinsurance amounts will go toward the out-of-pocket maximum but not the deductible.<\/p>\n\n\n\n Annual Out-of-Pocket Maximums<\/h2>\n\n\n\n
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