Medical Plan Comparison Chart
The medical plan comparison chart below illustrates the differences in costs for both of Emory's medical plans within the three networks:
| HSA Plan | POS Plan | |||||
|---|---|---|---|---|---|---|
| Emory Contribution | $300/$6001 | None | ||||
| Earned Incentives | $750/$9002 | $750/$9002 | ||||
| Health Savings Account | Yes | No | ||||
| Tier 1 | Tier 2 | Tier 33 | Tier 1 | Tier 2 | Tier 33 | |
| Annual Deductible - Single | $1,450 | $1,650 | $2,750 | $850 | $1,000 | $2,000 |
| Annual Deductible - Family | $2,9004 | $3,3004 | $5,5004 | $2,550 | $3,000 | $6,000 |
| Out-of-Pocket Maximum5 - Single | $3,750 | $5,500 | $11,500 | $3,000 | $4,500 | $11,250 |
| Out-of-Pocket Maximum5 - Family | $7,500 | $11,000 | $23,000 | $6,000 | $9,000 | $22,500 |
| Out-of-Pocket Maximum5 - Aggregate | Yes | Yes | Yes | Yes | Yes | Yes |
| Primary Care Office Visits6 | 15% after deductible | 25% after deductible | 50% after deductible | $25 co-pay | $35 co-pay | 50% after deductible |
| Pediatrician Office Visits | 15% after deductible | 25% after deductible | 50% after deductible | $25 co-pay | $25 co-pay | 50% after deductible |
| Specialist Office Visits | 15% after deductible | 25% after deductible | 50% after deductible | $35 co-pay | $50 co-pay | 50% after deductible |
| Diagnostic Labs & X-Ray | 15% after deductible | 25% after deductible | 50% after deductible | 15% after deductible | 25% after deductible | 50% after deductible |
| Durable Medical Equipment | 15% after deductible | 25% after deductible | 50% after deductible | 15% co-insurance | 25% co-insurance | 50% after deductible |
| Routine Preventive Care7 | Plan pays 100% | Plan pays 100% | 50% after deductible | $0 co-pay | $0 co-pay | 50% after deductible |
| Emergency Room Visits8 | 15% after deductible | 25% after deductible | 25% after deductible | $250 co-pay | $250 co-pay | $250 co-pay |
| Hospitalizations: Inpatient/Outpatient Coverage | 15% after deductible | 25% after deductible | 50% after deductible | 15% after deductible | 25% after deductible | 50% after deductible |
| Behavioral Health Inpatient | 15% after deductible | 25% after deductible | 50% after deductible | 15% after deductible | 25% after deductible | 50% after deductible |
| Behavioral Health Outpatient | 15% after deductible | 25% after deductible | 50% after deductible | $25 co-pay | $25 co-pay | 50% after deductible |
- 1 $600 is contributed annually to the HSA by Emory when Employee+Spouse, Employee+Children or Family level coverage is elected.
- 2 An annual maximum of $750 in incentives can be earned (for Single level coverage) or $900 (for Employee+Spouse or Family level coverage).
- 3 Amounts applied to deductible and out-of-pocket maximums are limited to the Reasonable and Customary charges.
- 4 Family deductible applies in the HSA plan when Employee+Spouse, Employee+Children or Family level coverage is elected.
- 5 Out-of-Pocket maximum includes co-pays.
- 6 Includes services of an internist, general physician, family practitioner, dermatologist or allergist.
- 7 Routine Preventive Care services ONLY are covered at 100% under the plan at the Tier 1 and Tier 2 Network levels. Diagnostic services are subject to the deductible and co-insurance.
- 8 Co-pay waived if admitted.
Disclaimer
Every attempt has been made to ensure the chart and information above accurately reflects the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description (SPD) prevail.