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High-Deductible Health Plans (HDHP)

2019 ACA Plan Comparison Guide | Iowa

Wellmark's myBlue HDHPSM high-deductible health plans can dramatically increase your employees' engagement in their health care. Because your employees pay the full cost of care (excluding preventive care) and prescriptions until they reach their deductible, an HDHP helps them understand the true cost of care.

Help your employees save with an HSA

When your employees enroll in a qualified, high-deductible health plan, they can also open a health savings account (HSA).

A health savings account is an individual savings account employees can contribute to, invest in, and receive certain distributions from. It can be used to pay for qualified medical expenses, like doctor visits, prescription drugs, eyeglasses and dental care, tax-free.

With an HSA, see triple tax-free savings

  1. When employees put money in their HSA.
  1. When it accumulates.
  1. When employees spend money from their HSA.

Employees won't be taxed when they take money out of their HSA as long as they use the funds exclusively to pay for qualified medical expenses.*

*If employees use any HSA funds to pay for expenses other than medical expenses, they may be subject to income taxes and additional penalties.

Here's how an HSA works

Employees contribute money into a health savings account tax-free. They receive an HSA debit card. The HSA account can be used to pay for qualified expenses like doctor visits, prescriptions drugs, eyeglasses and dental care. Unspent funds rollover for future health care expenses.
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High-deductible health plan options

Regardless of the network you choose, all the products in the table are available. Amounts shown reflect in-network services only. For PPO plans, additional cost shares will apply to out-of-network services.

Plan Details myBlue HDHPSM Bronze myBlue HDHPSM Silver myBlue HDHPSM Gold
Annual Benefit — Deductible1
Single deductible $6,600 $4,500 $3,000
Family2 deductible $13,200 $9,000 $6,000
Coinsurance — member pays 0% 0% 0%
Annual benefit — Out-of-Pocket Maximum (opm) In-network
Single out-of-pocket maximum $6,600 $4,500 $3,000
Family3 out-of-pocket maximum $13,200 $9,000 $6,000
Preventive care4 screenings, immunizations Free Free Free
Virtual Visits5 Deductible applies Deductible applies Deductible applies
Primary care office visits Deductible applies Deductible applies Deductible applies
Non-primary care office services Deductible applies Deductible applies Deductible applies
Emergency room Deductible applies Deductible applies Deductible applies
Prescription drugs - Blue Rx EssentialsSM Deductible applies Deductible applies Deductible applies
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1Both in-network and out-of-network services apply toward a single deductible. However, out-of-pocket costs for in-network services only apply to the in-network out-of-pocket maximum. Only out-of-pocket costs for out-of-network services apply to the out-of-network out-of-pocket maximum.
2For all plans except myBlue HDHPSM Gold (2000), the family deductible can be met through any combination of family members. No one member will be required to meet more than the single deductible amount to receive benefits for covered services during a benefit period. For myBlue HDHP Gold (2000), the family deductible amount is reached from amounts accumulated on behalf of any family member or combination of family members and the entire family deductible must be met before benefits are payable.
3For all plans except myBlue HDHP Gold (2000), the family out-of-pocket maximum (OPM) can be met through any combination of family members. No one member will be required to meet more than the single OPM amount to receive benefits for covered services during a benefit period. For myBlue HDHP Gold (2000), the family OPM amount is reached from amounts accumulated on behalf of any family member or combination of family members and the entire family OPM must be met before benefits are payable.
4All costs waived when using an in-network or participating provider on PPO plans. On all other available networks, costs are waived when using an in-network provider. Preventive care includes gynecological exam, preventive exam, screening mammography, well-child care and newborn care. For plans on the Wellmark ValueSM Health Plan HMO Network, a designated personal doctor must be seen for preventive care/screenings and immunizations. One preventive exam with separate gynecological exam per member per benefit period. Well-child care up to age 7 (includes normal newborn care, physical examinations, assessments and immunizations.)
5The virtual visit copay applies to Doctor On DemandTM.
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