The HDHP option offers you the lowest premiums per pay period in exchange for a higher deductible. With the HDHP option, you pay the full costs for services until the applicable deductible is met. When you reach the Ascension Network annual deductible, all of your eligible Ascension Network expenses are covered at 85% for the rest of the year.
Here's how it works:
- You have an annual deductible. The Ascension Network annual deductible is $2,000 individual / $4,000 family.
- 15% coinsurance after deductible. Copays apply until OOP is met.
- If you reach the maximum amount for paying out-of-pocket, $3,500 individual / $7,000 family (includes medical and prescription), then your eligible medical expenses are completely covered by SmartHealth for the remainder of the year, when you receive care within the Ascension Network.
If you are enrolled in anything other than employee-only coverage, you must meet the family deductible first before coinsurance or the out-of-pocket maximum applies. One covered individual could meet the entire family deductible, or it could be a combination of covered family members.
What's Covered
- Compare costs based on the provider network in a side-by-side chart.
- Compare key features of each plan and the payroll deductions.
- You can also view the Summary Plan Description for more information.
To review how costs are shared, visit the Summary of Benefits and Coverage page for each plan option.
Note: Different deductibles, coinsurance and out-of-pocket maximum amounts apply when you use National Network or out-of-network providers and facilities.
Rx Costs and HDHP
If you choose the HDHP, you pay the full cost of prescriptions until you meet your deductible. Once you meet the deductible you will pay copays/coinsurance up until you reach the out of pocket maximum.
The copay and coinsurance amounts count toward your out-of-pocket maximum. Once you reach your out-of-pocket maximum, your prescriptions are covered 100% for the remainder of the year.
The SmartHealth Flexible Copay program identifies coupons and patient assistance provided by the medication's manufacturer. Your copays may be reduced at preferred pharmacies for flexible copay medications. However, these coupons and manufacturer's patient assistance will not apply to your out-of-pocket costs or deductible for the year with the HDHP option.
Health Accounts and HDHP
HDHPs have another key feature. With the HDHP option, you can enroll in a health savings account (HSA). HSA dollars can be used to pay for your out-of-pocket healthcare expenses and Ascension contributes to it too. Learn more.