National Medical Plan Options
K-C offers national medical plans that give you more control of your health care spend and saving for your future. All of the plan options offer access to Anthem’s national network of doctors and CVS/caremark’s network of pharmacies. They also all provide free preventive care.
CDHP Blue or Green
With your two medical plan options, the Consumer Driven Health Plan (CDHP) Blue with Health Savings Account (HSA) and CDHP Green with HSA, K-C gives you more choices and control over how you pay for health care.
Plan Options
No matter which option you choose, both CDHP Blue and Green:
- Work the same way
- Offer the same coverage
- Operate under the same Anthem BlueCross BlueShield network of providers
- Experience the same network discounts
- Receive the same HSA contribution from K-C
How Other Coverage Outside of K-C Impacts HSA Eligibility
If you’re enrolled in TRICARE, Medicare, or a non-high deductible health plan outside of K-C, the IRS specifies that you cannot contribute to or receive company contributions into an HSA. There are also special eligibility considerations for Veterans Administration benefits. If you're ineligible for an HSA, you'll be offered a CDHP with Health Reimbursement Account (HRA) that meet IRS restrictions. Click here to learn more about HSA eligibility.
Tobacco-Free Discount
Did you know that if you and your covered dependents are tobacco-free or enrolled in a tobacco cessation program for the last 12 months, you receive a $240 discount on your annual medical paycheck costs? During enrollment, you’ll be asked your tobacco-use status to determine if you’re eligible for the tobacco-free discount.
If you or your covered dependent (18 or older) need to kick the habit, getting the support you need is easy using LiveHealth Online. Whether you’re at work or on the go, you can visit one-on-one with a health coach through live video or over the phone. Coaches can work with you to create a personalized plan of action with strategies to cope with your cravings. They can also send you nicotine replacement directly to your home at no cost to you.
To learn more, register at LiveHealth Online and click the Tobacco-free tile.
Plan Comparison & Paycheck Costs
When comparing the plans, it's important to note that a separate deductible, out-of-pocket maximum, and coinsurance apply to out-of-network services. Print a 2020 Medical Plan Comparison PDF for reference. Just remember, the paycheck costs don’t always tell the full story. For a more complete comparision of both medical plan options, try the Medical Enrollment Tool.
| CDHP Blue with HSA | CDHP Green with HSA | |||
|---|---|---|---|---|
| How the Options Are Different: | ||||
| Your 2020 annual medical paycheck costs (Before tobacco-free discount) |
$497 Individual $2,034 2-Party $3,585 2-Party Plus |
$300 Individual $1,300 2-Party $2,484 2-Party Plus |
||
| Deductible | In-Network: $1,500 Individual $3,000 2-Party $3,000 2-Party Plus Out-of-Network: $3,000 Individual $6,000 2-Party $6,000 2-Party Plus |
In-Network: $2,500 Individual $5,000 2-Party $5,000 2-Party Plus Out-of-Network: $5,000 Individual $10,000 2-Party $10,000 2-Party Plus |
||
| Out-of-pocket maximum | In-Network: $3,000 Individual $6,000 2-Party $6,000 2-Party Plus Out-of-Network: $6,000 Individual $12,000 2-Party $12,000 2-Party Plus |
In-Network: $5,000 Individual $10,000 2-Party $10,000 2-Party Plus Out-of-Network: $10,000 Individual $20,000 2-Party $20,000 2-Party Plus |
||
| How the Options Are the Same: | ||||
| K-C's HSA contribution |
$700 Individual $1,400 2-Party $1,400 2-Party Plus |
$700 Individual $1,400 2-Party $1,400 2-Party Plus |
||
| Preventive care |
In-Network: K-C pays 100%.
Out-of-Network: You pay 100% until you reach the out-of-network deductible, then K-C pays 60%. |
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| Coinsurance |
In-Network: You pay 100% until you reach the in-network deductible, then K-C pays 80%. Out-of-Network: You pay 100% until you reach the out-of-network deductible then K-C pays 60%. |
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| Office visits | ||||
| Urgent care | ||||
| Emergency room | ||||
| Hospitalization | ||||
| Lab, X-ray, imaging | ||||
| Mental health inpatient | ||||
| Mental health outpatient | ||||
| Physical (includes chiropratic), speech, and occupational therapy |
In-Network: You pay 100% until you meet the in-network deductible, then K-C pays 80% (combined 60-visit annual max).
Out-of-Network: You pay 100% until you meet the out-of-network deductible, then K-C pays 60% (combined 60-visit annual max). |
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| How Both Options Cover Prescription Drugs | ||||
| Maintenance | K-C pays 100% for certain maintenance prescriptions.1 | |||
| Generic | You pay 100% until you meet the deductible, then K-C pays 80%. | |||
| Preferred brand | ||||
| Non-preferred brand | ||||
| 1To learn which maintenance prescriptions are included, log in at caremark.com or call CVS/caremark. | ||||
Which Plan Is Right For You?
Not sure if you’re Blue or Green? The plans are very similar, but here’s an easy way to start thinking through the differences.
Go GREEN if...
you prefer paying less out of your paycheck now, but having a higher deductible and out-of-pocket maximum to meet when you need care, then you might prefer the CDHP Green with HSA.
Go BLUE if...
you prefer paying more out of your paycheck now, but having a lower deductible and out-of-pocket maximum to meet when you need care, you might prefer the CDHP Blue with HSA.
How a CDHP with HSA Works
The CDHP determines what and how your health care is covered and the HSA is where and how you save and pay for health care tax-free. That means for the CDHP:
Annual Checkups
Your annual checkups and other preventive care are 100% paid by the plan — as long as you see an in-network provider. If you go out of network for preventive care, you’ll pay the entire cost of that care. If you need any medical care beyond your annual checkup, you pay the full Anthem-negotiated cost out of your HSA or out of pocket until you reach your deductible.
Deductible
If you reach your deductible, K-C pays 80% of the cost and you pay the remaining 20% when you use Anthem network providers.
Prescription Drugs
Certain prescription drugs are covered at 100% without having to meet the deductible; for all other drugs, you pay the full CVS network cost until you meet your deductible — then K-C pays 80% and you pay 20%.
Out-of-pocket Maximum
If you reach your out-of-pocket maximum, the plan pays 100% of your eligible medical expenses and prescription drugs for the rest of the year.