2020 HSA Medical Plan
Your deductible is the annual amount you pay for medical services before the plan begins paying. Your out-of-pocket maximum is the annual “maximum” amount you pay for covered services. With the HSA Medical, each covered person must meet the in-network annual deductible, or combined family deductible which is the same as the out-of-pocket maximum. After the per person or family deductible and out-of-pocket maximum is met, the Plan pays 100% for in-network covered medical and prescription drug services. See table above for plan deductible amounts.
- Every dollar that accumulates toward the annual “per person” deductible and out-of-pocket maximum also counts toward the family deductible and family out-of-pocket maximum.
- For covered prescription drugs, you pay the full costs and the amount counts toward your deductible and out-of-pocket maximum.
- You may use your HSA Savings Account funds to pay for expenses applied to your deductible and for other qualified medical expenses (per IRS guidelines).
- Make sure you stay in-network. The out-of-network deductible and out-of-pocket maximum is higher and your costs are greater.
Paying for Prescription Drugs
If you enroll in the Empower HSA Medical Plan:
- You will be responsible for paying the full cost for your prescription drugs and other supplies provided through the pharmacy program.
- Your prescription drug plan expenses will count towards your annual deductible and out-of-pocket maximum.
- You may use the funds in your HSA Savings Account to pay your prescription drug expenses, or pay for them out-of-pocket and save the money in your HSA.
- Once you have reached your deductible, your prescription drugs will be covered at 100%.
Important! You may not enroll in the HSA Savings Account** if:
- You are also covered under a spouse's medical plan, unless your spouse's medical plan is also an HSA plan. If you are covered under both HSA medical plans, a maximum combined contribution amount of the current IRS limit would apply.
- You are enrolled in Medicare, are a dependent on another person's tax return, or have received VA medical benefits at any time over the past three months.
**(You can enroll in the HSA qualified high deductible health plan associated with the HSA Savings Account, but you cannot open/have the HSA investment account that compliments this health plan.)
Empower HSA National One Medical Open Access or Smart Care Plans
The Empower HSA Plan combines HealthPartners medical coverage with an optional self-funded, pre-tax savings/investment account through Optum Bank you can use to pay for your qualifying out-of-pocket health care expenses. If you enroll in either of the Empower HSA Medical Plans and you wish to have a Health Savings (Bank) Account, you must enroll in the savings account and indicate how much you’d like to contribute to your account annually (January through December), and equal pre-tax deductions will be taken from each paycheck and deposited into your HSA Savings (Bank) Account.
You may then choose to use the funds in your account to reimburse yourself for eligible health care expenses incurred by you and/or your covered dependents. Your dependents do not need to be covered by the medical plan to qualify their expenses. Click here for detailed information regarding an HSA Savings Account.
The SmartCare plans offer a lower premium by utilizing a smaller alternative network compared to the open access network plans. You'll have access to three SmartCare Clinics for primary care and the HealthPartners and Park Nicollet providers and facilities for additional care. SmartCare clinics offer phone, video or in-person care visits and have expanded hours to provide you with additional flexibility to get the care you need when you need it.
The Open Access Plan allows memebers to access any provider in the network, including specialists, without a referral and receive in-network benefits. Members on this type of plan do not need to select a primary care clinic. While members do not need referrals to access providers in the Open Access network, some services may require a written order from the recommending physician.
For specific tier information, contact HealthPartners at 952.883.5000 or HealthPartners.com
HSA Medical Plan Facts:
- Preventive care services – such as annual routine physicals and well-child care, are covered at 100%.