Medical (2027)

FREE In-Network Preventive Care

Staying up to date on preventive care can help you and your family stay healthy and may reduce future health care costs by catching problems early. All three medical plans cover eligible in-network preventive care at no cost to you.

Free 24/7 Virtual Visits

Need care without the waiting room? When you’re enrolled in any Amy’s medical plan, you can connect virtually with a licensed physician, psychologist or psychiatrist anytime, anywhere. Virtual care can help with common concerns like colds and flu, allergies, ear infections, rashes, anxiety, stress, depression and grief. Visit anthem.com/ca/virtual-care or use the My Allied Portal app to get started.

How to Pick Your Medical Plan

When deciding which medical plan is right for you, it is important to consider the total cost of coverage. This includes what you pay in premiums and what you pay for services.

Features	EPO Plan (In-Network Only)	PPO Plan (In-Network)	HDHP + HSA Plan (In-Network)
Annual Deductible Individual/Family	$2,000 / $4,000	$3,000 / $6,000	$4,000 / $8,000
Amy’s Annual Exam Deductible Credit Individual/Family	Up to $750 / $1,500	Up to $750 / $1,500	N/A
Health Care FSA or HSA eligible?	Health Care FSA	Health Care FSA	HSA
Coinsurance (percentage you pay after reaching deductible)	10%	20%	20%
Amy’s HSA Contribution Individual/Family	N/A	N/A	$1,000 / $2,000
Annual Out-of-Pocket Max Individual/Family	$3,000 / $6,000	$5,000 / $10,000	$8,000 / $16,000
Best If You…	Can pay slightly more per pay period for lower deductibles and manageable copays; comfortable receiving care from in-network providers only.	Want lower premiums and predictable copays for many common services.	Want the lowest premiums and are comfortable paying more when you need care.

Which Plan Fits Your Life?

There’s no “best” medical plan for everyone. Think about how you use health care, what you’re comfortable paying from your paycheck and when you receive care, and whether staying in-network works for you.

Erin

EPO

Why this plan works

• Erin expects to use more services beyond the doctor’s office, where the deductible and coinsurance apply.
• The EPO is a good fit because it has the lowest deductible and predictable copays for doctor visits and prescriptions.
• Erin has already established care with in-network doctors she trusts, so she doesn’t mind having in-network coverage only.

Cost per paycheck: Highest

Deductible: $2,000 / $4,000

Amy’s deductible credit: $750 / $1,500

Amy’s HSA contribution: N/A

FSA Eligible: Yes

Parker

PPO

Why this plan works

• Parker’s family uses health care throughout the year, including an out-of-network therapist for Parker’s child.
• The PPO is a good option because it covers both in-network and out-of-network care.
• It also offers a predictable deductible and out-of-pocket costs, as well as manageable monthly premiums.

Cost per paycheck: Mid-range

Deductible: $3,000 / $6,000

Amy’s deductible credit: $750 / $1,500

Amy’s HSA contribution: N/A

FSA Eligible: Yes

Hugo

HDHP + HSA

Why this plan works

• Hugo primarily uses health care services for preventive care and occasional medical needs.
• He chooses the HDHP + HSA to keep his paycheck deductions low, receive Amy’s HSA contribution, and save for future health expenses.
• He’s comfortable paying more when he needs care and likes the added financial protection from Critical Illness and Hospital Indemnity insurance, included at no cost.

Cost per paycheck: Lowest

Deductible: $4,000 / $8,000

Amy’s deductible credit: N/A

Amy’s HSA contribution: $1,000 / $2,000

FSA Eligible: No

Medical Plan Comparison Chart

Review the chart below to see an overview of what you will pay when you receive medical care. For detailed plan information, download the Summary of Benefits and Coverage from the sidebar.

Plan Features	EPO Plan	PPO Plan		HDHP + HSA Plan
	In-Network Only	In-Network	Out-of-Network	In-Network	Out-of-Network
Amy’s Annual Exam Deductible Credit Employee Only / Employee + 1	Up to $750 / $1,500	Up to $750 / $1,500		N/A
Amy’s HSA Contribution	N/A	N/A		$1,000/Individual or $2,000/Family
	You pay:	You pay:		You pay:
Annual Deductible Individual/Family	$2,000* / $4,000*	$3,000 / $6,000	$6,000 / $12,000	$4,000* / $8,000*	$8,000* / $16,000*
Annual Out-of-Pocket Maximum Individual/Family	$3,000 / $6,000	$5,000 / $10,000	$10,000 / $20,000	$8,000 / $16,000	$16,000 / $32,000
Coinsurance	10%	20%	50%	20%	40%
Preventive Care	Covered in full	Covered in full	50% after deductible	Covered in full	40% after deductible
Virtual Care
Primary Care	$10	$0		20% after deductible
Specialist
Lab & X-ray Advanced Imaging (MRI, CT, PET)	10% after deductible	$0 20% after deductible		20% after deductible
Urgent Care	$10	$0		20% after deductible
Emergency Room (copay waived if admitted)	$100 after deductible	$250 after deductible		$0 after deductible
Inpatient/Outpatient Hospital	10% after deductible	20% after deductible	50% after deductible	20% after deductible	40% after deductible
Outpatient Mental Health		$0
Infertility ($5,000 max./year)		20% after deductible
Chiropractic (24 visits/year)	$10	$0
Acupuncture (24 visits/year)	$10	$0

*Includes prescription deductible.

New to the HDHP + HSA?

The HDHP + HSA works differently from Amy’s other medical plans. You’ll generally pay more when you receive care before meeting your deductible, but you’ll pay less from your paycheck and have an HSA to help you save and pay for eligible expenses. Amy’s contributes $1,000 for individual coverage or $2,000 for family coverage to your HSA. Explore the Health Savings Account (HSA) page for more information.

In addition to the HSA, if you enroll in the HDHP + HSA plan, Amy’s automatically provides Critical Illness and Hospital Indemnity insurance at no cost to you. Review the HDHP Additional Benefits page for more information.

Need Help Understanding Your Options?

TouchCare gives you free, confidential access to a Personal Health Assistant who can help you navigate your medical benefits and get more from your coverage. They can help you find in-network providers, compare costs, schedule appointments, understand medical bills and answer benefit questions.

Where to Go for Care

Knowing where to go for care can save you time, money, and hassle. Our medical plan offers a range of care options to address any medical issues you may encounter. Remember to save the Emergency Room for true emergencies.

FREE Preventive Care

Staying up to date on preventive care can help you and your family stay healthy and may reduce future health care costs by catching problems early or preventing serious illness altogether. Preventive services are covered at no cost to you.

Examples of preventive care include:

• An annual physical exam or wellness visit for you, your spouse, and your children
• Adult screenings for diabetes, blood pressure, cholesterol, cancer, depression, and obesity
• Pediatric screenings for hearing, vision, autism, developmental disorders, depression, and obesity
• Immunizations
• Mammograms for women age 40 and over
• Colorectal cancer screening for adults age 50 and over

Note: Ask your doctor to set up a follow-up visit if further diagnosis or treatment is necessary. In order to receive preventive care at no cost, the preventive services must be the sole purpose of your doctor’s visit.

24/7 Virtual Visits

Download the My Allied Portal app to schedule virtual visits.