2024 Benefits

For information on your 2024 benefits, please refer to the 2024 Benefits Guide.

HOW ARE THE PLANS ALIKE?

Both plans:

  • Cover the same services, such as doctor’s office visits, hospitalization, emergency room care, and prescription drugs.
  • Require you to complete a Baseline Visit within 120 days after the start of the plan year to receive $0 copay and 0% coinsurance benefits. All members and dependents 18 or older in a Curative plan must complete a Baseline Visit to receive richer benefits.
  • Pay 100% for in-network preventive care, such as routine physicals, well-woman exams, well-baby exams, blood pressure checks, cholesterol tests, and cancer screenings.
  • Pay 100% for in-network virtual visits.
  • Let you see any doctor but offer savings when you use in-network doctors.

How Are the Plans Different?

PPO

  • You’ll pay more in premiums, but perhaps less at the time of service.
  • You can choose from a network of doctors who offer a fixed copay for services.
  • If you expect to need more medical care this year or have a chronic illness, the PPO may be the right choice for you to ensure your health care needs are covered.
Consider the PPO if you’re willing to have more money taken out of your paycheck in exchange for more predictable costs and the flexibility to see in-network and out-of-network doctors for your health care needs.

EPO

  • You’ll pay less in premiums. (Think less money from your paycheck.)
  • You must use health care providers within the plan’s network, except in cases of emergency or urgent care.
  • Out-of-network benefits are not covered.
Consider the EPO if you want less money taken out of your paycheck in exchange for seeing only in-network doctors for your health care needs (out-of-network benefits are not covered).

How the Plans Work

Here are some important things to know about the plans.

Baseline Visit

A Baseline Visit is an opportunity for you to meet your designated Care Navigator and a clinician to jump-start your health and wellness journey. You will be oriented to the plan, connected to wellness programs, and given the time to have your health questions answered. Visits are virtual — from the comfort of your home. All members and dependents 18 or older enrolled in a Curative plan must complete a Baseline Visit to receive richer benefits.

IMPORTANT: If you don’t complete a Baseline Visit within the first 120 days of coverage, you will have higher medical costs and miss out on a $0 deductible and $0 copays.

Go to curative.com/baseline to schedule a Baseline Visit.

Care Navigator

When you enroll in a Curative plan, you will be assigned a Care Navigator. Your Care Navigator can help you:

  • Learn about your new plan and benefits
  • Get support on finding in-network care and 24/7-365 telemedicine
  • Transfer prescriptions to an in-network pharmacy
  • Get connected to programs to help reach your health goals

If your Care Navigator is unavailable, you’ll have 24/7-365 access to Member Services at 855.428.7284.

 

Anytime, Anywhere Care, @Work or @Home*

Talk to a doctor 24/7 from your computer, smartphone, or tablet. Virtual Care doctors can answer your questions, make a diagnosis, and prescribe basic medications (subject to availability by state). You and your covered family members can use this benefit if you’re enrolled in a TEAM medical plan. For the PPO, you’ll pay a copay. If you’re in Texas, you’ll use NormanMD. If you are located anywhere else in the country, you will use Teladoc. Visit the Curative Member Portal or call 512-421-5678 to set up care.

* Available if enrolled in the Curative PPO or EPO.

Medical Plans at a Glance

The below benefits are for both the Curative PPO and EPO plans, except the out-of-network benefits are not covered under the EPO plan. All covered services are subject to medical necessity as determined by the plan. All out-of-network services are subject to reasonable and customary (R&C) limitations. Find a provider or facility near you by visiting the Curative Member Portal or calling 855.428.7284.

CDHP PPO 1 PPO 2
In-Network Out-of-Network1 In-Network Out-of-Network1 In-Network Out-of-Network1
2023 Health Savings Account (HSA) Contributions from TEAM
Employee only or employee and spouse $750 No contribution No contribution
Employee and children or family $1,500 No contribution No contribution
Deductible (The amount you must pay before the plan pays benefits for some services. Amounts you pay towards the deductible count toward your out-of-pocket maximum.)
Individual $3,000 $6,250 $2,000 $5,000 $1,250 $3,125
Family $6,000 $12,500 $6,000 $15,000 $3,750 $9,375
What you pay
Preventive care2 $0 50% after deductible $0 60% after deductible $0 40% after deductible
Office visits 20% after deductible 50% after deductible $25 copay for Blue Distinction provider; $40 copay for primary care physician (PCP); $50 copay for specialist; $35 copay for urgent care 60% after deductible $25 copay for Blue Distinction provider; $35 copay for primary care physician (PCP); $45 copay for specialist; $35 copay for urgent care 40% after deductible
Virtual visits 20% after deductible N/A $30 copay N/A $25 copay N/A
Maternity care 20% after deductible 50% after deductible $40 PCP copay/$50 specialist copay, then 30% of remaining eligible expenses after deductible 60% after deductible $35 PCP copay/$45 specialist copay, then 20% of remaining eligible expenses after deductible 40% after deductible
Inpatient hospital3 20% after deductible 50% after deductible4 $250 copay per admission, then 30% after deductible $500 copay per admission, then 60% after deductible4 20% after deductible $500 copay per admission, then 40% after deductible4
Outpatient surgery 20% after deductible 50% after deductible 30% after deductible 60% after deductible 20% after deductible 40% after deductible
Emergency care5 20% after deductible 30% after deductible $250 copay (waived if admitted)
Out-of-pocket maximum6 (The maximum amount you will have to pay out of pocket for the plan year. If you reach this limit, the plan will pay 100% of your eligible expenses for the rest of the plan year.)
Individual $6,000 $12,500 $6,000 $12,000 $3,750 $9,375
Family $12,000 $25,000 $12,000 $24,000 $11,250 $28,125
    * After deductible.                                                                                                                                                                                                                                                                                                                                                                                              ** Out-of-network benefits are not covered under the EPO Plan.
  1. Inpatient Hospital: Pre-certification is required.
  2. Care Coordination must be notified within two days. Coverage for true emergencies only.
  3. Expenses that count toward meeting your out-of-pocket maximum include medical plan coinsurance and copays, prescription drug coinsurance and copays, and amounts you pay toward the deductible. Amounts above the reasonable and customary charge for out-of-network care do not count toward your out-of-pocket maximum.

Additional Medical Care

Additional programs are included with your Curative medical coverage:

Care for acute and chronic musculoskeletal pain and conditions: Airrosti provides you personalized care for hip, back, neck, shoulder, foot, and other acute and chronic musculoskeletal pain conditions. If you are enrolled in a Curative plan, you can use Airrosti at no charge with a baseline visit. Virtual or in-person treatment plans include:

  • Thorough assessments and orthopedic testing to provide an accurate diagnosis and injury education.
  • Conservative manual treatment to restore function, increase mobility, and reduce pain.
  • Personalized, active rehab and at-home exercises designed to speed recovery and prevent future injuries.

Call Airrosti at 800-404-6050 to begin your recovery plan.

Care anywhere: Virtual Care connects you with a board-certified doctor in your home or wherever you are. Telemedicine providers can treat adults and children for many non-emergency conditions as an alternative to visiting an urgent care or emergency room. Visit the Curative Member Portal or call 512-421-5678 to set up care.

Kaiser HMO at a Glance (California only)

If you live in California, you have another medical option available: the Kaiser HMO.

With this plan, you must use in-network doctors to receive benefits — there is no out-of-network coverage except for urgent care and emergencies. You pay set copays for services, and there’s no deductible to meet. To find a provider, visit kp.org or call 800-464-4000.

Kaiser HMO (California only)
In-network only
Deductible
Individual $0
Family $0
What you pay
Preventive care1 $0
Office visits $20 copay
X-rays and lab tests $0
Inpatient hospital $0
Outpatient surgery $20 copay
Emergency care ER visit: $100 copay (waived if admitted)
Ambulance: $50 copay
Out-of-pocket maximum2 (The maximum amount you will have to pay out of pocket for the plan year. If you reach this limit, the plan will pay 100% of your eligible expenses for the rest of the plan year.)
Individual $1,500
Family $3,000
  1. Plan pays 100% for preventive care based on Kaiser’s preventive care guidelines.
  2. Expenses that count toward meeting your out-of-pocket maximum include medical plan copays and prescription drug copays and coinsurance.

Curative EPO and PPO Paycheck Costs

Here are the premiums for the EPO and PPO.

Curative EPO Curative PPO
Bi-weekly Monthly Bi-weekly Monthly
Employee only $25 $54.16 $69.43 $150.44
Employee and spouse $160 $346.66 $253.32 $548.87
Employee and children $140 $303.33 $226.11 $489.90
Employee and family $215 $465.83 $358.38 $776.49

 

Kaiser HMO Paycheck Costs (California Only)

Here are your premium costs for the Kaiser HMO.

Kaiser HMO
Bi-weekly Semi-Monthly
Employee only $48.56 $52.61
Employee and spouse $230.66 $249.88
Employee and children $209.92 $227.41
Family $314.62 $340.84