2024 Benefits
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.
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.
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.
- Inpatient Hospital: Pre-certification is required.
- Care Coordination must be notified within two days. Coverage for true emergencies only.
- 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 |
- Plan pays 100% for preventive care based on Kaiser’s preventive care guidelines.
- 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 |