Medical plans
Which medical plan is right for me?
Two plans. Same networks. Different deductibles.
Both use the Blue Cross Blue Shield network, and in-network preventive care costs you $0 in either one.
Do this
Pick one in Oracle by 5 p.m. Central on November 16, 2026.
Which medical plan should I pick?
Higher deductible Healthy Savings Plan
Lower deductible Traditional Plan
Deductible
$2,500just you
$5,000family
You pay 100% of medical and prescription costs until you reach it.
$850just you
$1,700family: $850 each, met by 2 people
Medical only. Prescriptions are separate.
Most you pay in a year (out-of-pocket maximum)
$5,000just you
$10,000family, or $7,900 for any one person
Medical and prescriptions together.
$4,000just you
$8,000family
Medical. Prescriptions have their own limit: $2,500 just you, $5,000 family.
You may choose
A Health Savings Account (HSA) and a Limited Purpose FSA.
A Health Care Flexible Spending Account (FSA).
What do I pay when I use care?
Medical plans · using them
Preventive care is $0 from the start.
Healthy Savings Plan Medical and prescriptions share one deductible
Traditional Plan Care and prescriptions differ
Non-preventive care after your deductible
20%you pay; the plan pays 80%
20%you pay; the plan pays 80%
Emergency room
$300copay plus deductible, you pay 20%
$300copay plus deductible, you pay 20%
Prescriptions
20%you pay; the plan pays 80% after deductible is met
10%generic
20%brand
35%not on the formulary
Immediate co-insurance, no deductible first. $5 minimum.
Both plans
Once you reach your maximum
The plan pays for the rest. Out of network may cost more.
100%
How are my prescriptions covered?
Check your medication, your plan’s cost share, and any approval.
More about this benefit
Your medical plan determines your share
Prescription coverage is included with your medical plan. Costs depend on the medical option and whether the drug is generic, formulary brand or non-formulary brand.
A cost that does not count toward the maximum
Copayments for the difference between a brand-name product and its generic equivalent do not count toward the out-of-pocket maximum.
Check before you fill
- 1
Review covered medications in the MyPrime formulary.
- 2
Compare local pharmacy prices, generic options and home delivery.
- 3
Ask your physician to complete any required prior authorization, step therapy or quantity-limit form.
What the approval terms mean
- 1
Prior authorization: certain medications need approval.
- 2
Step therapy: another clinically appropriate or lower-cost medication may need to be tried first.
- 3
Quantity limit: a dose outside recommendations may require additional explanation.
Next step
Use MyPrime to check the formulary, compare prices or find approval forms.
Estimate your yearly cost
Turn on JavaScript to use the calculator.
Estimate for planning only, in-network care. Assumes prescriptions average 20% on the Traditional Plan. Not tax or investment advice; before acting on these results, consult a tax consultant or expert.
What comes out of your paycheck, per week
Parent company · Healthy Savings Plan · per week
| Coverage | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|
| Just you | $24 | $32 | $38 |
| You + children | $33 | $47 | $58 |
| Family | $53 | $78 | $96 |
Parent company · Traditional Plan · per week
| Coverage | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|
| Just you | $44 | $50 | $57 |
| You + children | $70 | $79 | $91 |
| Family | $120 | $139 | $153 |
Parent company · Dental and vision · per week
| Coverage | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|
| Just you | $8 | $9 | $10 |
| You + children | $10 | $11 | $12 |
| Family | $12 | $13 | $14 |
Subsidiary · Healthy Savings Plan · per week
| Coverage | Per week |
|---|---|
| Just you | $24 |
| You + children | $33 |
| Family | $53 |
Subsidiary · Traditional Plan · per week
| Coverage | Per week |
|---|---|
| Just you | $34 |
| You + children | $53 |
| Family | $90 |
Subsidiary · Dental and vision · per week
| Coverage | Per week |
|---|---|
| Just you | $8 |
| You + children | $10 |
| Family | $12 |
Tobacco/nicotine use adds a surcharge: see Will I pay the tobacco/nicotine surcharge?
Where should I go for care?
Online care is the easiest place to start, and Doctor On Demand video visits are free to enrolled members and covered dependents. The $ signs show relative cost, not prices.
Where you can get care
- Online care$Common health concerns
- Retail clinic$Common illnesses in convenient retail locations
- Physician’s office$$Routine and other services during regular hours
- Urgent care$$$Office-type concerns outside regular hours
- Emergency room$$$$The most serious or life-threatening conditions
At a glance
Preventive care
Covered in-network care: $0
Emergencies
Serious / life-threatening
Who to call
Questions? Horizon Solution Center · (866) 449-7712