You probably noticed that the High Deductible Health Plan (HDHP) has a higher deductible and lower monthly premiums than a typical health plan like the university’s 85/60 PPO plan. If you would typically choose your health plan by premium cost, be sure you understand the tradeoff for a lower monthly premium.
The HDHP requires you or your family to pay the full cost of your health care, including your medications, until you reach a fixed dollar amount. This is called your plan’s annual deductible.
With the HDHP, non-preventive medication drugs must be paid for in full until the deductible is met. Once your annual deductible has been met, covered medical expenses are covered at 100% and prescription drugs are covered at the coinsurance levels.
The HDHP is a non-grandfathered health plan and must cover routine immunizations and other services required by healthcare reform (the Patient Protection and Affordable Care Act (ACA).
If these services are performed by an in-network provider, members cannot be charged a copayment, coinsurance or deductible. Out-of-network charges may apply if the services are performed by a non-network provider.
Like all university medical plans, preventive care is covered at 100%. This means when you receive annual physicals, mammograms, colonoscopies and well-child care, there is no deductible or coinsurance. Remember, immunizations are covered by the medical plan only.
Plan Highlights
- With the election of an HDHP, a Health Savings Account (HSA) can be created for you. For the 2024 plan year, Kent State will contribute to your HSA $1,300 for single plans or $2,000 for family plans. To increase your savings in your HSA, you can elect to contribute to the HSA at any time throughout the year. You can also increase or decrease your contributions throughout the year. Another great thing about an HSA is that it allows you to use your pre-tax dollars to pay for eligible healthcare expenses incurred by you or your eligible dependents.
- Got Dependents? No problem! You can enroll in the Dependent Care FSA that allows you to use pre-tax dollars to pay for DAYCARE expenses for dependents up to the age of 13 or for elderly care; however, be aware that you cannot increase or decrease your elections to your FSA during the plan year. Visit our FSA and HSA web page for more information.
- Preventive services are covered at 100% with in-network providers at NO COST to you. Examples of preventive care services (PDF) are annual exams, immunizations, and preventive screenings.
- Deductible for in-network providers: $3,300 for single coverage and $5,400 for family coverage.
- Coinsurance for in-network providers: $0.00
- Office Co-pays: $0.00
- Out of Pocket Maximum for in-network providers: $3,300 for single coverage and $5,400 for family coverage.
- Employer contribution to your health savings account (HSA) of $1,300 for single coverage and $2,000 for family coverage effective at the first of the year!
- Preventive Services for Medical Mutual High Deductible Health Plan and 85/60 PPO plan (PDF)
- Preventive Therapy Drug List (PDF)