Medical HDHP + HSA

Need help choosing a medical plan option?

Ask ALEX.

If you are enrolled or planning to enroll in Medicare, read the flyer available to download below before enrolling in one of our medical plan options.

Our medical plan, administered by OhioHealthy, allows you to access quality healthcare and provide comprehensive coverage.

The OhioHealthy HDHP+HSA has:

  • Lower premiums than the OhioHealthy PPO
  • A higher deductible than the OhioHealthy PPO (which you must meet before this plan pays any benefits)
  • Access to a special tax-advantaged savings account with matching contributions from OhioHealth - a Health Savings Account (HSA)

By choosing in-network providers or specialists, you’ll keep more dollars in your pocket.

OhioHealthy HDHP+HSA coverage

In-network Out-of-network
Annual deductible $1,800 for associate only
$2,800 for associate + 1
$3,600 for associate + 2 or more
Annual out-of-pocket maximum - you won't pay any in-network expenses for the rest of the year if you reach this $4,400 for associate only
$6,600 for associate + 1
$8,800 for associate + 2 or more ($7,150 individual out-of-pocket maximum)
Unlimited
Preventive care0% (plan pays 100%)50% of UCR after deductible
Other medical20% after deductible50% of UCR after deductible
Primary Care Physicians20% after deductible50% of UCR after deductible
Specialty Care Physicians20% after deductible50% of UCR after deductible
Clinically Integrated Network Specialty Care Physicians10% after deductibleNot applicable
Telemedicine (MDLIVE)10% after deductibleNot applicable
Urgent care20% after deductible20% after deductible
ER20% after deductible20% after deductible
Chiropractic (maximum 20 visits)50%50% of UCR after deductible
Infertility (lifetime maximum $10,000)20% after deductible50% of UCR after deductible
Prescription Medications
Rx (retail and mail)20% after deductiblePay difference INN vs. OON
Specialty Rx20% after deductible, only at Specialty PharmacyNot covered
Diabetes and Asthma Rx0% after deductible (if in program)Pay difference INN vs. OON
Infertility Rx40% after deductible (maximum $2,000)Not covered
Mandatory genericYesNot applicable
UCR = Usual, customary, and reasonable, INN = In-network, OON = Out-of-network

Read more about Prescription Medications coverage.

HSA (Health Savings Account)

When you enroll in the OhioHealthy HDHP+HSA, you get access to a special tax-advantaged savings account with matching contributions from OhioHealth - a Health Savings Account (HSA), administered by HealthEquity. Very simply, save dollars to pay for future out-of-pocket healthcare expenses, with help from OhioHealth, and reduce your taxable income.

Your HSA, your dollars
Your HSA funds stay with you, even when you leave OhioHealth or retire.
+
Triple tax advantages
Your contributions are not taxed, the interest you earn is not taxed, and the dollars you spend on qualified healthcare expenses (including your deductible) is not taxed.
+
OhioHealth helps you save
You make contributions by payroll deductions and OhioHealth will match your contributions up to a maximum based on the number of people you cover: Associate only - $500; Associate + 1 - $750; Associate + 2 or more - $1,000. See below for IRS maximums.
+
Invest and earn interest
You can earn interest if you choose to invest your HSA funds.
+
You decide how and when to spend
You decide whether to use your funds to pay for your share of your healthcare expenses (your deductible, prescription medications, and even dental or vision expenses) - or you can choose to pay another way and save your funds for the future or retirement. HealthEquity provides a Debit Card for ease of payment.
+
Get early access with Balance Booster
You can access both your own and OhioHealth’s contributions to your HSA early, which means your entire HSA contribution for the year can be available to you earlier in the calendar year, if you need it. Download the Balance Booster User Guide below for more information.
+
No “use it or lose it” rule
Any unused funds stay in your HSA so you can use them in the future. You could use your HSA like a retirement savings account just for healthcare expenses not covered by Medicare when you retire or become Medicare-eligible.

Making contributions

During annual enrollment and at any time during the year, you can start, stop or change your own HSA contributions. To change your contributions:

If you want to make a lump sum contribution, log in to the HealthEquity website or call 1 (844) 311.9730.

Previous HSAs or IRA funds

If you have another HSA from a prior employer that you would like to combine with your OhioHealthy HSA or funds in an IRA you would like to roll over, log in to the HealthEquity website or call 1 (844) 311.9730.

IRS HSA maximums for 2021

There are IRS-established annual maximums on the combined total of how much you and OhioHealth can contribute to your HSA:

Who is covered?IRS maximum*
Associate only$3,600
Associate + 1 or more$7,200
* If you will be age 55 or older in 2021, you are eligible to contribute an additional $1,000.
Note: These maximums include OhioHealth’s matching contribution.

Visit the HealthEquity website to:

  • Learn more about HSAs
  • Use calculators to see how much you can save into your HSA and on your taxes
  • Learn how to invest your HSA funds to earn interest
  • Find out what healthcare expenses you can cover with your HSA

How much does this benefit cost?

Associate cost per pay period (26 pay periods per year)
Full-time ratesPart-time rates*
Coverage type No discounts earned All discounts earned No discounts earned All discounts earned
Associate only$71$26$84$39
Associate + spouse$180$90$206$116
Associate + child$125$80$151$105
Associate + children$141$96$173$128
Family$196$106$228$138
*48-63 scheduled hours per pay period - Per-Pay Amounts
In 2020, 69% of associates chose the OhioHealthy HDHP+HSA

How to make the most of this benefit

  • Need care? Consult your Primary Care Physician first
  • Physician not available? Call the 24/7 Nurse Advice Line at 1 (844) 834.4375 to get free private advice from a nurse
  • Can’t see your usual physician? Contact MDLIVE for a virtual visit, where doctors can diagnose your symptoms, prescribe medications and send prescriptions to your pharmacy of choice - great if you’re away from home
  • Use urgent care instead of the emergency room for non-emergencies - but always go to the emergency room if it is an emergency and be sure to follow-up with your physician if you have questions or need further care
  • Visit ohiohealthyplans.com/ohiohealth to find in-network providers and facilities, and estimate the costs with the treatment cost calculator
  • You’ll pay less for certain services from OhioHealth providers, including lower out-of-pocket costs for visits to one of the plan's preferred specialists in the OhioHealth Clinically Integrated Network
  • A wide range of preventive care services are available at no cost to you, including annual physical exams, vaccines and tobacco cessation benefits - download the Preventive Care Summary below
  • Need to cover a large healthcare expense? You can get early access to both your own and OhioHealth’s contributions to your HSA using Balance Booster - download the Balance Booster User Guide below
  • Combine this benefit with a Healthcare Flexible Spending Account if you need to save more for out-of-pocket dental and vision expenses
  • Combine this benefit with Critical Illness Insurance, Accident Ca$hback Insurance or Hospital Indemnity Insurance to help cover out-of-pocket expenses without using your HSA
  • Add dependent coverage - your spouse and any children through the month they turn age 26 are eligible
  • Change your coverage at any time during the year if you have a relevant and qualified change in family status (e.g. you get married and want to add your spouse) - read more under Enrollment
For medical plan questions
Call 1 (844) 200.6449 (Monday - Friday, 8 a.m. - 6 p.m. EST)

Download the on-site OhioHealthy representative schedule below for in-person help

Contact HealthEquity

For help managing your HSA or deciding how much to contribute

Call (844) 311.9730 (available 24/7)
Visit healthequity.com/ohiohealth and log in to manage your HSA

Download the HealthEquity mobile app from your app store