How much do I pay for preventive care?
Preventive care*, such as physicals, screenings, immunizations and more, are provided at no cost. Preventive eye exams are not included as part of our medical plans. If you or a covered dependent need routine eye care, our vision plan can help make glasses and contacts more affordable.
How much do I pay for prescription drugs?
You’ll pay low fixed copays or coinsurance (a percentage of the cost) for prescription drugs at Baylor Scott & White Health Pharmacies (mail order and retail), as well as contracted pharmacies. When you use a BSW pharmacy, covered generics are just $3. With such low copays, the prescription costs do not count toward your deductible but do count toward your out-of pocket max limit. Click here to learn more about our prescription drug benefits.
How much is the out-of-pocket maximum?
Your out-of-pocket maximum will vary based on how many dependents you are covering. All plans have an embedded out of-pocket maximum so that no one in the family must pay more than the individual maximum.
Will I have out-of-pocket protection?
Yes. Your copays and coinsurance count toward your out-of-pocket maximum. Once you reach your out-of-pocket maximum, the plan will pay 100% of the cost of any additional eligible care expenses.
*Services will be covered at 100% when billed with a preventive diagnosis code.