Page 5 - 2022 Thrall Benefits Guide

Medical and Pharmacy Plan Overview

We offer the choice of two medical plans administered by Cigna Healthcare. Both medical plan options
include coverage for preventive services, diagnostic testing, major medical, inpatient & outpatient care, and
prescription drugs. To select the plan that best suits your family, you should consider the key differences
between the plans, the cost of coverage and the healthcare needs of yourself and your dependents.

Understanding how your plan works

2. Yourcoverage 3. Your out-of-pocket maximum
1. Your deductible
You pay out-of-pocket for most Once your deductible is met, you and When you reach your out-of-pocket
medical and pharmacy expenses until the plan share the cost of covered maximum, the plan pays 100% of covered
you reach the deductible. medical and pharmacy expenses with medical and pharmacy expenses for the
coinsurance. The plan will pay a rest of the plan year.
You can pay for these expenses from a percentage of each eligible expense,
Flexible Spending Account or Health and you will pay the rest. Your deductible and coinsurance apply
Savings Account, depending on which toward the out-of-pocket maximum.
healthcare plan you choose.

Making the most of your plan
These tiers also affect your coverage.
Getting the most out of your plan also depends on how
΅ Generic – A drug that offers equivalent uses, doses,
well you understand it. Keep these important tips in mind
when you use your plan. strength, quality and performance as a brand-name
drug, but is not trademarked.
΅ In-network providers and pharmacies: You will always
΅ Brand preferred – A drug with a patent andtrademark
pay less if you see a provider within the medical and name that is considered “preferred” because it is
pharmacy network.
appropriate to use for medical purposes and is usually
΅ Preventive care: In-network preventive care is covered
less expensive than other brand-name options.
at 100% (no cost to you). Preventive care is often ΅ Brand non-preferred – A drug with a patent and
received during an annual physical exam and includes trademark name. This type of drug is “not preferred” and
immunizations, lab tests, screenings and other services is usually more expensive than alternative generic and
intended to prevent illness or detect problems before brand preferred drugs.
you notice anysymptoms.
΅ Specialty – A drug that requires special handling,
΅ Preventive drugs: Many preventive drugs and those
administration or monitoring. Most can only be filled
used to treat chronic conditions like diabetes, high
by a specialty pharmacy and have additional required
blood pressure, high cholesterol and asthma are approvals.
designated on the Preventive Drug List. These
prescriptions are covered at 100% (no cost to you) ΅Mail order pharmacy: If you take a maintenance
when you use an in-network pharmacy. medication on an ongoing basis for a condition like high
cholesterol or high blood pressure, you can use the mail
΅ Pharmacy coverage: Medications are placed in
order pharmacy to save on a 90-day supply of your
categories based on drug cost, safety and effectiveness.
medication.

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