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Health Options

Members can choose from Preferred Provider Organization (PPO) options or a Consumer-driven Health Plan (CDHP) option.

Members can choose from the following health insurance options (if you qualify):

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All options cover the same services and treatments, but medical necessity decisions may vary by carrier. Free in-network preventive health services are covered by each option.

Individuals who select the Partnership Promise PPO or the Promise HealthSavings CDHP agree to the Partnership Promise.

Below is information about costs and how plan options work. For more detailed information, member handbooks are available on the Benefits Administration website.

 

Annual Deductible

All options include an annual deductible. You pay this amount out of your pocket before the plan pays for services that require coinsurance.

Coinsurance

Some services require that you pay coinsurance after you meet a deductible. Coinsurance is a percentage of the total cost.

Copays

Some services require that you pay a copay (instead of a deductible and coinsurance). A copay is a flat dollar amount, like $25 for a doctor's visit.

Out-of-Pocket Maximum

The out-of-pocket maximum is the most you will pay for your copays and coinsurance each year. Once you reach your out-of-pocket maximum, the plan pays 100% of covered medical expenses.

In-Network vs. Out-of-Network Providers

You can see any doctor or go to any healthcare facility you want. However, if you use an “in-network” provider, you will always pay less. That’s because an in-network provider agrees to provide services to our members at discounted rates. Broad networks of doctors and hospitals are available.

Network Options

You have three insurance networks to choose from:

All three networks have providers available across Tennessee. Doctors and facilities in the networks can change. Check the networks carefully for your preferred doctor or hospital when making your selection.