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2022 Medical Plan Comparison (Text Only)

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Here are some of the key differences in the plans that Stanford offers to employees.

Choose a Stanford Medical Plan That Works for You and Your Family

Stanford employees say* these are their top factors in choosing a plan: Cost, FSA/HSA, and Access. This is based on the Open Enrollment survey data, 2016 to 2020. 

How I pay for services

Copays are fixed amounts you pay for services. Deductibles are set amounts you must meet before insurance starts sharing costs.

Plans with a copay include Kaiser HMO, Stanford Health Care Alliance and Trio. Providers you can see with these plans: You must stay “in-network" and these plans require a primary care physician (PCP). With these plans, you pay out-of-pocket costs with a health care FSA.

Plans with a deductible include Healthcare + Savings HDHP and ACA Basic HDHP. Providers you can see with these plans: Any provider, but you’ll save more “in-network” and a primary care physician (PCP) is not required. With these plans, you pay out-of-pocket costs with an HSA and university contribution.

Copays are fixed amounts you pay at the time of the service.

Deductibles are set amounts you must meet each year before the plan pays benefits.

The deductible does not apply to annual preventative care. These expenses are paid 100% (in network).

Saving on my out-of-pocket expenses

Health care flexible spending account (FSA): You save only what you need to spend in the year. An FSA is built with your before-tax dollars. You can pay for eligible medical expenses with a FSA debit card or file for reimbursement. You can rollover up to $550 to next year. Your full elected amount is available in the beginning of the year.

Health savings account (HSA): There is no limit to what you can save in a lifetime, and it includes a contribution from Stanford. An HSA is built with your before-tax dollars and, when eligible, a university contribution. You pay for eligible medical expenses with an HSA debit card or file for reimbursement. You can rollover unused funds every year; the money is yours forever.

NOTE: You cannot have an HSA if you or your spouse has a health care FSA, however, you can have a dependent day care FSA with either.

Access to my favorite doctors

Your favorite doctors and your home ZIP code, may influence your options in plans.

When does it pay to have a plan with a copay? The doctor’s you already have are within the plan’s network and service area. You want to keep your costs low by having a primary care physician help manage your care.

When does it pay to have a plan with a deductible? You want access to a nationwide network. You want flexibility in finding a specialist. 

At a glance

Plans with a nationwide network: Healthcare + Savings and ACA Basic HDHP

Plans that include Stanford Health Care providers: Healthcare + Savings, SHCA and ACA Basic HDHP

Plans that accept Palo Alto Medical Foundation: Healthcare + Savings and ACA Basic HDHP

Requires a PCP for referrals: Kaiser, SHCA and Trio

Has a copy, no deductible: Kaiser, SHCA and Trio

Eligible for an FSA: Heath Care + Savings HDHP, Kaiser, SHCA, Trio and ACA HDHP

Stanford contributes to HSA:  Heath Care + Savings HDHP

Eligible for HSA + university contribution: Healthcare + Savings

Covers non-network mental health care: Healthcare + Savings and SHCA

Has an out-of-pocket maximum: All plans

Note that Stanford cannot guarantee that any doctor, medical group or hospital will continue to participate in an plan's network. This information is current as of Sept. 4, 2020. If you are enrolled in the Healthcare+ Savings HDHP or ACA Basic HDHP, you may contribute to a health care FSA if you are not eligible for an HSA. This also applies to employees enrolled in Medicare who may not contribute to an HSA.

cardinalatwork.stanford.edu/benefits

 

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