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Palmetto Health offers two comprehensive medical plans that provide you with affordable access to quality health care providers. So which plan is right for you and your family?

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Watch a video comparing the plans

What’s the same?

  • Both plans use the same great network of experienced providers.
  • Both plans provide 100% coverage for preventive care.
  • Both plans provide the same prescription drug plan.
  • Both encourage you to be smart health care consumers and seek out the best care at the best price.
  • Both maximize your benefits when you use Palmetto Health facilities and Palmetto Health Quality Collaborative physicians.

What’s different?

HRA Plan

  • Higher premium but lower deductible than HSA plan.
  • No-cost Tier 1 primary care physician and specialist office visits.
  • Palmetto Health contributes into a Health Reimbursement Account, which you can use for eligible health care expenses.
  • You also can contribute to a Health Care Flexible Spending Account (FSA).

HSA Plan

  • Lower premium but higher deductible and higher out-of-pocket maximum than HRA plan.
  • Pay a deductible for primary care physician and specialist office visits.
  • Palmetto Health contributes into a Health Savings Account, which you can use for eligible health care expenses.
  • You own your HSA account funds.
 

HRA
Medical Plan
coverage

HSA
Medical Plan
coverage

HRA/HSA
Medical Plan
coverage

 
  Primary (PH/PHQC)
Tier
Secondary (BCBS)
Tier
Out-of-Network
Deductibles and Out-of-Pockets Maximums
Individual Deductible $1,250 $2,000 $3,125 $4,000
Family Deductible $2,500 $4,000 $6,250 $8,000
Ind. Out-of-Pocket Max $2,500 $4,000 $6,250 none
Family Out-of-Pocket Max $5,000 $8,000 $12,500 none
Physician Office Visits
Primary Care Preventive 100%, no
Deductible
100%, no
Deductible
100%, no
Deductible
50%, after
Deductible
Primary Care Sick 100%, no
Deductible
100%, after
Deductible
70%, after
Deductible
50%, after
Deductible
Specialists 100%, no
Deductible
100%, after
Deductible
70%, after
Deductible
50%, after
Deductible
Physician Office Services
Lab Tests and X-rays 100%, no
Deductible
100%, after
Deductible
70%, after
Deductible
50%, after
Deductible
Reading of Labs Preventive 100%, no
Deductible
100%, no
Deductible
100%, no
Deductible
50%, after
Deductible
Reading of Labs Sick and X-rays 90%, after
Deductible
90%, after
Deductible
70%, after
Deductible
50%, after
Deductible
Other Physician Office Services 90%, after
Deductible
90%, after
Deductible
70%, after
Deductible
50%, after
Deductible
Outpatient Hospital Charges
Surgery – Facility Charge 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Surgery – Physician/Anesthesiologist 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Labs – Test 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Labs – Reading of Labs 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
X-rays – Facility 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
X-rays – Physician 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
MRI/CAT/PET/Nuc Scans – Facility 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
MRI/CAT/PET/Nuc Scans – Physician 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
OT, PT, SLP and Cardiac Rehab 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Inpatient Hospital Charges
Facility 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Physician/Anesthesiologist 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Urgent Care
Visit 100% no
Deductible
100% after
Deductible
70% after
Deductible
50% after
Deductible
Emergency Dept
Visit 90% after
Deductible
90% after
Deductible
90% after
Deductible
90% after
Deductible
Mental Health
Office Visit 100% no
Deductible
100% after
Deductible
70% after
Deductible
50% after
Deductible
ED Visit 90% after
Deductible
90% after
Deductible
90% after
Deductible
90% after
Deductible
Other Ancillary Services
Home Health 100% after
Deductible
100% after
Deductible
70% after
Deductible
50% after
Deductible
DME 90% after
Deductible
90% after
Deductible
70% after
Deductible
50% after
Deductible
Hospice 100% no
Deductible
100% after
Deductible
70% after
Deductible
50% after
Deductible

Palmetto Health’s 2018 HRA Contributions

  Full-time Part-time
Individual $450 per year deposited January 1, 2018  $300 per year deposited January 1, 2018
Family $900 per year deposited January 1, 2018  $600 per year deposited January 1, 2018

Palmetto Health’s 2018 HSA Contributions

  Full-time Part-time
Individual $282 per quarter; $1,128 per year $160 per quarter; $640 per year
Family $562.50 per quarter; $2,250 per year $320 per quarter; $1280 per year

What's the difference between the different Tax-Free accounts available through the plans?

HRA

Must be a participant in Palmetto Health HRA Medical Plan.
You can't contribute to this account; only Palmetto Health can contribute.
Palmetto Health owns the account.
Automatically pays eligible expenses.
Unused balances can roll over year to year.

HSA

Must be a participant in Palmetto Health HSA Medical Plan.
You can contribute pre-tax dollars up to IRS limits, in addition to Palmetto Health contributions.
You own the account.
You decide when to pay from this account for eligible expenses.
Unused balances can roll over year to year.

FSA

Can be a participant in either plan, but can only use for dental and vision if you have an HSA.
You can contribute pre-tax dollars up to IRS limits.
You own the account.
You decide when to pay from this account for eligible expenses.
Use it or lose it.
 

Related Links

Enrollment Information

New Benefits for 2018

Have a Question?
Contact the Total Rewards Benefits Center at 800-963-3456 or 803-296-8893, or email TotalRewards
@PalmettoHealth.org

IMPORTANT: If you do not elect your benefits within 30 days of your date of hire, you will not have Palmetto Health plan coverage until the next year unless you have a qualified life event.

Effective Dates: Medical, dental, vision, flexible spending and/or health savings benefits will be effective on the first day of the second pay period of employment. All other benefits will be effective on the 91st  day of continuous employment. New team members will have 90 days to complete the myHealth Rewards program in its entirety to receive wellness incentives. Existing team members who become eligible for benefits have 30 days from their eligibility date to enroll in benefits, otherwise benefits will be forfeited until the next plan year. Existing team members who become eligible for benefits have 90 days to complete myHealth Rewards program.