2023 Lion Advantage (formerly PPO Savings plan)

2023 Lion Advantage (formerly PPO Savings plan) - Coverage - Faculty & Staff
Health Savings Account Seed Money
Salary Range	< = $45,000	$45,001 - $60,000	$60,001 - $90,000	>$90,000
Individual	$800	$600	$400	$200
Family	$1,600	$1,200	$800	$400
Deductible
Individual	$1,600
Family	$3,200
Coinsurance Maximum
Individual	$1,975
Family	$3,950
Member Coinsurance (after deductible)
Percentage	10%
Services
Preventive Care Highmark Preventive Schedule	Covered at 100%
Office Visits	Deductible and Coinsurance
Specialist	Deductible and Coinsurance
Urgent Care	Deductible and Coinsurance
Emergency Room (waived if admitted)	Deductible and Coinsurance
Prescription (after deductible)
Preventive drugs
Generic Drugs	10% Coinsurance
Preferred Brand Drugs	20% Coinsurance
Non-Preferred Brand Drugs	40% Coinsurance
Retail (30-day supply)
Generic Drugs	10% Coinsurance
Preferred Brand Drugs	20% Coinsurance
Non-Preferred Brand Drugs	40% Coinsurance
mail (90-day supply)
Generic Drugs	10% Coinsurance
Preferred Brand Drugs	20% Coinsurance
Non-Preferred Brand Drugs	40% Coinsurance
Specialty Medications
Preferred Brand Drugs	20% Coinsurance, $65 Minimum
Non-Preferred Brand Medications	40% Coinsurance, $100 Minimum
Out-of-Pocket Maximums	Integrated with Medical