Changes are Coming -Take a look at the new DHMP
DHMO vs HDHP
A broader network offered in both our plans
The HighPoint Denver Plus Network
HighPoint Denver Plus consists of:UCHealth
University of Colorado Hospital
Poudre Valley Hospital Medical Center of the Rockies Memorial Hospital Memorial Hospital North
Children’s Hospital ColoradoCU Health PartnersDenver Health networkFirst Health national network
Cofinity network
1st tier
2nd tier
Who is in HighPoint Denver?
1st tier providers in HighPoint Denver Plus
Cofinity providers are the 2nd tier of HighPoint Denver Plus This includes facilities such as:
The “PLUS” in HighPoint Denver Plus
This includes providers such as:
Cofinity has thousands of primary care and specialty physicians in the Denver Metro area. Go to Cofinity.net to check for your provider.
2016 DHMP Monthly Premiums
HDHP* DHMOEmployee $22.50 $84.52
Employee/Spouse $123.75 $278.91
Employee/Child(ren) $90.00 $225.38
Family $216.01 $450.76
Familyplans
Individual plan
*HSA eligible
HDHP vs DHMO
HDHP DHMODeductible Out-of-Pocket Max Copays Coinsurance HSA account
Deductible
HDHP DHMOIndividual/Family Individual/Family
Deductible $1,350/$2,700 $500/$1,500
The deductible is the amount you must pay before your insurance begins to pay.
In an HDHP, the individual deductible does not apply to a family plan. A family must meet the entire family deductible before the Plan begins toPay for any services.
HDHP DHMOIndividual/Family Individual/Family
Out-of-Pocket Max $2,700/$5,400 $2,500/$5,000
The Out-of-Pocket Maximum is the most you will ever have
to pay for health care services in any given year.
Out-of-Pocket Max
In an HDHP, the individual out-of-pocket maximum does not apply to a family plan. A family must meet the entire family out-of-pocket maximum before the Plan begins to pay at 100% for covered services.
■ Preventive care is covered at no charge in BOTH plans
■ Annual check ups
■ Prenatal visits
■ Well child care
■ Well woman exams
■ Immunizations
All of the above are covered at no charge Deductible and coinsurance do not apply.
IMPORTANT NOTE
Preventive Care
Accessing Care: PCP/Specialty
HDHP DHMO1st tier
HighPoint Denver2nd tier
Plus (Cofinity)1st tier
HighPoint Denver2nd tier
Plus (Cofinity)
When I visit my PCP, what will I pay?(non-preventative)
Deductible and 10% coinsurance
Deductible and 20% coinsurance
$25/visit $30/visit
What about when I visit a specialist?
Deductible and 10% coinsurance
Deductible and 20% coinsurance
$50/visit $50/visit
Urgent Care Visit Deductible and 10% coinsurance
Deductible and 20% coinsurance
$75/visit $75/visit
Emergency Room visit Deductible and 10% coinsurance
Deductible and 20% coinsurance
$300/visit $300/visit
Inpatient Stay/Outpatient Surgery
Deductible and 10% coinsurance
Deductible and 20% coinsurance
Deductible and 20% coinsurance
Deductible and 30% coinsurance
You will pay more out of pocket at the beginning of the year with the HDHP. However, your monthly premiums are lower AND you have a
Health Savings Account (HSA) to help pay these costs.
HDHP plan Save money on
monthly premiums Have a tax-free HSA to
help you with unexpected health care expenses
Which is the plan for you?
Traditional plan Pay larger monthly premiumsLess out of pocket, butNo HSA
Broader network More than 18,000 providers Easy Access – DHMP requires
NO referrals
Don’t forget…
Questions?