Compare Plans

You deserve the freedom to choose what’s best for you, especially when it comes to your health. Explore our health plans to find one that fits your needs.

Open enrollment for 2018 runs from November 1 to December 15, 2017. View details

  • Please note that you can’t enroll in an ACA plan if you have a Medicare plan.
  • On average, 2018 premiums are higher than in 2017. Find out why in this ACA update.
  • Premiums are determined by your age when your plan starts and may be adjusted based on tobacco use.
  • Prices and benefits are for one person. If you’re shopping for a family, total price will vary based on each family member’s age.
  • Benefits are for services received from participating providers.
  • Services are subject to the deductible unless noted.
  • PPO and HMO plans are different. Review the benefits of each plan type to help you choose a plan that’s right for you.
  • Go to ACA plan resources to learn how to submit claims, get a preauthorization, and more.
  • View the medical drug list. These drugs are usually covered under medical benefits and not by the drug rider. The cost share for these drugs may differ based on your plan. To find out the cost of your drugs, please contact HMSA’s Customer Relations team at 1-800-776-4672.

Dental plans

Get covered for teeth cleanings, exams, and more.

View plans

Pediatric dental benefits are required by the ACA. Although our medical plans don’t include pediatric dental benefits, you may choose an HMSA dental plan to get covered.

Plan Deductible Max out– of–pocket Coinsurance Doctor visit copayment Specialist visit copayment Premiums
based on age:
Platinum PPO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 
  • Tier 3 - mostly other brand name drugs: $75 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 
  • Tier 5 – mostly other brand name specialty drugs: $300 or 30% whichever is greater
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

Chiropractic, acupuncture, and massage therapy benefit.

$0 $7,150 10% - 20% 5 $20 $20 $336.95 / month $366.91 / month $378.36 / month $389.81 / month $402.15 / month $414.47 / month $427.25 / month $440.46 / month $440.46 / month $440.46 / month $440.46 / month $442.22 / month $451.03 / month $461.60 / month $478.78 / month $492.88 / month $499.92 / month $510.50 / month $521.06 / month $527.67 / month $534.72 / month $538.25 / month $541.77 / month $545.29 / month $548.81 / month $555.86 / month $562.91 / month $573.48 / month $583.61 / month $597.71 / month $615.32 / month $636.02 / month $660.69 / month $688.44 / month $720.15 / month $751.42 / month $786.66 / month $821.46 / month $859.78 / month $898.54 / month $940.38 / month $982.23 / month $1,027.60 / month $1,073.40 / month $1,122.30 / month $1,146.52 / month $1,195.41 / month $1,237.70 / month $1,265.45 / month $1,300.24 / month $1,321.38 / month
Platinum HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 
  • Tier 3 - mostly other brand name drugs: $75 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 
  • Tier 5 – mostly other brand name specialty drugs: $300 or 30% whichever is greater
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

Chiropractic, acupuncture, and massage therapy benefit.

$0 $7,150 10% $10 $20 $341.07 / month $371.39 / month $382.98 / month $394.57 / month $407.05 / month $419.54 / month $432.47 / month $445.84 / month $445.84 / month $445.84 / month $445.84 / month $447.63 / month $456.54 / month $467.25 / month $484.64 / month $498.90 / month $506.03 / month $516.73 / month $527.43 / month $534.12 / month $541.26 / month $544.82 / month $548.39 / month $551.95 / month $555.52 / month $562.66 / month $569.79 / month $580.48 / month $590.74 / month $605.01 / month $622.84 / month $643.80 / month $668.77 / month $696.85 / month $728.95 / month $760.61 / month $796.28 / month $831.50 / month $870.28 / month $909.52 / month $951.87 / month $994.23 / month $1,040.15 / month $1,086.52 / month $1,136.01 / month $1,160.53 / month $1,210.02 / month $1,252.82 / month $1,280.91 / month $1,316.13 / month $1,337.52 / month
Gold PPO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $10 
  • Tier 2 - mostly preferred drugs: $50 
  • Tier 3 - mostly other brand name drugs: $100 4
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 
  • Tier 5 – mostly other brand name specialty drugs: $400 or 30% whichever is greater
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$0 $7,350 30% $30 $30 $303.18 / month $330.13 / month $340.43 / month $350.74 / month $361.83 / month $372.94 / month $384.43 / month $396.32 / month $396.32 / month $396.32 / month $396.32 / month $397.90 / month $405.83 / month $415.33 / month $430.80 / month $443.48 / month $449.82 / month $459.33 / month $468.84 / month $474.78 / month $481.13 / month $484.30 / month $487.47 / month $490.63 / month $493.81 / month $500.15 / month $506.49 / month $516.00 / month $525.12 / month $537.80 / month $553.65 / month $572.28 / month $594.48 / month $619.45 / month $647.98 / month $676.11 / month $707.82 / month $739.13 / month $773.61 / month $808.48 / month $846.13 / month $883.78 / month $924.60 / month $965.82 / month $1,009.81 / month $1,031.61 / month $1,075.60 / month $1,113.65 / month $1,138.61 / month $1,169.93 / month $1,188.96 / month
Gold PPO 1000

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 1
  • Tier 3 - mostly other brand name drugs: $75 1,4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $300 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$1,000 $7,350 20% 1 $20 $20 $284.53 / month $309.82 / month $319.50 / month $329.16 / month $339.58 / month $349.98 / month $360.78 / month $371.93 / month $371.93 / month $371.93 / month $371.93 / month $373.42 / month $380.86 / month $389.79 / month $404.29 / month $416.20 / month $422.15 / month $431.08 / month $439.99 / month $445.58 / month $451.52 / month $454.50 / month $457.48 / month $460.45 / month $463.43 / month $469.38 / month $475.33 / month $484.26 / month $492.81 / month $504.72 / month $519.59 / month $537.07 / month $557.90 / month $581.33 / month $608.11 / month $634.52 / month $664.28 / month $693.65 / month $726.01 / month $758.74 / month $794.08 / month $829.42 / month $867.72 / month $906.41 / month $947.69 / month $968.14 / month $1,009.42 / month $1,045.14 / month $1,068.57 / month $1,097.94 / month $1,115.79 / month
Gold HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 1
  • Tier 3 - mostly other brand name drugs: $75 1,4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $300 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$1,000 $7,350 20% 1 $15 $30 $287.91 / month $313.51 / month $323.29 / month $333.07 / month $343.61 / month $354.15 / month $365.06 / month $376.35 / month $376.35 / month $376.35 / month $376.35 / month $377.86 / month $385.38 / month $394.42 / month $409.10 / month $421.14 / month $427.16 / month $436.19 / month $445.23 / month $450.87 / month $456.90 / month $459.91 / month $462.92 / month $465.92 / month $468.93 / month $474.95 / month $480.98 / month $490.01 / month $498.67 / month $510.72 / month $525.76 / month $543.45 / month $564.53 / month $588.24 / month $615.33 / month $642.06 / month $672.16 / month $701.90 / month $734.64 / month $767.76 / month $803.52 / month $839.27 / month $878.03 / month $917.17 / month $958.94 / month $979.65 / month $1,021.42 / month $1,057.55 / month $1,081.26 / month $1,110.99 / month $1,129.05 / month
Silver PPO 2000

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $15 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1,3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $400 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$2,000 $7,350 30% - 50% 1,5 $45 $45 $320.85 / month $349.37 / month $360.27 / month $371.18 / month $382.92 / month $394.66 / month $406.82 / month $419.41 / month $419.41 / month $419.41 / month $419.41 / month $421.08 / month $429.48 / month $439.54 / month $455.89 / month $469.31 / month $476.03 / month $486.10 / month $496.16 / month $502.45 / month $509.16 / month $512.51 / month $515.87 / month $519.23 / month $522.58 / month $529.29 / month $536.00 / month $546.06 / month $555.72 / month $569.13 / month $585.91 / month $605.62 / month $629.11 / month $655.53 / month $685.73 / month $715.50 / month $749.06 / month $782.19 / month $818.68 / month $855.59 / month $895.43 / month $935.28 / month $978.48 / month $1,022.10 / month $1,068.65 / month $1,091.72 / month $1,138.27 / month $1,178.53 / month $1,204.96 / month $1,238.09 / month $1,258.23 / month
Silver PPO 2500

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $15 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1,3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $400 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$2,500 $7,350 25% - 30% 1,5 $35 $35 $249.64 / month $271.82 / month $280.31 / month $288.79 / month $297.92 / month $307.06 / month $316.53 / month $326.32 / month $326.32 / month $326.32 / month $326.32 / month $327.62 / month $334.15 / month $341.98 / month $354.71 / month $365.15 / month $370.37 / month $378.20 / month $386.04 / month $390.93 / month $396.15 / month $398.76 / month $401.37 / month $403.98 / month $406.59 / month $411.82 / month $417.03 / month $424.87 / month $432.38 / month $442.81 / month $455.86 / month $471.21 / month $489.48 / month $510.03 / month $533.53 / month $556.70 / month $582.81 / month $608.58 / month $636.97 / month $665.69 / month $696.69 / month $727.69 / month $761.30 / month $795.24 / month $831.46 / month $849.41 / month $885.63 / month $916.95 / month $937.51 / month $963.29 / month $978.96 / month
Silver PPO 3500

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $15 
  • Tier 2 - mostly preferred drugs: $50 
  • Tier 3 - mostly other brand name drugs: $100 3
  • Tier 4 - mostly preferred specialty drugs: 40% 1
  • Tier 5 – mostly other brand name specialty drugs: 40% 1
Additional benefits

Urgent Care visit: $75

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$3,500 6 $7,350 20% 1 $30 $65 $316.00 / month $344.09 / month $354.83 / month $365.57 / month $377.13 / month $388.70 / month $400.68 / month $413.07 / month $413.07 / month $413.07 / month $413.07 / month $414.72 / month $422.98 / month $432.89 / month $449.01 / month $462.22 / month $468.83 / month $478.75 / month $488.66 / month $494.86 / month $501.47 / month $504.77 / month $508.07 / month $511.38 / month $514.69 / month $521.29 / month $527.91 / month $537.82 / month $547.31 / month $560.53 / month $577.06 / month $596.47 / month $619.60 / month $645.62 / month $675.37 / month $704.70 / month $737.74 / month $770.37 / month $806.32 / month $842.67 / month $881.90 / month $921.14 / month $963.69 / month $1,006.65 / month $1,052.50 / month $1,075.22 / month $1,121.07 / month $1,160.73 / month $1,186.75 / month $1,219.39 / month $1,239.21 / month
Silver HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $15 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1,3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $400 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$2,500 $7,350 30% 1 $30 $50 $318.59 / month $346.91 / month $357.73 / month $368.57 / month $380.23 / month $391.89 / month $403.96 / month $416.46 / month $416.46 / month $416.46 / month $416.46 / month $418.12 / month $426.45 / month $436.45 / month $452.69 / month $466.01 / month $472.68 / month $482.67 / month $492.67 / month $498.92 / month $505.58 / month $508.91 / month $512.25 / month $515.57 / month $518.91 / month $525.56 / month $532.23 / month $542.23 / month $551.80 / month $565.13 / month $581.79 / month $601.36 / month $624.69 / month $650.92 / month $680.90 / month $710.48 / month $743.79 / month $776.69 / month $812.92 / month $849.57 / month $889.13 / month $928.70 / month $971.60 / month $1,014.91 / month $1,061.13 / month $1,084.04 / month $1,130.26 / month $1,170.24 / month $1,196.48 / month $1,229.38 / month $1,249.38 / month
Bronze PPO 7350

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $25 
  • Tier 2 - mostly preferred drugs: $0 1
  • Tier 3 - mostly other brand name drugs: $0 1
  • Tier 4 - mostly preferred specialty drugs: $0 1
  • Tier 5 – mostly other brand name specialty drugs: $0 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$7,350 $7,350 0% 1 $50 2 $0 1 $212.99 / month $231.92 / month $239.16 / month $246.40 / month $254.20 / month $261.99 / month $270.07 / month $278.42 / month $278.42 / month $278.42 / month $278.42 / month $279.53 / month $285.10 / month $291.79 / month $302.64 / month $311.55 / month $316.01 / month $322.68 / month $329.37 / month $333.55 / month $338.00 / month $340.23 / month $342.46 / month $344.68 / month $346.91 / month $351.37 / month $355.81 / month $362.50 / month $368.90 / month $377.81 / month $388.95 / month $402.04 / month $417.63 / month $435.17 / month $455.22 / month $474.98 / month $497.26 / month $519.25 / month $543.47 / month $567.97 / month $594.43 / month $620.88 / month $649.55 / month $678.51 / month $709.41 / month $724.73 / month $755.63 / month $782.36 / month $799.90 / month $821.89 / month $835.26 / month
Bronze HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $25 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $400 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$6,000 $7,350 40% 1 $40 2 $60 1 $207.95 / month $226.43 / month $233.50 / month $240.56 / month $248.18 / month $255.78 / month $263.67 / month $271.82 / month $271.82 / month $271.82 / month $271.82 / month $272.91 / month $278.35 / month $284.87 / month $295.47 / month $304.17 / month $308.52 / month $315.05 / month $321.57 / month $325.64 / month $329.99 / month $332.17 / month $334.34 / month $336.52 / month $338.69 / month $343.04 / month $347.39 / month $353.92 / month $360.16 / month $368.86 / month $379.74 / month $392.51 / month $407.74 / month $424.86 / month $444.43 / month $463.73 / month $485.48 / month $506.95 / month $530.60 / month $554.52 / month $580.35 / month $606.17 / month $634.16 / month $662.44 / month $692.61 / month $707.56 / month $737.73 / month $763.83 / month $780.95 / month $802.42 / month $815.46 / month
Catastrophic Plan

This is single coverage for individuals under 30 years of age OR who have a hardship exemption from healthcare.gov.

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $0 1
  • Tier 2 - mostly preferred drugs: $0 1
  • Tier 3 - mostly other brand name drugs: $0 1
  • Tier 4 - mostly preferred specialty drugs: $0 1
  • Tier 5 – mostly other brand name specialty drugs: $0 1
Additional benefits
$7,350 $7,350 0% 1 $50 2 $0 1 $147.44 / month $160.54 / month $165.56 / month $170.56 / month $175.97 / month $181.36 / month $186.95 / month $192.73 / month $192.73 / month $192.73 / month $192.73 / month $193.50 / month $197.36 / month $201.98 / month $209.49 / month $215.66 / month $218.75 / month $223.38 / month $228.00 / month $230.89 / month $233.98 / month $235.51 / month $237.05 / month $238.60 / month $240.14 / month $243.22 / month $246.31 / month $250.94 / month $255.37 / month $261.54 / month $269.24 / month $278.30 / month $289.10 / month $301.24 / month $315.12 / month $328.80 / month $344.21 / month $359.44 / month $376.21 / month $393.17 / month $411.48 / month $429.78 / month $449.64 / month $469.68 / month $491.07 / month $501.68 / month $523.07 / month $541.57 / month $553.71 / month $568.94 / month $578.19 / month

1 Member’s cost after the deductible is met.
2 First three visits are covered before you reach the deductible.
3 $50 copayment plus $50 other brand name cost share.
4 $30 copayment plus $45 other brand cost share.
5 Coinsurance varies depending on the service received.
6 $3500 for medical and vision services. $500 for specialty prescription drugs.

Health benefits

These benefits are included in all HMSA individual plans and others are available when you enroll:

  • HMSA’s Online Care.
  • An annual preventive exam with no copayment.
  • Generic drug coverage*.
  • Adult vision coverage.

*Generic drugs are covered before you meet the deductible, except for single-source generic drugs (drugs manufactured by a single pharmaceutical company) dispensed at a pharmacy.

Pediatric dental benefits are required by the ACA. Although our medical plans don’t include pediatric dental benefits, you may choose an HMSA dental plan to get covered.

Plan Deductible Max out– of–pocket Coinsurance Doctor visit copayment Specialist visit copayment Premiums
based on age:
Platinum PPO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 
  • Tier 3 - mostly other brand name drugs: $75 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 
  • Tier 5 – mostly other brand name specialty drugs: $150 or 30% whichever is greater
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

Chiropractic, acupuncture, and massage therapy benefit.

$0 $6,850 10% - 20% 5 $20 $20 $273.52 / month $430.74 / month $430.74 / month $430.74 / month $430.74 / month $432.47 / month $441.08 / month $451.42 / month $468.22 / month $482.00 / month $488.90 / month $499.23 / month $509.57 / month $516.03 / month $522.92 / month $526.37 / month $529.82 / month $533.26 / month $536.71 / month $543.60 / month $550.49 / month $560.83 / month $570.74 / month $584.52 / month $601.75 / month $622.00 / month $646.12 / month $673.25 / month $704.27 / month $734.85 / month $769.31 / month $803.34 / month $840.81 / month $878.72 / month $919.64 / month $960.56 / month $1,004.93 / month $1,049.72 / month $1,097.54 / month $1,121.23 / month $1,169.04 / month $1,210.39 / month $1,237.53 / month $1,271.56 / month $1,292.22 / month $1,292.22 / month
Platinum HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 
  • Tier 3 - mostly other brand name drugs: $75 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 
  • Tier 5 – mostly other brand name specialty drugs: $150 or 30% whichever is greater
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

Chiropractic, acupuncture, and massage therapy benefit.

$0 $7,150 10% $10 $20 $268.21 / month $422.38 / month $422.38 / month $422.38 / month $422.38 / month $424.07 / month $432.52 / month $442.66 / month $459.13 / month $472.65 / month $479.41 / month $489.54 / month $499.68 / month $506.02 / month $512.77 / month $516.15 / month $519.53 / month $522.91 / month $526.29 / month $533.05 / month $539.81 / month $549.94 / month $559.66 / month $573.18 / month $590.07 / month $609.92 / month $633.58 / month $660.19 / month $690.60 / month $720.59 / month $754.38 / month $787.75 / month $824.49 / month $861.66 / month $901.79 / month $941.92 / month $985.42 / month $1,029.35 / month $1,076.24 / month $1,099.47 / month $1,146.35 / month $1,186.90 / month $1,213.51 / month $1,246.88 / month $1,267.14 / month $1,267.14 / month
Gold PPO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 
  • Tier 3 - mostly other brand name drugs: $75 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 
  • Tier 5 – mostly other brand name specialty drugs: $150 or 30% whichever is greater
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$0 $7,150 30% $30 $30 $234.44 / month $369.20 / month $369.20 / month $369.20 / month $369.20 / month $370.68 / month $378.06 / month $386.92 / month $401.32 / month $413.14 / month $419.04 / month $427.91 / month $436.77 / month $442.30 / month $448.21 / month $451.17 / month $454.12 / month $457.07 / month $460.03 / month $465.93 / month $471.84 / month $480.70 / month $489.19 / month $501.01 / month $515.78 / month $533.13 / month $553.80 / month $577.06 / month $603.65 / month $629.86 / month $659.40 / month $688.56 / month $720.68 / month $753.17 / month $788.25 / month $823.32 / month $861.35 / month $899.75 / month $940.73 / month $961.03 / month $1,002.02 / month $1,037.46 / month $1,060.72 / month $1,089.89 / month $1,107.60 / month $1,107.60 / month
Gold PPO 1000

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 1
  • Tier 3 - mostly other brand name drugs: $75 1, 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $150 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$1,000 $7,150 20% 1 $20 $20 $222.32 / month $350.11 / month $350.11 / month $350.11 / month $350.11 / month $351.51 / month $358.51 / month $366.92 / month $380.57 / month $391.77 / month $397.38 / month $405.78 / month $414.18 / month $419.43 / month $425.04 / month $427.84 / month $430.64 / month $433.44 / month $436.24 / month $441.84 / month $447.44 / month $455.85 / month $463.90 / month $475.10 / month $489.11 / month $505.56 / month $525.17 / month $547.22 / month $572.43 / month $597.29 / month $625.30 / month $652.96 / month $683.42 / month $714.23 / month $747.49 / month $780.75 / month $816.81 / month $853.22 / month $892.08 / month $911.34 / month $950.20 / month $983.81 / month $1,005.87 / month $1,033.53 / month $1,050.33 / month $1,050.33 / month
Gold HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $7 
  • Tier 2 - mostly preferred drugs: $30 
  • Tier 3 - mostly other brand name drugs: $75 1, 4
  • Tier 4 - mostly preferred specialty drugs: $150 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $150 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$1,000 $7,150 20% 1 $15 $30 $216.83 / month $341.46 / month $341.46 / month $341.46 / month $341.46 / month $342.82 / month $349.65 / month $357.85 / month $371.17 / month $382.09 / month $387.56 / month $395.75 / month $403.95 / month $409.07 / month $414.53 / month $417.26 / month $419.99 / month $422.73 / month $425.46 / month $430.92 / month $436.38 / month $444.58 / month $452.43 / month $463.36 / month $477.02 / month $493.07 / month $512.19 / month $533.70 / month $558.28 / month $582.53 / month $609.84 / month $636.82 / month $666.53 / month $696.58 / month $729.01 / month $761.45 / month $796.62 / month $832.13 / month $870.04 / month $888.82 / month $926.72 / month $959.50 / month $981.01 / month $1,007.99 / month $1,024.38 / month $1,024.38 / month
Silver PPO 1500

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $10 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1, 3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $200 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$1,500 $7,150 30% - 50% 1,5 $40 $40 $189.70 / month $298.75 / month $298.75 / month $298.75 / month $298.75 / month $299.94 / month $305.92 / month $313.09 / month $324.74 / month $334.30 / month $339.08 / month $346.25 / month $353.42 / month $357.90 / month $362.68 / month $365.07 / month $367.46 / month $369.85 / month $372.24 / month $377.02 / month $381.80 / month $388.97 / month $395.84 / month $405.40 / month $417.35 / month $431.39 / month $448.12 / month $466.94 / month $488.45 / month $509.66 / month $533.56 / month $557.16 / month $583.15 / month $609.44 / month $637.82 / month $666.21 / month $696.98 / month $728.05 / month $761.21 / month $777.64 / month $810.80 / month $839.48 / month $858.30 / month $881.90 / month $896.25 / month $896.25 / month
Silver PPO 2500

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $10 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1, 3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $200 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$2,500 $7,150 20% - 30% 1,5 $30 $30 $183.45 / month $288.90 / month $288.90 / month $288.90 / month $288.90 / month $290.06 / month $295.84 / month $302.77 / month $314.04 / month $323.28 / month $327.91 / month $334.84 / month $341.77 / month $346.11 / month $350.73 / month $353.04 / month $355.35 / month $357.66 / month $359.97 / month $364.60 / month $369.22 / month $376.15 / month $382.80 / month $392.04 / month $403.60 / month $417.18 / month $433.36 / month $451.56 / month $472.36 / month $492.87 / month $515.98 / month $538.80 / month $563.94 / month $589.36 / month $616.81 / month $644.25 / month $674.01 / month $704.06 / month $736.13 / month $752.02 / month $784.08 / month $811.82 / month $830.02 / month $852.84 / month $866.70 / month $866.70 / month
Silver PPO 3500

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $15 
  • Tier 2 - mostly preferred drugs: $50 
  • Tier 3 - mostly other brand name drugs: $100 3
  • Tier 4 - mostly preferred specialty drugs: 40% 
  • Tier 5 – mostly other brand name specialty drugs: 40%
Additional benefits

Urgent Care visit: $75

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$3,500 $7,150 20% 1 $30 $65 $178.51 / month $281.12 / month $281.12 / month $281.12 / month $281.12 / month $282.25 / month $287.87 / month $294.62 / month $305.58 / month $314.58 / month $319.07 / month $325.82 / month $332.57 / month $336.78 / month $341.28 / month $343.53 / month $345.78 / month $348.03 / month $350.28 / month $354.78 / month $359.27 / month $366.02 / month $372.49 / month $381.48 / month $392.73 / month $405.94 / month $421.68 / month $439.39 / month $459.64 / month $479.59 / month $502.08 / month $524.29 / month $548.75 / month $573.49 / month $600.20 / month $626.90 / month $655.86 / month $685.10 / month $716.30 / month $731.76 / month $762.97 / month $789.95 / month $807.66 / month $829.87 / month $843.36 / month $843.36 / month
Silver HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $10 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 1, 3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $200 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$2,500 $7,150 30% 1 $20 $40 $177.75 / month $279.92 / month $279.92 / month $279.92 / month $279.92 / month $281.04 / month $286.64 / month $293.36 / month $304.28 / month $313.23 / month $317.71 / month $324.43 / month $331.15 / month $335.35 / month $339.83 / month $342.06 / month $344.30 / month $346.54 / month $348.78 / month $353.26 / month $357.74 / month $364.46 / month $370.90 / month $379.85 / month $391.05 / month $404.21 / month $419.88 / month $437.52 / month $457.67 / month $477.55 / month $499.94 / month $522.05 / month $546.41 / month $571.04 / month $597.63 / month $624.23 / month $653.06 / month $682.17 / month $713.24 / month $728.64 / month $759.71 / month $786.58 / month $804.22 / month $826.33 / month $839.76 / month $839.76 / month
Bronze PPO 7150

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $25 
  • Tier 2 - mostly preferred drugs: $0 1
  • Tier 3 - mostly other brand name drugs: $0 1
  • Tier 4 - mostly preferred specialty drugs: $0 1
  • Tier 5 – mostly other brand name specialty drugs: $0 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$7,150 $7,150 0% $50 2 $0 1 $160.22 / month $252.31 / month $252.31 / month $252.31 / month $252.31 / month $253.32 / month $258.36 / month $264.42 / month $274.26 / month $282.33 / month $286.37 / month $292.43 / month $298.48 / month $302.27 / month $306.30 / month $308.32 / month $310.34 / month $312.36 / month $314.38 / month $318.41 / month $322.45 / month $328.51 / month $334.31 / month $342.38 / month $352.47 / month $364.33 / month $378.46 / month $394.36 / month $412.52 / month $430.44 / month $450.62 / month $470.55 / month $492.51 / month $514.71 / month $538.68 / month $562.65 / month $588.63 / month $614.87 / month $642.88 / month $656.76 / month $684.76 / month $708.99 / month $724.88 / month $744.81 / month $756.93 / month $756.93 / month
Bronze HMO

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $25 
  • Tier 2 - mostly preferred drugs: $50 1
  • Tier 3 - mostly other brand name drugs: $100 3
  • Tier 4 - mostly preferred specialty drugs: $200 or 20% whichever is greater 1
  • Tier 5 – mostly other brand name specialty drugs: $200 or 30% whichever is greater 1
Additional benefits

Fitness membership
(With $75 annual copayment)
Must be at least 16 years of age to participate.

$6,000 $7,150 40% 1 $40 2 $60 1 $147.60 / month $232.45 / month $232.45 / month $232.45 / month $232.45 / month $233.38 / month $238.03 / month $243.60 / month $252.67 / month $260.11 / month $263.83 / month $269.41 / month $274.99 / month $278.47 / month $282.19 / month $284.05 / month $285.91 / month $287.77 / month $289.63 / month $293.35 / month $297.07 / month $302.65 / month $307.99 / month $315.43 / month $324.73 / month $335.65 / month $348.67 / month $363.32 / month $380.05 / month $396.56 / month $415.15 / month $433.51 / month $453.74 / month $474.19 / month $496.28 / month $518.36 / month $542.30 / month $566.47 / month $592.28 / month $605.06 / month $630.86 / month $653.18 / month $667.82 / month $686.18 / month $697.35 / month $697.35 / month
Catastrophic Plan

This is single coverage for individuals under 30 years of age OR who have a hardship exemption from healthcare.gov.

Plan Benefits

  (amount you pay)

Prescription drugs (30-day supply)
  • Tier 1 - mostly generic drugs: $0 1
  • Tier 2 - mostly preferred drugs: $0 1
  • Tier 3 - mostly other brand name drugs: $0 1
  • Tier 4 - mostly preferred specialty drugs: $0 1
  • Tier 5 – mostly other brand name specialty drugs: $0 1
Additional benefits
$7,150 $7,150 0% 1 $50 2 $0 1 $129.36 / month $203.72 / month $203.72 / month $203.72 / month $203.72 / month $204.54 / month $208.61 / month $213.50 / month $221.44 / month $227.96 / month $231.22 / month $236.11 / month $241.00 / month $244.06 / month $247.32 / month $248.95 / month $250.58 / month $252.21 / month $253.84 / month $257.09 / month $260.35 / month $265.24 / month $269.93 / month $276.45 / month $284.60 / month $294.17 / month $305.58 / month $318.41 / month $333.08 / month $347.55 / month $363.84 / month $379.94 / month $397.66 / month $415.59 / month $434.94 / month $454.30 / month $475.28 / month $496.47 / month $519.08 / month $530.28 / month $552.90 / month $572.45 / month $585.29 / month $601.38 / month $611.16 / month $611.16 / month

1 Member’s cost after the deductible is met.
2 First three visits are covered before you reach the deductible.
3 $50 copayment plus $50 other brand name cost share.
4 $30 copayment plus $45 other brand cost share.
5 Coinsurance varies depending on the service received.
6 $3500 for medical and vision services. $500 for specialty prescription drugs.

Health benefits

These benefits are included in all HMSA individual plans and others are available when you enroll:

  • HMSA’s Online Care.
  • An annual preventive exam with no copayment.
  • Generic drug coverage*.
  • Adult vision coverage.

*Generic drugs are covered before you meet the deductible, except for single-source generic drugs (drugs manufactured by a single pharmaceutical company) dispensed at a pharmacy.

medicare eligibility trigger