High Deductible Health Plan (HDHP)

Network:

Alliance Select

Group Number:

56851-0319 GreenState PPO

56851-0419 GreenState HDHP

56851-0309 Insurance PPO

56851-0409 Insurance HDHP

56851-0329 Trust PPO

56851-0429 Trust HDHP

Website:

https://www.wellmark.com/

Support:

1.800.524.9242

Claim Submission Address:

Wellmark BC/BS of IA

Station 39

636 Grand Avenue

Des Moines, IA 50309-2565

Find a Doctor

With the High Deductible Health Plan (HDHP), you pay a low monthly premium in exchange for a high deductible. One feature that makes the HDHP special is that it's compatible with a Health Savings Account. A Health Savings Account (HSA) is like a savings plan for your healthcare. The combination of the HDHP and an HSA gives you greater flexibility and control over how you pay for and save for health care.

 

The Basics

  • The HDHP is a preferred provider organization health plan. This means you can choose to see any provider you want, but higher benefits are paid when you go to a network provider. 

  • The HDHP generally covers the same services as GreenState's Traditional PPO Plan, but there are important differences in how the HDHP works that will change how you pay for medical, prescription drug, mental health and substance abuse benefits under this plan. Be sure to read about these important differences before you enroll. 

  • The HDHP is the only medical plan GreenState offers that is compatible with a Health Savings Account (HSA).

BENEFITS

PPO

HDHP

Deductible

$1,500 Single

$3,000 Family

$3,000 Single

$6,000 Family

Coinsurance

80/20%

0%

Out of Pocket

Maximum

$3,000 Single

$6,000 Family

$3,000 Single

$6,000 Family

Office Visits

PCP: $20 copay

Specialist: $40 copay

Doctor on Demand: $40 Copay

PCP: Deductible applies

Specialist: Deductible applies

Doctor on Demand: $49 Copay

Preventative Services

Covered at 100%

Covered at 100%

Emergency Room

20% after deductible

Deductible applies

Urgent Care

$20 copay

Inpatient Hospital

20% after deductible

Outpatient Hospital

20% after deductible

Prescription Drug

$100/$200 deductible

(waived for Tier 1)

Non-preferred Pharmacy Copay

(Walgreens and CVS)

$10 / $35 / $50 / $200

All Other Pharmacies Copay

$4 / $25 / $40 / $200

Prescription Drug Out of Pocket Maximum

$3,000 Single

$6,000 Family

Deductible applies

Deductible applies

Deductible applies

Deductible applies

All prescription expenses apply to the Medical OPM.

There is no separate OPM.

Review the Benefits enrollment presentation slides covering HDHP/HSA basics.

Review this FAQ for answers to some commonly asked questions about HDHPs and HSAs.

Want to dig a little deeper and learn more about how the High Deductible Health Plan and Health Savings Account can help you take control of your health care costs by keeping more money in your pockets? Check out the below video! 

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Health Savings Account Compatible

One feature that makes the HDHP special is that it's compatible with a health savings account. A health savings account – or HSA – is like a savings plan for your health care. Visit the Health Savings Account page to learn more about this special account.