Medical plans overview | BAE Systems Benefits

What you need to know

Our medical plans protect both your health and your finances. You can choose between two different plan options—an HMO and a PPO. The difference between them is how much you pay in payroll deductions, how much you pay out of pocket when you get care, and how much flexibility you have in choosing providers. The right plan for you is the one that best matches how you and your family use health care.

HMO option PPO option TRICARE Supplement Insurance

HMO option

You can choose to enroll in the Kaiser of Hawaii HMO option, which features:

A requirement to receive all care (except for emergencies) through HMO doctors, pharmacies, and facilities, and to get referrals to see specialists (except in-network ob-gyns).

No deductible for most services.

100% coverage for preventive care (no deductible or out-of-pocket cost to you for annual physical exams, lab tests, and age-appropriate screenings).

Office visits and prescription drugs covered in full after your copay.

Coverage for vision exams, lenses, and frames and an allowance for contact lenses.

An out-of-pocket maximum (the most that you’ll pay in a year for medical services) of $2,500 for individual coverage or $7,500 per family.

Note: Kaiser strongly encourages members to select a primary care physician.

Learn more about Kaiser.

What you pay for in-network care

Plan features	Kaiser HMO
Deductible	None
Out-of-pocket maximum	$2,500 individual $7,500 family
Preventive care	You pay nothing
Office visits Primary care and specialist	$15 copay
Urgent care	$15 copay
X-ray and lab	10% coinsurance

PPO option

You can choose to enroll in a PPO medical plan administered by HMSA. This plan features:

The option to choose any doctor you want and self-refer to specialists, with discounted rates when you use health care providers in the HMSA network.

A low deductible ($200 for individual coverage or $600 for family coverage) that applies to both in- and out-of-network care.

100% coverage for preventive care (no deductible or out-of-pocket cost to you for annual physical exams, lab tests, and age-appropriate screenings).

Office visits and prescription drugs covered in full after your copay.

Other services, like hospitalization, x-rays and medical equipment covered at 80% after the deductible.

Coverage for vision exams, lenses, and frames with a copay, and an allowance for contact lenses.

An out-of-pocket maximum (the most that you’ll pay, including the deductible, in a year for medical services) of $2,200 for individual coverage or $6,600 for family coverage that applies to both in- and out-of-network care.

A separate out-of-pocket maximum for prescription drugs of $3,600 for individual coverage or $4,200 for family coverage.

What you pay for in-network care

Plan features	HMSA PPO
Deductible	$200 individual $600 family
Out-of-pocket maximum*	$2,200 individual $6,600 family
Preventive care	You pay nothing
Coinsurance	20% after deductible
Office visits Primary care and specialist	$12 copay
Urgent care	$12 copay
X-ray and lab	20% after deductible Outpatient lab: You pay nothing

* HMSA plans have a separate out-of-pocket maximum for prescription drugs of $3,600 individual and $4,200 family.

TRICARE Supplement Insurance

TRICARE is the Department of Defense’s health benefit program for the military community. TRICARE Supplement Insurance is a voluntary insurance plan designed to supplement your TRICARE benefits and help minimize health care expenses. Learn more about the program and determine your eligibility.