Medical plan at a glance

Medical plan at a glance

Plan features HRA Plus HSA Base HRA Value
Type of account Health reimbursement account (HRA) Health savings account (HSA) Health reimbursement account (HRA)
Allscripts contributions to health account
Associate only Up to $500 annually Up to $500 annually Up to $500 annually
Associate & spouse/ domestic partner or associate & child(ren) Up to $750 annually Up to $750 annually Up to $750 annually
Family Up to $1,000 annually Up to $1,000 annually Up to $1,000 annually
What you pay when you receive services
In-network Out-of-network In-network Out-of-network In-network Out-of-network
Deductible $1,500 person
$3,000 family
$4,500 person
$9,000 family
$1,750 person
$3,500* family
$5,250 person
$10,500* family
$2,250 person
$4,500 family
$6,750 person
$13,500 family
Coinsurance 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Out-of-pocket maximum $4,500 person
$9,000 family
$9,000 person
$18,000 family
$5,250 person
$10,500 family
$10,500 person
$21,000 family
$6,650 person
$13,300 family
$13,300 person
$26,600 family
Preventive care visit Fully covered 50% after deductible Fully covered 50% after deductible Fully covered 50% after deductible
Primary care physician office visit
(General practice, family practice, internal medicine, Pediatricians, Obstetrics/Gynecologists)
20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Specialist office visit
(Specialist such as Allergist, Cardiologist, Orthopedist, Physical Therapist)
20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Chiropractic or acupuncture
(30 visits combined)
20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Urgent care 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Outpatient surgery 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Outpatient lab & X-ray 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
X-ray scans
(CT, PET, MRI)
20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Hospital facility charge 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Physician charge in hospital 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Outpatient mental health & substance abuse 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible
Inpatient mental health & substance abuse 20% after deductible 50% after deductible 20% after deductible 50% after deductible 25% after deductible 50% after deductible

*Under the HSA Base Plan, if more than one individual is enrolled, the family deductible must be met. Once the family deductible has been met, the plan will pay each enrolled family member’s covered expenses based on the co-insurance level. However, one individual may satisfy the per person out-of-pocket maximum.

Medical plan comparison

Medical plan comparison

While all three options have characteristics in common, there are significant differences that you need to understand so you can choose the plan that will best meet your needs.

How they are similar:

  • All administered by Cigna
  • Require you to pay a premium
  • Include prescription drug coverage through Cigna
  • Cover in-network preventive care at 100% as defined by ACA and other government guidelines
  • Offer lower out-of-pocket expenses for in-network services
  • Share the cost of non-preventive services once you meet the deductible
  • Protect you with an out-of-pocket maximum, at which point the plan covers eligible expenses at 100%
  • Offer out-of-network coverage at a higher cost

How they are different:

  • Premium amounts.
  • Deductibles/copayments.
  • Coinsurance.
  • Out-of-pocket maximums.
  • Health reimbursement account (HRA).
  • Health savings account (HSA).
  • Limited (combination) vs general purpose healthcare flexible spending account (FSA) eligibility.
  • Preventive drug coverage
Preventive care

Preventive care

All Allscripts Medical Plans cover in-network preventive care services, such as annual check-ups, immunizations and age appropriate screenings at 100 percent.

You pay nothing for these services that help keep you healthy:

  • Well-adult exams
  • Well-child exams
  • Child immunizations
  • Age and gender-related screenings
  • Flu shot (once a year)

Preventive care services covered under the Affordable Care Act

Preventive care received out-of-network is subject to the out-of-network deductible and coinsurance.
What is preauthorization?

What is preauthorization?

Preauthorization is the determination of a medical necessity review, which is a review process that determines whether or not certain medical services or medications are necessary and will be covered by our plan. This determination for approval by Cigna is based on evidence-based medicine guidelines. Its primary purpose is to help assure you get the right care, at the right time, in the right place and at the right cost.

Your in-network provider is responsible for initiating the preauthorization process with Cigna.

If you are eligible for Medicare

If you are eligible for Medicare

If you’re an active associate considering enrolling in Medicare, it’s important to understand how Medicare impacts medical coverage for you and your spouse or domestic partner:

  • If you and your spouse are both age 65 or older. If you continue medical coverage under Allscripts, Medicare pays secondary benefits to both you and your spouse. The Allscripts plan pays primary benefits. You’re not required to enroll in Medicare at age 65 because you already have employer-provided coverage in place.
  • If one of you (you and your spouse) is under age 65 and the other is over age 65. If you continue medical coverage under Allscripts, Medicare pays secondary benefits to the participant who is 65 or older. You’re not required to enroll in Medicare at age 65 because you already have employer-provided coverage in place.
  • If you’re under age 65 or over age 65, and your domestic partner is age 65 or older. If you continue medical coverage under Allscripts, Medicare pays primary benefits for your domestic partner. The Allscripts plan pays secondary benefits regardless of whether your domestic partner enrolls in Medicare. This means that the Allscripts medical plan will only pay secondary benefits after what Medicare would pay, regardless of whether your domestic partner is enrolled in Medicare.
  • If you’re age 65 or older and your domestic partner is under age 65. For you, if you continue medical coverage under Allscripts, Allscripts pay primary benefits for you and Medicare pays secondary benefits. For your domestic partner, the Allscripts plan continues to pay primary benefits.

Can you have COBRA as well as Medicare?

If you leave Allscripts and continue medical coverage through COBRA and are Medicare-eligible, COBRA benefits depend on when you become entitled to Medicare:

  • If your Medicare benefits (Part A or Part B) become effective on or before the day you elect COBRA coverage, you can continue COBRA coverage as well as having Medicare. This is true even if your Part A benefits begin before you elect COBRA but you don’t sign up for Part B until later. In this situation, Medicare is always primary to COBRA coverage.
  • If you become entitled to Medicare after you’ve signed up for COBRA, your COBRA benefits cease. (But if COBRA covers your spouse and/or dependent children, their coverage may be extended for up to 36 months because you qualified for Medicare.)
2022 Medical plan rates

2022 Medical plan rates

Coverage level Associate per-pay-period contribution
With All Well premium credit Without All Well premium credit
HRA Plus
Associate only $75.00 $137.50
Associate + spouse/DP $239.50 $302.00
Associate + child(ren) $136.00 $198.50
Associate + family $239.50 $302.00
HSA Base
Associate only $59.00 $121.50
Associate + spouse/DP $189.50 $252.00
Associate + child(ren) $107.00 $169.50
Associate + family $189.50 $252.00
HRA Value
Associate only $41.50 $104.00
Associate + spouse/DP $135.50 $198.00
Associate + child(ren) $75.00 $137.50
Associate + family $135.50 $198.00

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Group Number 3339080

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