HDHP Medical Plan

HDHP Medical Plan

The High Deductible Health Plan (HDHP) is a consumer-driven approach to health care, which encourages you to consider the best option for your health. This plan is different from a traditional PPO because there are no copays; all eligible services (including prescriptions) apply toward the deductible and no benefits, other than preventative, will be paid until the deductible is met.

    An HDHP has:

  • A higher annual deductible than typical health plans.
  • A maximum limit on the annual deductible and out-of-pocket medical expenses you must pay for covered expenses. Out-of-pocket expenses include coinsurance and other amounts but do not include premiums.

An HDHP provides preventive care benefits at 100% without a deductible. Preventive care includes, but is not limited to, the following:

  • Periodic health evaluations
  • Routine prenatal and well-child care
  • Child and adult immunizations
  • Tobacco cessation programs
  • Obesity weight-loss programs
  • Screening services (e.g., cancer, heart and vascular diseases, infectious diseases)

Please refer to the preventive care services listed in the plan documents. Individuals covered under the family tier of coverage must only meet the individual deductible versus the family deductible.

Benefits HDHP In-Network Benefits*
Deductible $3,000 Individual / $6,000 Family
Coinsurance 20%
Out-of-Pocket Maximum $5,000 Individual / $10,000 Family
Primary/Specialist Visit $20%
Emergency Room Visit 20%
*Benefits using out-of-network providers may vary. Please refer to the Summary of Benefits and Coverage (SBC) for additional information.
Your Rights

This website highlights some of your benefit plans. Your actual rights and benefits are governed by the official plan documents. If any discrepancy exists between this communication and the official plan documents, the plan documents will prevail. The company reserves the right to change any benefit plan without notice. Benefits are not a guarantee of employment.

City of Baytown Human Resources

(281) 420-6520