Click here to skip navigation
An official website of the United States Government.

Healthcare Compare 2020 Plans

The information contained in this comparison tool is not the official statement of benefits. Before making your final enrollment decision, always refer to the individual FEHB brochure which is the official statement of benefits. The amounts shown below indicate what you will pay for each class of service. When you see a plus sign (+), it means you must pay the stated coinsurance AND any difference between your Plan’s allowance and the provider’s billed amount. When a “yes” appears indicating that there is coverage for a specific service, you must check the plan brochure for your cost share. NOTE: HDHP plans require that the combined medical and pharmacy deductible be met before traditional coverage begins.

Self
Self
Self Plus One
Self Plus One
Self & Family
Self & Family
|
Aetna HealthFund HDHP and Aetna Direct Plan (HDHP) Blue Cross and Blue Shield Service Benefit Plan (Basic) GEHA Benefit Plan (HDHP) MHBP Consumer Option (HDHP)
 General Information
State Alabama Alabama Alabama Alabama
Enrollment Code - Self 224 Self 111 Self 341 Self 481 Self
Enrollment Code - Self & Family 225 Self & Family 112 Self & Family 342 Self & Family 482 Self & Family
Enrollment Code - Self Plus One 226 Self Plus One 113 Self Plus One 343 Self Plus One 483 Self Plus One
Carrier Code 22 11 34 48
Plan Type HMO FFS FFS FFS
Telephone Number 877-459-6604 1-800-411-2583 800-821-6136 800-694-9901
 Costs & Network
Biweekly Premium
$100.60
Self
$223.31
Self Plus One
$195.50
Self & Family
$75.94
Self
$178.61
Self Plus One
$191.22
Self & Family
$59.29
Self
$127.48
Self Plus One
$150.04
Self & Family
$66.15
Self
$146.38
Self Plus One
$153.70
Self & Family
In-Network 1 Out-of-Network In-Network 1 In-Network 1 Out-of-Network In-Network 1 Out-of-Network
Annual Deductible
Annual Deductible: The amount you may have to pay for covered health care services before the plan begins to pay. Some plans have both an overall deductible for all or most covered items/services, but some also have separate deductibles for specific types of services (e.g. prescription services).
$1,800.00
Self
$3,600.00
Self Plus One
$3,600.00
Self & Family
$2,600.00
Self
$5,200.00
Self Plus One
$5,200.00
Self & Family
None
Self
None
Self Plus One
None
Self & Family
$1,500.00
Self
$3,000.00
Self Plus One
$3,000.00
Self & Family
$3,000.00
Self
$6,000.00
Self Plus One
$6,000.00
Self & Family
$2,000.00
Self
$4,000.00
Self Plus One
$4,000.00
Self & Family
$2,000.00
Self
$4,000.00
Self Plus One
$4,000.00
Self & Family
Type of Account
HSA/HRA HSA/HRA None HSA/HRA HSA/HRA HSA/HRA HSA/HRA
Medical Account Contribution
The amount of funds available to you for paying your out-of-pocket qualified medical expenses through a premium pass-through contribution or a virtual account.
$800.00
Self
$1,600.00
Self Plus One
$1,600.00
Self & Family
$800.00
Self
$1,600.00
Self Plus One
$1,600.00
Self & Family
N/A
$900.00
Self
$1,800.00
Self Plus One
$1,800.00
Self & Family
$900.00
Self
$1,800.00
Self Plus One
$1,800.00
Self & Family
$1,200.00
Self
$2,400.00
Self Plus One
$2,400.00
Self & Family
$1,200.00
Self
$2,400.00
Self Plus One
$2,400.00
Self & Family
Net Deductible
A net deductible is the sum of your deductible minus any medical account fund.
$1,000.00
Self
$2,000.00
Self Plus One
$2,000.00
Self & Family
$1,800.00
Self
$3,600.00
Self Plus One
$3,600.00
Self & Family
None
Self
None
Self Plus One
None
Self & Family
$600.00
Self
$1,200.00
Self Plus One
$1,200.00
Self & Family
$2,100.00
Self
$4,200.00
Self Plus One
$4,200.00
Self & Family
$800.00
Self
$1,600.00
Self Plus One
$1,600.00
Self & Family
$800.00
Self
$1,600.00
Self Plus One
$1,600.00
Self & Family
Annual Out-of-Pocket Maximum
Annual Maximum Out of Pocket: Yearly amount the Federal government sets as the most each individual or family is required to pay in cost sharing (e.g. copayments, deductibles and coinsurance) during the plan year for covered, in-network services. This amount may be higher than the out of pocket limits the plan sets.
$6,900.00
Self
$13,800.00
Self Plus One
$13,800.00
Self & Family
$9,000.00
Self
$18,000.00
Self Plus One
$18,000.00
Self & Family
$5,500.00
Self
$11,000.00
Self Plus One
$11,000.00
Self & Family
$5,000.00
Self
$10,000.00
Self Plus One
$10,000.00
Self & Family
$7,000.00
Self
$14,000.00
Self Plus One
$14,000.00
Self & Family
$6,000.00
Self
$12,000.00
Self Plus One
$12,000.00
Self & Family
$7,500.00
Self
$15,000.00
Self Plus One
$15,000.00
Self & Family
Medicare Coordination
 Services & Benefits
In-Network 1 Out-of-Network In-Network 1 In-Network 1 Out-of-Network In-Network 1 Out-of-Network
  Member Cost with Medicare A & B Primary
This is your cost share.
Deductible Waiver
This field will indicate either the amount of your annual deductible or that the deductible has been waived (forgiven) when Medicare A and B is the primary coverage.
$1800 $2600 N/A $1500 $3000 $3000 $6000 Deductible Waived Deductible Waived
Out-of-Pocket Maximum
This is the most you have to pay annually in cost-sharing (deductibles, copayments and coinsurance) for covered, in-network services in your FEHB plan when Medicare A and B is your primary coverage.
$6900 $9000 $5500 $5000 $10000 $7000 $14000 $6000 $12000 $7500 $15000
Primary Care Office Visit with Medicare A & B Primary
This is the amount you pay for a primary care visit. When you have Medicare A and B, some plans will waive the copay.
15% 40% Member Pays Nothing 5% 25% + Member Pays Nothing Member Pays Nothing +
Specialty Office Visit
This is the amount you pay for a Specialty care visit. When you have Medicare A and B, some plans will waive the copay.
15% 40% Member Pays Nothing 5% 25% + Member Pays Nothing Member Pays Nothing +
Inpatient Hospital
This is the amount you pay for an inpatient hospital stay. When you have Medicare A and B, some plans waive this amount.
15% 40% Member Pays Nothing 5% 25% + Member Pays Nothing Member Pays Nothing +
Outpatient Hospital
This is the amount you pay for an outpatient hospital visit when you have Medicare Parts A & B as your primary coverage.What is the amount a member with Medicare A and B pays for an outpatient hospital visit?
15% 40% Member Pays Nothing 5% 25% + Member Pays Nothing Member Pays Nothing +
Part B Premium Reimbursement
If a plan reimburses you for your Part B premiums, this displays the maximum amount that you will be reimbursed. A ‘No” means that the premium will not be reimbursed.
No No $800 Max $900 max N/A No No
  Primary/Specialty Care
This is your cost share.
Preventive Care
What is the member cost share for Preventive Care, as defined by the U.S. Preventive Services Task Force with a rating of A or B?
You pay nothing 40% + Member Pays Nothing You pay nothing 25% + Member Pays Nothing Member Pays All Charges
Primary Care Office Visit
The amount you pay for a visit to a primary care practitioner (typically an M.D. or D.O., but can include other licensed providers).
15% 40% + $30 5% 25% + $15 40% +
Specialist Office Visit
The amount you pay for a visit to a provider focusing on a specific area of medicine. Some plans require a referral from your primary care provider for you to see a specialist. You must get a referral, if required, or your plan may not pay for the services.
15% 40% + $40 5% 25% + $15 40% +
Plan Requires Referral to See Certain Specialists
A written order from your primary care provider for you to see a specialist or get certain health care services. Some plans may require you need to get a referral before you can get health care services from anyone other than your primary care provider. In those plans, if you don’t get a referral first, the plan may not pay for the services
No No No No No No No
  Emergency & Urgent Care
This is your cost share.
Emergency Care
What is the member cost share for Emergency Care?
15% 15% $125 5% 5% + $50 $50 +
Urgent Care
What is the member cost share for Urgent Care?
15% 40% + $35 5% 25% + $50 $50 +
Out-of-Pocket Waived
Is a member's Out-of-Pocket cost waived when the member is admitted to the hospital following ER treatment? Select "NA" if a member pays nothing for any medical emergency.
No No Yes No No Yes Yes
  Surgery & Hospital Charges
This is your cost share.
Doctor Costs Inpatient Surgery
The amount you will pay for a doctor to perform inpatient surgery.
15% 40% + $200 5% 25% + Member Pays Nothing 40% +
Hospital Inpatient Cost Per Admission
This is the amount you pay before the Plan pays benefits when you are admitted as an inpatient to a hospital.
15% 40% + $175 Per Day Up To $875 Per Admission 5% 25% + $75 Per Day $750 max 40% +
Room & Board Charges
This is the amount you pay for covered Room & Board charges while an inpatient in a hospital.
15% 40% + Member Pays Nothing 5% 25% + Member Pays Nothing 40% +
Other Inpatient Costs
This is the amount you pay for other costs associated with inpatient surgery.
15% 40% + Member Pays Nothing 5% 25% + Member Pays Nothing 40% +
Doctor Costs Outpatient Surgery
This is the amount you pay for a doctor to perform surgery in an outpatient hospital setting or ambulatory surgery center.
15% 40% + $150 Or $200 5% 25% + $150 40% +
Other Outpatients Costs
This is the amount you pay for other outpatient care at a hospital (not surgery or emergency room services).
15% 40% + $100 Per Day Or $150 Per Day 5% 25% + $75 40% +
  Lab, X-Ray & Other Diagnostic Tests
This is your cost share.
Simple Diagnostic Tests/Procedures
What is the member cost share for Simple Diagnostic Tests/Procedures (e.g., blood tests, urinalysis, ultrasounds)?
15% 40% + $0 Or $30 Or $40 5% 25% + $15 40% +
Complex Diagnostic Tests/Procedures
What is the member cost share for Complex Diagnostic Tests/Procedures (e.g., CT scans, MRIs, PET scans, sleep labs)?
15% 40% + $40 Or $100 5% 25% + $15 40% +
Enhanced Lab Network
What is the member cost share for Enhanced lab Network?
15% 40% + N/A N/A N/A Member Pays Nothing 40% +
  Prescription Drugs
(Plans may not have drugs on the same tier. For more information on a specific drug, refer to each plan's RX Pricing tool below.)
This is your cost share.
Separate Annual Out-of-Pocket Maximum None None None None None None None
Separate Annual Deductible
None
Self
None
Self Plus One
None
Self & Family
None
Self
None
Self Plus One
None
Self & Family
None
Self
None
Self Plus One
None
Self & Family
None
Self
None
Self Plus One
None
Self & Family
None
Self
None
Self Plus One
None
Self & Family
None
Self
None
Self Plus One
None
Self & Family
None
Self
None
Self Plus One
None
Self & Family
Retail Generic
The amount you will pay to fill a prescription for retail generic drugs.
Tier 1: $10 Tier 3: 50% $300 max 40% + Tier 1: $10 25% 25% + $10 Member Pays All Charges
Retail Brand
The amount you will pay to fill a prescription for retail brand name drugs.
Tier 2: 50% $200 max Tier 3: 50% $300 max 40% + Tier 2: $55 Tier 3: 60% $75 min 25% Or 40% 25% + Or 40% + Tier 2: 30% + $200 max Tier 3: 50% + $200 max Member Pays All Charges
Specialty
Your cost share for specialty prescription drugs. Specialty prescription drugs are high cost, complex drugs placed on a specialty tier of the formulary and/or dispensed from a designated specialty pharmacy.
Tier 4: 50% $350 Max Tier 5: 50% $700 Max Member Pays All Charges Tier 4: $70 Or Tier 4: $65 Tier 5: $95 Or Tier 5: $90 25% Or 40% N/A 20% - $200 max Member Pays All Charges
Mail Service Pharmacy Benefit
This is the amount you pay for a mail order prescription. These are medications sent via mail for maintenance prescriptions, typically greater than a 30-day supply.
Yes No No Yes N/A Yes No
Medication Pricing Tool Go To RX Pricing Tool Go To RX Pricing Tool Go To RX Pricing Tool Go To RX Pricing Tool
  Treatment Therapies
This is your cost share.
Applied Behavioral Analysis (ABA)
This is the amount you pay for Applied Behavior Analysis (ABA) coverage.
15% 40% + $30 Or $40 5% 25% + $15 40% +
Chiropractic
Your cost share for chiropractic care.
Member Pays All Charges Member Pays All Charges $30 Any Amount Over $20 Any Amount Over $20 $15 40% +
Occupational Therapy
Your cost share for occupational therapy.
15% 40% + $30 Or $40 50 Combined Visits 5% 25% + $15 40% +
Physical Therapy
Your cost share for physical therapy.
15% 40% + $30 Or $40 50 Combined Visits 5% 25% + $15 40% +
Speech Therapy
Your cost share for speech therapy.
15% 40% + $30 Or $40 50 Combined Visits 5% 25% + $15 40% +
  Dental
This is your cost share.
Preventive Dental for Adults
Does the plan cover Preventive Dental for Adults?
Yes No Yes Yes Yes No No
Preventive for Children
Does the plan cover Preventive Dental for Children?
Yes No Yes Yes Yes No No
Minor Restorative for Adults
Does the plan cover Minor Restorative for Adults (e.g., fillings, local anesthesia)?
No No No Yes Yes No No
Minor Restorative for Children
Does the plan cover Minor Restorative for Children (e.g., fillings, local anesthesia)?
No No No Yes Yes No No
Major Restorative for Adults
Does the plan cover Major Restorative for Adults (e.g., endodontics, crowns, prosthodontics)?
No No No No No No No
Major Restorative for Children
Does the plan cover Major Restorative for Children (e.g., endodontics, crowns, prosthodontics)?
No No No No No No No
Orthodontic
Does the plan cover Orthodontics?
No No No No No No No
  Vision
This is your cost share.
Routine Eye Exams
Does the plan cover Routine Eye Exams?
Yes Yes No Yes Yes No No
Eye Exams for Medical Condition or Non-Surgical Treatment
Does the plan cover Eye Exams for Medical Condition or Non-Surgical Treatment?
Yes Yes Yes Yes Yes Yes Yes
Eyeglass Frames & Lenses
Does the plan cover Eyeglass Frames and Lenses?
Yes Yes No Yes Yes Yes Yes
Contacts
Does the plan cover Contacts?
Yes Yes No Yes Yes Yes Yes
  Alternative Care
This is your cost share.
Alternative Care
Your plan may cover some type of alternative care such as: acupuncture, massage therapy, hypnotherapy, holistic medicine, Yoga, herbal treatments, or naturopathic services. Please consult the plan brochure for more information.
Yes Yes Yes Yes Yes Yes Yes
 Quality
The measures below show how well a plan provides or coordinates care for its enrollees.
Key: Outstanding Excellent Good Fair Poor NA is displayed if a plan did not report or is unable to report a result in this coverage area.
Breast Cancer Screening
Do women who need screening mammograms get them?
Avoidance of Antibiotics in Adults with Acute Bronchitis
Appropriate use of antibiotics for accute bronchitis
Controlling High Blood Pressure
People with high blood pressure receive effective treatment.
Timeliness of Prenatal Care
Pregnant women receive care in the first trimester.
Use of Imaging Studies for Low Back Pain
Appropriate treatment of lower back pain.
Asthma Medication Ratio
Appropriate ratio of controller medications to total asthma medications
Plan All Cause Readmissions
Reduced likelihood of readmission following inpatient hospital stay.
 Customer Service
The measures below show what people think about their plan.
Overall Plan Satisfaction
How pleased are customers with the plan overall?
Claims Processing
How quickly do customers say the plan handles claims?
Customer Service
How satisfied are customers with the plan's customer service?
Getting Needed Care
Members report getting the care they need.
Coordination of Care
Members say that their doctors know about care from other providers
Control Panel