Clarification on Pharmacy Deductibles for 2019 HMO 3500a Plans

This week, we’re mailing individual members on 2019 HMO 3500a plans a letter explaining that the deductible listed in the Prescription Drugs section of the benefit summary posted online and included in the printed sales brochure refers to a separate pharmacy deductible, not the plan year (medical) deductible listed near the top of the page. The deductible listed in the Summary of Benefits and Coverage (SBC) is accurate.

The pharmacy deductible for the HMO 3500a plans listed below is $400/individual or $800/family.

• HMO 3500a Elite Silver – Direct
• HMO 3500a Methodist Silver – Direct
• HMO 3500a OSF Silver – Direct
• HMO 3500a Elite Silver – Marketplace
• HMO 3500a Elite Silver CSR 73– Marketplace
• HMO 3500a Methodist Silver – Marketplace
• HMO 3500a Methodist Silver CSR 73 – Marketplace
• HMO 3500a OSF Silver – Marketplace
• HMO 3500a OSF Silver CSR 73– Marketplace
• HMO 3500a Elite Silver Ind CSR – Marketplace
• HMO 3500a Methodist Silver Ind CSR – Marketplace
• HMO 3500a OSF Silver Ind CSR – Marketplace

We’ll update printed sales brochures and online benefit summaries with a note explaining the deductible and which plans it applies to. For more information about HMO 3500a and other plans, visit HealthAlliance.org/Individual.

If you have questions, call Broker Support at 1-877-917-8489 or email BrokerServices@healthalliance.org. Members can call Customer Service at 1-866-247-3296 with questions.