2023 AtlantiCare Benefits Booklet

Medical

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-14 PRESCRIPTION DRUG. ................15-17 ADDITIONAL MEDICAL PLAN RESOURCES........18-22 DENTAL...............23-24 VISION.....................25 LIFECENTER..............26 LIFE INSURANCE. .....27 DISABILITY...............28 VOLUNTARY OFFERINGS. ........29-32 SPENDING ACCOUNTS. ............33 RETIREMENT BENEFITS..................34 WELLNESS. .........35-38 LEGAL NOTICES...39-41 GLOSSARY..........42-43 FAQs...................44-46 CONTACTS.........47-48 FORMS................49-58

! YOU’RE NOW IN CONTROL OF YOUR HEALTH RECORDS

Horizon Preferred Provide Plan (PPO) continued • Utilizing AtlantiCare and its affiliates for service will result in the lowest out-of-pocket cost. • Some services performed through a Blue Cross Blue Shield network provider will be covered at 70% after the deductible is met. • When you use the Blue Cross Blue Shield network, services will usually be paid at 50% after the deductible is met. • If services are not available at AtlantiCare, your responsibility will be at the Tier 2 or Out-of-Network level of coverage. For both plans, visit https://www.horizonblue.com/atlanticare/ to find a participating physician, facility or other service provider.

With our HealtheLife Patient Portal, you can securely access your health information and communicate with your AtlantiCare Physician Group providers. Manage all your health information in one place at no cost! For further information, go to page 22 or visit www.atlanticare.org/patient-portal/ .

The Plans At A Glance

HORIZON ENGAGED HORIZON PPO

Has AtlantiCare Network

Has “Out-of-Network” Providers

Has High Copays When Using Non-AtlantiCare Facilities.

Lowest Contributions

Wellness Credits Reduce Deductible

Wellness Credits Reduce Contributions

Access to Telehealth Benefit

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