Medical Plan Options

Choose the Right Plan for You

You have a choice of medical plan options — so you’re able to select the cost and coverage that best fits your needs and budget. Each plan has a different premium (what you pay up front through payroll deductions) and out-of-pocket costs (what you pay when you receive care throughout the year).

Need Help Choosing?

Choosing your benefits doesn’t have to be complicated. ALEX is an interactive benefits advisor that asks a few simple questions about you and your needs, then helps you find the plans that may be the best fit. It’s personalized, easy to use and available whenever you’re ready to explore your options. When you’re ready to enroll, you’ll complete your benefit elections in Workday.

Navigating Medicare Made Simple

If you're eligible for Medicare, ALEX can also help you understand Medicare Parts A, B, C and D in plain language.

ALEX can help you understand:

  • Medicare coverage options
  • Eligibility requirements
  • Enrollment timelines
  • Expected costs
Get Personalized Benefits Guidance with ALEX

Comparing Your Medical Plan Options

Whether you’re looking for routine preventive care or ongoing treatment, comparing your medical plan options can help you choose the coverage that best fits your needs. Review the chart below to compare deductibles, copays, coinsurance, and out-of-pocket costs across each plan.

Important: Except in emergencies, out-of-network care is not covered.

Need more information? Search “2026 Benefits Information” in Workday to access plan documents, the Summary of Benefits and Coverage (SBC), and additional enrollment resources. To view your personalized payroll contributions, visit Workday.

Understanding Tier 1 and Tier 2

Tier 1 and Tier 2 are not separate medical plans. They are provider tiers within each plan that show what you may pay depending on where you receive care.

  • Tier 1 – AdventHealth & Friends: Includes AdventHealth and other participating Tier 1 providers.
  • Tier 2 – Aetna Network: Includes providers in the Aetna network.

In general, Tier 1 providers may cost less than Tier 2 providers, which can help you save on care. Be sure to check the chart below to compare costs by tier before you enroll.

AdventHealth Benefits

Traditional Plan

Health Savings Plan

Tier 1

AdventHealth & Friends

Tier 2

Aetna Network

Tier 1

AdventHealth & Friends

Tier 2

Aetna Network

Annual Deductible
Individual/Family

$750/$1,500

$2,000/$4,000

$2,000/$4,000

$4,000/$6,000

Annual Out-of-Pocket
Maximum*
Individual/Family

$4,000/$8,000

$6,000/$12,000

$4,000/$8,150

$6,000/$12,000

AdventHealth HSA
Contribution*

N/A

Available for eligible team members

earning less than $21 per hour.

Well Child, Preventive
and Routine Care

You pay $0

You pay $0

You pay $0

You pay $0

AdventHealth Video
Visits (On-Demand
Urgent Care)

You pay $0

You pay $0

You pay $64 until
deductible is met,
$0 after deductible

You pay $64 until
deductible is met,
$0 after deductible

Primary Care
Physician Office Visit

You pay $25

You pay $40

You pay 10%,
after deductible

You pay 30%,
after deductible

Specialist Office Visit

You pay $50

You pay $80

You pay 10%,
after deductible

You pay 30%,
after deductible

Inpatient Hospital
Services

You pay 15%,
after deductible

You pay 30%,
after deductible

You pay 10%,
after deductible

You pay 30%,
after deductible

Emergency Room

You pay $400
(waived if admitted)

You pay $400
(waived if admitted)

You pay 20%,
after deductible

You pay 20%,
after deductible

Urgent Care

You pay $50

You pay $80

You pay 10%,
after deductible

You pay 30%,
after deductible

Surgery (Inpatient
and Outpatient)

You pay 15%,
after deductible

You pay 30%,
after deductible

You pay 10%,
after deductible

You pay 30%,
after deductible

Diagnostic X-Rays
and Labs

You pay 15%,
after deductible

You pay 30%,
after deductible

You pay 10%,
after deductible

You pay 30%,
after deductible

Inpatient Mental
Health

You pay 15%,
after deductible

You pay 30%,
after deductible

You pay 10%,
after deductible

You pay 30%,
after deductible

Outpatient Mental
Health

You pay $25

You pay $40

You pay 10%,
after deductible

You pay 30%,
after deductible

* Both medical and prescription deductibles and copays count toward your out-of-pocket maximum under the Health Savings Plan.
** AdventHealth HSA contributions are made in quarterly installments for eligible team members.

Select Plan (Florida & Colorado Only)

The Select Plan is designed to support your whole health with preventive care and condition management, helping you stay healthy and manage costs. It’s a great option if you plan to use AdventHealth and Aetna Select providers, except in emergencies.

The Select Plan is only available during Open Enrollment for coverage effective January 1. When you enroll in Workday, you’ll review and accept the Select Plan participation requirements before completing your election.

If you cover dependents, they must also live in an eligible county in Florida or Colorado to use Select Plan benefits. If a dependent lives outside of the counties listed, the Select Plan does not provide benefits for that dependent.

Benefit Highlights:

  • Free preventive and well-child care
  • Lower copays for primary, specialist and urgent care
  • Same deductibles as the Traditional Plan
  • Lower coinsurance for other services and inpatient care
  • Access to Care Concierge and Virtual PCP

Select Plan

In-Network
AdventHealth
Providers

Annual Deductible
Individual/Family

$750/$1,500

Annual Out-of-Pocket
Maximum*
Individual/Family

$4,000/$8,000

AdventHealth HSA
Contribution*

N/A

Well Child, Preventive
and Routine Care

You pay $0

AdventHealth Video
Visits (On-Demand
Urgent Care)

You pay $0

Primary Care
Physician Office Visit

You pay $10

Specialist Office Visit

You pay $40

Inpatient Hospital
Services

You pay 10%,
after deductible

Emergency Room

You pay $400
(waived if admitted)

Urgent Care

You pay $40

Surgery (Inpatient
and Outpatient)

You pay 10%,
after deductible

Diagnostic X-Rays
and Labs

You pay 10%,
after deductible

Inpatient Mental
Health

You pay 10%,
after deductible

Outpatient Mental
Health

You pay $10

Plan Requirements

To keep your premium at the standard rate, you and your covered spouse must complete three requirements by June 30.

If the requirements are not completed by the deadline, a surcharge will begin in the fourth quarter and remain in place for the rest of the year. Even if you complete all the requirements after June 30, the surcharge will still apply.

Surcharge amounts are listed below as monthly amounts and are deducted each pay period:

  • $200/month for team member
  • $200/month for spouse
  • $400/month for both
    (Children are not subject to the surcharge.)

Coverage Area

You may enroll in the Select Plan if your home address is located in one of the following eligible counties:

Florida
Flagler, Marion, Pinellas, Hardee, Orange, Polk, Highlands, Osceola, Seminole, Hillsborough, Pasco, Volusia, Lake

Colorado
Adams, Broomfield, Elbert, Arapahoe, Denver, Jefferson, Boulder, Douglas

Dedicated Care Concierge

When you enroll in the Select Plan, you’ll have access to a Care Concierge who can help you:

  • Coordinate care across providers and connect with health and benefits experts
  • Schedule appointments for primary care, specialists and virtual visits
  • Help you find in-network facilities and providers
  • Support preventive care, such as health screenings, for you and your family

Enjoy Complimentary Care Concierge Services

Who Can Enroll in Benefits?

Before you explore all of your benefit options, it’s important to first understand who’s eligible for coverage and when you can make your benefit choices. You’re eligible for many benefits on your very first day, so let’s get started!

Team Members

Dependents

If you’re a regular full-time or part-time team member, you’re eligible for AdventHealth benefits. PRN team members are also eligible for select benefits.

Status

Hours Worked per Week

Full-Time

36+

Part-Time

16–35.99

PRN

0–15.99

Your benefits will vary based on your status — check Workday for more details.


We’re proud to invest in benefits that support you and your family. To keep our program strong, please make sure only eligible dependents are enrolled.

Your benefits are designed to support you and the people who matter most. If you’re enrolling family members in coverage, here’s who may be eligible:

  • Your spouse, including anyone required to be recognized as a spouse under applicable state law
  • Your children — biological, adopted, foster or stepchildren, or children covered by a Qualified Medical Child Support Order — up to age 26
  • Children in your care for whom you are the legal guardian or have a court order granting permanent custody — up to age 26
  • Adult dependent children over age 26 with a mental, physical or developmental disability who are incapable of self-support, provided the condition began before age 26


Eligibility is subject to review and approval of required documentation.

The Right Care, Right When You Need It

Not sure where to go? When in doubt, seek medical care. For a medical emergency, call 911.

  • Urgent Care

    For non-emergency illnesses and injuries that need prompt attention but aren't life-threatening.

    Examples:

    • Colds, flu and sore throats
    • Ear infections and fevers
    • Minor cuts, burns and injuries
    • Sprains and strains
    Find Urgent Care

  • Emergency Department

    For serious or life-threatening conditions that need emergency care.

    Examples:

    • Chest pain
    • Severe trouble breathing
    • Stroke symptoms
    • Severe bleeding
    • Loss of consciousness
    Find an Emergency Department

Manage Your Benefits & Connect to Care

With the Aetna Health℠ app and your Aetna® member website, everything you need is right at your fingertips.

Here’s what you can do:

  • Manage your plan and ID card
  • Track your spending and deductibles
  • Pay claims and review costs
  • Find trusted, in-network providers
  • Estimate costs before you book care

Getting started is easy:
Create your account online—or text GETAPP to 90156 for a link to download the Aetna Health app. (Message and data rates may apply.)

Apple App Store
Google Play

This site summarizes the programs and benefits available to team members and their eligible dependents. Official plan documents, policies and certificates of insurance that contain the details, conditions, maximum benefit levels and restrictions on benefits govern our benefits program. In case of a conflict between this site and the official documents, the official documents prevail. The information on this site isn't a guarantee of benefits. AdventHealth reserves the right to modify or terminate its employee benefit plans and programs at any time for any reason.