MEDICAL
You can choose from one of four medical plans and have the security of knowing you’re covered when you need professional medical care.
All Southwest medical plans offer health care benefits for you and your eligible dependents. Each is structured a little differently so you can select the plan that best meets your needs.
- New in 2024 – MedFlex Select Plan designed for those who prefer the lowest out-of-pocket costs, in exchange for using providers that are exclusively within the MedFlex Network, as there is no coverage for out-of-network benefits except for medical emergencies.
- The Consumer Driven Health Plan (CDHP) allows you to minimize your out-of-pocket premium and to open and contribute to a Health Savings Account (HSA) to offset qualified medical expenses.
- High Paid Provider Organization Plans (PPO) designed for those who prefer the predictability of set payments for doctors’ appointments and other medical services.
- Basic Paid Provider Organization Plans (PPO) designed for those who prefer the predictability of set payments for doctors’ appointments and other medical services.
Prescription Drug Coverage
When you select a Southwest medical plan, you’re automatically enrolled in our prescription drug plan. Your prescription coverage is managed by MedImpact, one of the nation’s leading pharmacy partners.
CLICK HERE to learn more
Resources
New in 2024!
The Medflex Select Plan
- Covers 100% of preventive care services provided in-network (according to age and gender)
- Allows coinsurance and copayments to accumulate toward the out-of-pocket maximum
- Does not cover out-of-network benefits except for medical emergencies. Member is responsible for the costs of non-emergency care received out-of-network
- Plan design allows for members to experience $0 deductible for both single/family
- Must use providers within the MedFlex Network
| MedFlex Select Plan | In-Network | Out-of-Network |
| You Pay | You Pay | |
| Annual Deductible (Individual/Family) |
$0/$0 | Not Covered |
| Coinsurance | 20% | Not Covered |
| Annual Out-of-Pocket Maximum (Individual/Family) |
$4,000/$8,000 | Not Covered |
| Preventive Care | $0 | Not Covered |
| Primary Care Office Visit | $20 Copay $0 Copay – SGMG Provider |
Not Covered |
| Specialist Office Visit | $40 Copay $0 Copay – SGMG provider |
Not Covered |
| Diagnostic1 | $0 | Not Covered |
| Inpatient Hospital Services | $250 Copay + 20% Coinsurance | Not Covered |
| Inpatient Surgical Services | 20% Coinsurance | Not Covered |
| Outpatient Hospital Services | $0 | Not Covered |
| Outpatient Surgical Services | 20% Coinsurance | Not Covered |
| Emergency Room Care (Waived if admitted) |
$250 Copay | $250 Copay |
| Infertility Testing/Treatment | 50% coinsurance, $10,000 Lifetime Max | Not Covered |
| Urgent Care | $40 Copay | Not Covered |
- Prior authorization is required for all CT, PET and MRI scans.
The birth of a child at Southwest General (only main campus) is covered at 100%.
Resources
The Consumer Driven Health Plan (CDHP) Paired With Health Savings Account (HSA)
This plan is designed to meet your health care needs today, throughout your career and into retirement. The CDHP has a higher annual deductible, but features a Health Savings Account (HSA), which is a tax-advantaged savings account that allows you to set aside pre-tax contributions to pay for eligible health care expenses now and in the future.
- Covers 100% of preventive care services provided in-network (according to age and gender
- Allows you to visit any provider – in- or out-of-network
- You receive a higher level of coverage when you utilize in-network providers
- Requires that you pay medical and prescription costs out-of-pocket until the deductible is met
- Allows you to open and contribute to a tax-advantaged Health Savings Account to pay for medical expenses now and in the future
| The Consumer Driven Health Plan (CDHP) | In-Network | Out-of-Network |
| You Pay | You Pay | |
| Annual Deductible (Individual Deductible and Aggregate Family Deductible)1 |
$2,000/$4,0001 | $3,000/$6,000 |
| Coinsurance | 20% | 45% |
| Annual Out-of-Pocket Maximum (Individual/Family)2 |
$4,000/$8,000 | $22,500/$45,000 |
| Preventive Care | $0 | Deductible then 45% Coinsurance3 |
| Primary Care Office Visit | Deductible then 20% Coinsurance $0 after Deductible – SGMG provider |
Deductible then 45% Coinsurance3 |
| Specialist Office Visit | Deductible then 20% Coinsurance $0 after Deductible – SGMG provider |
Deductible then 45% Coinsurance3 |
| Diagnostic4 | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
| Inpatient Hospital Services | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
| Inpatient Surgical Services | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
| Outpatient Hospital Services | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
| Outpatient Surgical Services | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
| Emergency Room Care | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
| Infertility Testing/Treatment | Deductible then 50% coinsurance, $10,000 Lifetime Max |
Not Covered |
| Urgent Care | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance3 |
- You must satisfy the full family deductible (Aggregate Family Deductible) amount before medical or Rx benefits are paid for any family member covered under the plan.
- Annual Out-of-Pocket Maximum includes your deductible and coinsurance; plan pays at 100% after this maximum has been met.
- You will be responsible for paying any amount in excess of R&C (Reasonable and Customary allowed amount for out of network) in addition to the Deductible and Coinsurance.
- Prior authorization is required for all CT, PET and MRI scans.
*The birth of a child at Southwest General (only main campus) is covered at 100%.
(Note that the CDHP plan [High Deductible with HSA] will cover at 100% after the deductible has been met.)
| Southwest’s contributions in 2024* | You can contribute up to** | |
| Individual | $500 | $3,650 |
| Family |
$1,000 |
$7,300 |
*Southwest will deposit contributions into your HSA on a biweekly pay cycle basis. In order to receive Southwest contributions, you will need to contribute a minimum of $.01 per pay cycle up to no more than the IRS maximum, and activate your account at HealthEquity. Shortly after completing the enrollment process, you will receive email instructions from HealthEquity on how to open your account. For further information, please refer to the HSA section on www.mysouthwestbenefits.com.
Fifth Third Employer Code: FTB-149563
YOUR HEALTH SAVINGS ACCOUNT
- Allows you to make contributions with pre-tax dollars through payroll deduction
- Is tax-advantaged. You do not pay federal or state taxes on Southwest’s contributions or the money you add to the account
- Can be used for the CDHP’s annual deductible, coinsurance and other qualified medical expenses
- Can also be used for eligible dental and vision expenses
- Is flexible. Contributions can be changed during the year by contacting Human Resources
- Does not include a “lose it or use it” feature – the balance rolls over year after year
- Includes investment options when your balance reaches $2,000
- Is your account – your HSA goes with you if you leave Southwest for any reason
- Is regulated by the IRS – in 2024, the maximum limit, including Southwest’s contributions to your account is $4,150 single/$8,300 family **
Resources
The Basic PPO Plan
- Covers 100% of preventive care services provided in-network (according to age and gender)
- Offers the predictability of copayments for many services
- Allows deductibles, coinsurance and copayments to accumulate toward the out-of-pocket maximum
- You receive a higher level of coverage when you utilize in-network healthcare providers
- Allows you to visit any provider – in- or out-of-network
| Basic PPO Plan | In-Network | Out-of-Network |
| You Pay | You Pay | |
| Annual Deductible (Individual/Family) |
$500/$1,000 | $3,000/$6,000 |
| Coinsurance | 20% Coinsurance | 45% R&C1 |
| Annual Out-of-Pocket Maximum (Individual/Family) |
$4,000/$8,000 | $22,500/$45,000 |
| Preventive Care | $0 | Deductible then 45% Coinsurance |
| Primary Care Office Visit | $20 Copay $0 Copay – SGMG provider |
Deductible then 45% Coinsurance |
| Specialist Office Visit | $40 Copay $0 Copay – SGMG provider |
Deductible then 45% Coinsurance |
| Diagnostic2 | $0 | Deductible then 45% Coinsurance |
| Inpatient Hospital Services | $250 Copay + Deductible then 20% Coinsurance | Deductible then 45% Coinsurance |
| Inpatient Surgical Services | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance |
| Outpatient Hospital Services | $0 | Deductible then 45% Coinsurance |
| Outpatient Surgical Services | Deductible then 20% Coinsurance | Deductible then 45% Coinsurance |
| Emergency Room Care (Waived if admitted) |
$250 Copay | $250 Copay |
| Infertility Testing/Treatment | Deductible then 50% coinsurance, $10,000 Lifetime Max |
Not Covered |
| Urgent Care | $40 Copay | Deductible then 45% Coinsurance |
- You will be responsible for paying any amount in excess of R&C (Reasonable and Customary allowed amount) in addition to the Deductible and Coinsurance.
- Prior authorization is required for all CT, PET and MRI scans.
The birth of a child at Southwest General (only main campus) is covered at 100%.
Resources
The High PPO Plan
- Is structured like the Basic PPO Plan but includes different copayments, deductibles and premiums
- Covers 100% of preventive care services provided in-network (according to age and gender)
- Offers the predictability of copayments for many services
- Allows deductibles, coinsurance and copays to accumulate toward the out-of-pocket maximum
- You receive a higher level of coverage when you utilize in-network healthcare providers
- Allows you to visit any provider – in- or out-of-network
| High PPO Plan | In-Network | Out-of-Network |
| You Pay | You Pay | |
| Annual Deductible (Individual/Family) |
$300/$600 | $3,000/$6,000 |
| Coinsurance | 15% | 45% R&C1 |
| Annual Out-of-Pocket Maximum (Individual/Family) |
$3,000/$6,000 | $22,500/$45,000 |
| Preventive Care | $0 | Deductible then 45% Coinsurance |
| Primary Care Office Visit | $15 Copay $0 Copay – SGMG provider |
Deductible then 45% Coinsurance |
| Specialist Office Visit | $30 Copay $0 Copay – SGMG provider |
Deductible then 45% Coinsurance |
| Diagnostic2 | $0 | Deductible then 45% Coinsurance |
| Inpatient Hospital Services | Deductible then 15% Coinsurance | Deductible then 45% Coinsurance |
| Inpatient Surgical Services | Deductible then 15% Coinsurance | Deductible then 45% Coinsurance |
| Outpatient Hospital Services | $0 | Deductible then 45% Coinsurance |
| Outpatient Surgical Services | Deductible then 15% Coinsurance | Deductible then 45% Coinsurance |
| Emergency Room Care (Waived if admitted) |
$250 Copay | $250 Copay |
| Infertility Testing/Treatment | Deductible then 50% coinsurance, $10,000 Lifetime Max |
Not Covered |
| Urgent Care | $40 Copay | Deductible then 45% Coinsurance |
- You will be responsible for paying any amount in excess of R&C (Reasonable and Customary allowed amount) in addition to the Deductible and Coinsurance.
- Prior authorization is required for all CT, PET and MRI scans.
*The birth of a child at Southwest General (only main campus) is covered at 100%.
