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Benefit Information

If you are not currently an enrollee click here to learn more about ACHIA and the benefits that are available.

If you are currently an ACHIA member, simply select your plan below to see a copy of your policy and learn more about your benefits.

NON-MEDICARE PLANS:

MEDICARE PLANS:

PLAN DESCRIPTIONS:

ACHIA offers six different comprehensive PPO plans. The primary differences between the plans are the annual deductible and the associated out-of-pocket expense limitations. All plans pay 80 % of the allowed charges once you have satisfied the annual deductible for that plan, as long as you receive treatment either from a preferred hospital or from a hospital that is not preferred when you do not have reasonable access to a preferred hospital. If you have reasonable access to a preferred hospital and choose to receive treatment from a hospital that is not preferred, ACHIA will pay only 60 % of the usual and customary charges. Once your deductible and out of pocket maximum have been satisfied, ACHIA will pay your claims at 100 %.

ACHIA also offers a Traditional non-PPO plan. This plan pays 80 % of the allowed charges after the $1,000 annual deductible has been satisfied. Once your deductible and out of pocket maximum have been satisfied, ACHIA will pay your claims at 100%.

For those covered under Medicare, ACHIA has three Medicare supplement plans: standardized Plan A, Plan F and Plan G. If you are not enrolled in Part B of Medicare, benefits under these plans will not include benefits normally paid by Medicare. These plans do not cover basic prescription drugs, but do cover drugs that are covered by Medicare Part B.

Please NOTE: ACHIA Standardized Medicare Supplement Plan F will no longer be available to individuals who became eligible for Medicare on or after January 1, 2020. Those eligible for Medicare prior to January 1, 2020, will be able to purchase or keep their Standardized Medicare Supplement Plan F. Medicare Supplement Plan G is now available starting on January 1, 2020 to everyone.


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