Choosing a medical plan

Choosing the right benefits takes careful planning because your choices have a big impact on your health and finances. Most of your selections—like health care and life insurance—can’t be changed until the next Open Enrollment period or when you experience a qualified life event.

Medical plan options

You may have one or more Adobe medical plan options, depending on your location and circumstances. The medical plans that are available to you based on eligibility, home ZIP code and other criteria will appear as options on the Adobe Benefits Enrollment Site.

Your medical plan options can change if you move or experience other changes. For example, Kaiser HMO is only available to California and Washington employees whose home ZIP codes are in Kaiser’s Service Area. Contact Adobe’s Benefits Support Team with any questions.

Graphic of available plans

How the plans compare

For an at-a-glance look at what each plan covers, review the 2019 Total Rewards Guide [PDF] and watch the plan videos. You can find more information on the Adobe/Aetna microsite and the Adobe/Kaiser microsite and complete coverage details in our plan documents.

Aetna HealthSave plans

The Aetna medical plans offer access to a large network of providers and the option to go out of network at a higher cost.

  • The Aetna HealthSave (HSA) plan covers in-network services at 90% after you meet your deductible. You can manage health care spending through a HealthEquity Health Savings Account (HSA), and Adobe will contribute to that account, too! Just be sure you are eligible for an HSA before you enroll in this plan.
  • The Aetna HealthSave Basic plan has the lowest per-paycheck price. However, it also has higher deductibles and out-of-pocket maximums and pays for a smaller share of medical expenses, so you’ll pay more when you get care. This plan is HSA-compatible, so you can open one with your own contributions. (Adobe will not make any HSA contributions.) 
  • The Aetna Out of Area HealthSave (HSA) plan is only available to those who do not live within the Aetna Choice POS II network.

Aetna plan provisions

PLAN PROVISIONS HEALTHSAVE
(IN-NETWORK/ OUT-OF-NETWORK)
HEALTHSAVE BASIC
(IN-NETWORK/ OUT-OF-NETWORK)
HEALTHSAVE OUT OF AREA
Annual Deductible Individual: $1,350/$2,700
Family: $2,700/$5,400
Individual: $1,600/$3,200
Family: $3,200/$6,400
Individual: $1,350
Family: $2,700
Preventive Care Plan pays 100%
Deductible waived if in-network
Plan pays 100%
Deductible waived if in-network
Plan pays 100%
Deductible waived if in-network
Office Visit, Outpatient Services
(after deductible)
Plan pays 90%/70% Plan pays 80%/60% Plan pays 80%
Inpatient Services
(after deductible, with precertification)
Plan pays 90%/70% Plan pays 80%/60% Plan pays 80%
30-Day Retail Prescriptions
(after deductible)
$15 generic
$45 brand-name drug on Aetna Performance Drug List
$65 other brand-name drug
$15 generic
$45 brand-name drug on Aetna Performance Drug List
$65 other brand-name drug
$15 generic
$45 brand-name drug on Aetna Performance Drug List
$65 other brand-name drug
Out-of-Pocket Maximum
(includes deductible)
Individual: $2,800/$5,400
Family: $6,500/$10,800
Individual: $4,200/$7,500
Family: $7,900/$15,000
Individual: $2,800
Family: $6,500

Kaiser plan

In the Kaiser HMO (California and Washington), you must use Kaiser doctors, specialists, pharmacies and facilities, and your care is subject to referrals from your primary care physician. Your paycheck contributions are higher, but when you get care, you pay low copays for most eligible services.

The types of services covered by Kaiser may differ from those covered under Aetna plans, so be sure to check any specific services that are important to you if you are considering the Kaiser plan. To learn more about Kaiser HMO benefits and programs or to find a doctor, visit the Adobe/Kaiser microsite.

Kaiser plan provisions

Plan Provisions HMO
Annual Deductible None
Preventive Care Plan pays 100%
Office Visit, Outpatient Services You pay $20
Hospitalization, Inpatient Services You pay $100 per admission
30-Day Retail Prescriptions $15 generic
$45 brand-name 
$45 specialty
Out-of-Pocket Maximum Individual: $3,000
Family: $6,000

Waive coverage

You also have the option to waive Adobe medical coverage. Compare Adobe’s medical plan offerings to other coverage you have available (e.g., through your spouse or parents), and if another plan better meets your needs, you may opt out of Adobe’s medical coverage and receive $650 in a full year from Adobe with proof of other coverage ($25 added to your earnings every pay period).

Tools to help you choose

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Tips to keep in mind

Factor in your spouse's/domestic partner's coverage. If your spouse/domestic partner has health coverage through his/her employer, review those plans and costs. Their plans’ network or coverage design may better align with how you use health care, or it may be cheaper for him/her or even your whole family to be covered by his/her plan.

Watch out for dual-coverage pitfalls. If you have access to another health plan through your spouse or parents, consider choosing the one plan that best meets your needs versus having dual coverage. If you're considering dual coverage, make sure you understand the coordination of benefits rules under both plans (see Plan Booklets for Adobe’s). Coordination of benefits is the process of determining which of two or more insurance policies will have the primary responsibility of processing/paying a claim and the extent to which the other policies will contribute.

Understand the cost of covering a domestic partner. If you cover a domestic partner or domestic partner's child who does not qualify as a tax dependent, the coverage will cost you more, because that contribution will be taken on an after-tax basis, and the income tax withheld from your paycheck will be increased to cover the tax due on the imputed income value [PDF] of the benefit coverage.

Pick a plan that's best aligned with how you and your family commonly use health care. If you or a covered family member needs a particular type of health care—chiropractic care or specialized behavioral health services, for example—you may want to select a plan that offers the most coverage [PDF] for that service.

Check for your favorite doctors. Make sure your preferred primary care doctors and specialists are in-network for the plan you choose. If you elect an Aetna plan, you can use out-of-network providers, but your cost will be higher, so be sure you know before you go. The Aetna HealthSave (HSA) plan and the Aetna HealthSave Basic plan offer the same list of network providers, the Open Access Choice POS II Network (and for Utah employees, the Utah Connected Network). If you’re considering Kaiser, remember, you must use Kaiser doctors and facilities, and your care is subject to referrals from your primary care physician.

Don't forget about prescription coverage. Adobe has full prescription coverage that addresses most employees’ medicine needs. To check drug coverage and costs, log in to your plan’s member website, or call their member services team. Your plan's drug formulary also will describe what discounts you might receive by opting for generics or getting your prescriptions in the mail.

Decide if you want a plan that features a Health Savings Account (HSA). Just be sure you are eligible for an HSA. If you are not eligible for an HSA, you should not make personal HSA contributions nor receive HSA employer contributions.

In terms of how to save for health care expenses, it's hard to beat the tax advantages of an HSA:

  • Your contributions to the account are federal tax-free.
  • The interest on your savings is federal tax-free.
  • When you spend your HSA funds on eligible medical expenses, those expenses also are tax-free.

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Plan videos

 
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