What you need to know
Deductible. Coinsurance. Copays. Making sense of medical plans is no easy feat. The most important thing to know about our plans is that all of them protect your and your family’s health. The difference among them comes down to things like how much you pay when you get care, how much you pay in paycheck contributions, and how much flexibility you have in choosing providers and receiving care.
Your medical plan choices
Your options include: a Meritain Health (Aetna) Copay Plan, a Consumer Directed Health Plan called the Meritain Health (Aetna) CDHP with Health Savings Account (HSA), and a Health Maintenance Organization (HMO) plan if you live in California, and the HMSA medical plan if you live in Hawaii.
Need help with your medical plan? Accolade is your first place to turn to whenever you have a health benefits question, big or small.
How do I know which plan is right for me?
Use the Medical Plan Cost Estimator
Are you paying too much for health care? In just a few easy steps, you can find out which PayPal medical plan is the best for you financially. The Medical Plan Cost Estimator gives you an idea of your annual costs under each of PayPal's medical plans based on:
- The services you and your family may use during the year
- The estimated annual cost of in-network care in your area
You can also view important information like what you’ll pay out of your paycheck and what you’ll potentially pay out of pocket.
Before making a decision, consider these points:
Does your spouse / domestic partner have coverage through an employer?
You may find that your spouse’s / domestic partner’s coverage design better aligns with how you use health care, or it may be cheaper to be covered by his / her plan.
Which plan best aligns with how you and your family use health care?
If you or a covered family member need a particular type of care, you should consider a plan that gives you more coverage and better financial protection.
Are your doctors and other providers in-network?
You can use any of the plans’ Find a Doctor tools to check whether yours is in-network.
How much prescription coverage do you need?
Each plan has different coverage, so evaluate your needs, and see what each plan offers.
Do you want or need to save on taxes?
Only one plan — the CDHP — comes with the Health Savings Account (HSA), which lets you save pretax dollars for eligible medical expenses.
Need help understanding how the plans work?
Considering the Meritain CDHP with HSA?
The Meritain CDHP with HSA may be the right plan for you if you:
- Want to save on taxes with an HSA
- Prefer to pay less out of your paycheck and more when you need care
- Are comfortable with a plan that has a higher deductible for you to meet
- Would like free money from PayPal in your HSA
- Want flexibility in the providers you can see
The Meritain CDHP with HSA may not be the right plan if you:
- Are currently covered by Medicare Part A or Part B, or will enroll in Medicare in 2024
- Are covered under a spouse’s plan that’s not compatible with an HSA
- Have a spouse enrolled in an FSA
- Are unable to cover a health expense that is more than $1,700 or $3,400 (the deductible amounts for the CDHP)
- Need a lot of care or have a health condition that requires frequent doctor office visits and/or treatment, frequent prescriptions, or you have a family member in this situation
Preventive care is all about building healthy habits and catching problems early on. It’s generally your routine physical or annual checkup. Diagnostic care is when you have symptoms or risk factors and your doctor wants to diagnose them.
For example, it’s preventive care if:
- Your doctor recommends a colonoscopy because of your age or family history
It’s not preventive care if:
- Your doctor recommends a colonoscopy because of symptoms you're having. You’ll have to pay your share of the costs for that service.
All of PayPal’s medical plans cover in-network preventive care services, like screenings, immunizations, and exams, at 100% — so you pay nothing for these services.
If you use an out-of-network provider, your deductible and out-of-network coinsurance will apply. (Remember: HMO members must use in-network providers to receive any benefits.)
Preventive care tips
- Take advantage of preventive care at no cost to you
- Do other things to improve and maintain your health, and make the most of your health care benefits, such as eating right and exercising
- Find a primary care doctor whom you trust and feel comfortable with to coordinate your wellness care
- Ask your doctor to help design a personalized wellness plan that includes diet, exercise, and, if needed, weight-loss. Vida can help you achieve your weight loss goal!
- Keep good records. Stay up to date on preventive care by scheduling a wellness visit once a year.
- Prepare for appointments. Doctors spend an average of 10 to 20 minutes with patients, so bring along a list of what you want to discuss.
- If you have diabetes, take advantage of additional free care. If you’re enrolled in a Meritain Health medical plan, you won’t pay anything when you see a doctor for care related to your diabetes.
- Receive an extra dental cleaning and free eye exam every year if you’re enrolled in the dental and vision plans
- If you’re a CVS Caremark member, you can now get the measles, mumps, and rubella (MMR), and varicella (which protects against chickenpox) vaccinations at your local in-network pharmacy without an office visit
Chat with a doctor at any time, day or night — from anywhere! With virtual visits, you can talk with a doctor from your mobile device or computer, without an appointment. Virtual visits are best for nonemergency medical conditions and minor health issues.
Meritain Health members
With Accolade Care, you’ll be able to see doctors and therapists by phone or computer — day or night. Get support for urgent care needs, including the flu, a sore throat, or an infection, or virtually see the same doctor or therapist for ongoing care needs, such as diabetes or high blood pressure. Virtual care can be used for many of the same reasons you would visit a doctor in person, such as for prescriptions, mental health, or sleep problems.
Your cost for virtual care services is based on your medical plan’s coverage for office visits.
The Accolade member portal and mobile app puts everything in one place. Visit member.accolade.com, or download the Accolade mobile app on the App Store or Google Play, to activate your account today. You can call or message your Health Assistant or nurse directly from the mobile app.
Note: Accolade Care is not available to Kaiser medical plan members or to those who waived medical coverage.
Kaiser Permanente members (HMO available to California employees only)
HMSA members (available to Hawaii employees only)
If you live in Hawaii, PayPal offers a bundled health care program through HMSA, which includes medical, prescription, dental, and vision coverage. All programs are covered under HMSA.