Medical Coverage
Michaels offers several medical plans to fit your life.Michaels offers several medical plan options, all with prescription drug coverage.
Here’s an overview of how each plan works. All Aetna plans have separate — and higher — deductibles and out-of-pocket maximums for out-of-network care. See the Enrollment Guide for details on out-of-network benefits.
How the PPO Plans Work – The PPO plans have copay, deductibles, and coinsurance. You can choose any provider, but you’ll save money when you use a provider in the Aetna Premier Care Network (APCN).
How the Choice HSA Plan Works – The Choice HSA uses the same network as the PPO Plans, covers the same services and allows you to choose any provider, but you’ll save money when you use in-network providers.
If you live in California, you may also choose to enroll in the Kaiser HRA, but you must use a Kaiser provider for the plan to pay benefits.
Learn more about using your HSA or HRA.
A note about deductibles – The way the deductible works in the Choice HSA plan is different. With the PPOs and the Kaiser HRA, if you have Family coverage, one person can meet the individual deductible and then the plan will share costs (coinsurance) for that individual. With the Choice HSA, if you enroll yourself and at least one dependent, there is no individual deductible. The entire family deductible must be met before the plan pays coinsurance for any covered family member.
Transparency in Coverage Information – Effective July 1, 2022, if you would like would like to see pricing information for covered items and services for Aetna in-network and out-of-network provider rates, click here. For pricing information for covered items and services for Kaiser network provider rates, click here. These URL links are being provided to you as a fulfillment of our requirement to you to provide transparent pricing information, effective July 1, 2022.
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What You Pay When You Receive Care In-Network
| Aetna Choice HSA | Aetna Basic PPO | Aetna Enhanced PPO | Kaiser HRA |
| Money from Michaels (Amount deposited into HSA or HRA. You can use this money to pay for health care expenses.) | |||
| Individual | |||
| $500 | N/A | N/A | $425 |
| Family | |||
| $1,000 | N/A | N/A | $950 |
| Deductible (The amount you must pay before the plan will pay benefits for non-preventive care). | |||
| Individual | |||
| $1,750 | $2,500 | $750 | $1,500 |
| Family | |||
| $3,500 | $5,000 | $1,500 | $3,000 |
| Preventive Care2 | |||
| $0, no deductible | $0, no deductible | $0, no deductible | $0, no deductible |
| Office visits | |||
| 20% | Primary Care $25 copay, no deductible Specialist $50 copay, no deductible |
Primary Care $25 copay, no deductible Specialist $40 copay, no deductible |
$20 copay |
| Urgent Care3 | |||
| 20% | $75 copay, no deductible | 20% | $20 copay |
| Retail Clinic4 | |||
| 20% | $25 copay, no deductible | 20% | $20 copay |
| Emergency Room5 | |||
| 20% | 25% | $250 copay + 20% | 20% |
| Hospital Care and Mental Health6 | |||
| 20% | 25% | 20% | 20% |
| Routine Prenatal Care | |||
| $0, no deductible | $0, no deductible | $0, no deductible | $0, no deductible |
| Delivery | |||
| 20% | 25% | 20% | 20% |
| Out-of-pocket maximum (The maximum amount you will have to pay out of pocket. If you reach this amount, Michaels will pay 100% of your eligible expenses for the rest of the plan year). | |||
| Individual | |||
| $5,000 | $4,500 | $4,000 | $3,000 |
| Family | |||
| $12,500 | $10,600 | $8,000 | $6,000 |
1. Out-of-network expenses are paid based on the allowed charge. You are responsible for any amount above the allowed charge, even after you reach your out-of-pocket maximum, if applicable.
2. Preventive care includes, but is not limited to, annual physical exams, annual gynecological exams, routine mammograms, colonoscopies and immunizations. Coverage for preventive care is based on federal guidelines for frequency and age.
3. Must be an urgent care issue or you will pay 100% of the cost. See your Summary Plan Description (SPD) for more details.
4. Aetna participants may only use clinics inside a pharmacy or retail store such as CVS MinuteClinic. Kaiser participants may use approved Kaiser clinics at specified locations or inside certain Target Stores.
5. Must be a true emergency or you will pay 100% of the cost. See your Summary Plan Description (SPD) for more details.
6. Pre-certification is required for inpatient care except for delivery.
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What the Plans Cost
| Aetna Choice HSA | Aetna Basic PPO | Aetna Enhanced PPO | Kaiser HRA | |
| Bi-Weekly | $50.86 | $38.16 | $97.41 | $64.71 |
| Annually | $1,322.36 | $992.16 | $2,532.66 | $1,682.46 |
| Bi-Weekly | $136.45 | $102.93 | $244.86 | $154.60 |
| Annually | $3,547.70 | $2,676.18 | $6,366.36 | $4,019.60 |
| Bi-Weekly | $100.48 | $69.39 | $186.69 | $122.25 |
| Annually | $2,612.48 | $1,804.14 | $4,853.94 | $3,178.50 |
| Bi-Weekly | $168.70 | $120.28 | $297.63 | $182.15 |
| Annually | $4,386.20 | $3,127.28 | $7,738.38 | $4,735.90 |
Have an ongoing medical condition like diabetes or high blood pressure?
If you’re enrolled in an Aetna plan, let Aetna’s In Touch Care program help. If you are enrolled in a full-time Aetna medical plan through Michaels, this program is a free resource that can help you manage your condition. The program has nurses and clinicians on hand to help you make sure you get the appropriate treatment and preventive care, understand your doctor’s treatment plan, and identify and manage risks you may have for other conditions.
To start using the digital support of Aetna In Touch Care, log in to the secure member website address shown on the back of your member ID card. First-time users will need to register. Then, go to your health dashboard.
Call Aetna at 1-866-269-4500 for details.
Provider
Turning 65 and eligible for Medicare?
Contact Medicare Transition Services for information and assistance.
Medicare Transition Services Guide
Medicare Transition Services Term Flyer
Medicare Part D Prescription Drug Creditable Coverage Letter