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 each plan works.

How the PPO Plan Works – The PPO plan has co-payments, deductibles, and coinsurance.

How the Select HRA & Choice HSA Plans Work – Both plans use the same network, cover the same services and allow you to choose any provider, but pay more of the cost when you use in-network providers. The biggest differences are the amount of money Michaels puts into your account, the cost of coverage and your deductible.

The Aetna plans allow you to choose any provider, but pay more of the cost when you use in-network providers. If you’re enrolled in the Kaiser HRA, 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 deductibles work in the HRA plan versus the Choice HSA plan is different. With the HRA plan, if you have Family coverage, one person can meet the individual deductible before the plan will share costs (coinsurance). With the Choice HSA plan, if you have Family coverage, there is no individual deductible. The entire family deductible must be met before expenses are paid for any covered family member.

blank

What you Pay When You Receive Care

Aetna Basic PPO Aetna Select HRA Aetna Choice HSA Kaiser HRA
In Network Benefits Only1
Money from Michaels (Amount deposited into HRA or HSA. You can use this money to pay for health care expenses.)
Individual
N/A $525 $375 $425
Family
N/A $1,050 $750 $950
Deductible (The amount you must pay before the plan will pay benefits for non-preventive care).
Individual
$2,500 $1,500 $1,750 $1,500
Family Maximum
$5,000 $3,750 $3,500 $3,000
What You Pay After the Deductible (except as noted)
Preventive Care2
$0, no deductible $0, no deductible $0, no deductible $0, no deductible
Office visits
Primary Care $25 copay, no deductible
Specialist $50 copay, no deductible
20% 20% $20 copay
Urgent Care
$75 copay, no deductible 20% 20% $20 copay
Retail Clinic
$25 copay, no deductible 20% 20% $20 copay
Emergency Room
25% 20% 20% 20%
Hospital Care and Mental Health
25% 20% 20% 20%
Routine Prenatal Care
$0, no deductible $0, no deductible $0, no deductible $0, no deductible
Delivery
25% 20% 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
$4,500 $3,350 $5,000 $3,000
Family
$10,600 $8,375 $12,500 $6,000

1. Out-of-network expenses are covered at a different rate than in-network expenses. See the Summary Plan Description under the “Resources” tab for more information. 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. Must be a true emergency or you will pay 100% of the cost. See your Summary Plan Description (SPD) for more details.

5. Pre-certification is required for inpatient care.

6. With the HSA plan, if you have Family coverage, there is no individual deductible. The entire family deductible must be met before expenses are paid for any covered family member.

blank

What the Plans Cost

Cigna PPO Cigna DHMO
You
$14.00 $5.77
You + Spouse/Domestic Partner1
$32.00 $10.54
You + Child(ren)
$30.00 $10.80
You + Family
$51.00 $16.86

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