CareWay Tiered Provider Network

Finding the right doctor is about more than just a name on a list — it’s about balancing quality and costs.

That’s why Michaels is introducing the Blue Cross Blue Shield of Texas (BCBSTX) CareWay Tiered Network for those enrolled in the Basic PPO and Enhanced PPO medical plans. It takes the guesswork out of the process by vetting providers for you, looking at everything from medical expertise to efficiency, so you can focus on staying healthy.

How It Works

Providers are grouped into four tiers based on quality, results, and efficiency – as illustrated in the “CareWay Tiering Structure” table below.
Choosing Tier 1 providers means you’ll get high-quality care with lower copays and coinsurance.
Regardless of the tier your provider(s) are in, your out-of-pocket eligible expenses accumulate to your annual deductible and out-of-pocket maximums.
To compare benefit tiers and find out what you can save on copayments and coinsurance when choosing a Tier 1 provider, review the “What You Pay For Medical Care” table below.
You can use the “Search for Providers” link below to confirm whether your physician is in the CareWay network and what tier they fall under.

Search for Providers

CareWay Tiering Structure

Tier 1 (Pay Lower Copays & Coinsurance)	Tier 2	Tier 3
Physicians in this tier meet a predetermined upper score threshold for Qualify of Care, Medical Appropriateness, and Cost Efficiency, resulting in a lower in-network member cost share. (Tier 1 also includes unscored in-network PPO behavioral health providers.)	Physicians in this tier include professionals with average scores for the same measurements and unscored in-network PPO providers.	Physicians in this tier are comprised of the lower scored professionals for the same measurements.

Tier 1

(Pay Lower Copays & Coinsurance)

Tier 2

Tier 3

Physicians in this tier meet a predetermined upper score threshold for Qualify of Care, Medical Appropriateness, and Cost Efficiency, resulting in a lower in-network member cost share. (Tier 1 also includes unscored in-network PPO behavioral health providers.)

Physicians in this tier include professionals with average scores for the same measurements and unscored in-network PPO providers.

Physicians in this tier are comprised of the lower scored professionals for the same measurements.

What You Pay for Medical Care

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	Choice HSA	Basic PPO		Enhanced PPO		360 Protect Plan		Kaiser HRA (Calif. Only)
	In-Network	CareWay Tier 1 Provider	CareWay Tier 2 or 3 Provider	CareWay Tier 1 Provider	CareWay Tier 2 or 3 Provider	Select Tier 1 Provider	National Tier 2 or 3 Provider	In-Network
Plan Deductible
Team Member Only	$2,500	$3,000		$1,500		$1,000	$1,500	$1,500
Team Member + Spouse/Child(ren)	$5,000	$6,000		$3,000		$2,000	$3,000	$3,000
Team Member + Family	$5,000	$6,000		$3,000		$2,000	$3,000	$3,000
Out-of-Pocket Maximum
Team Member Only	$6,000	$6,000		$6,000		$4,500	$6,000	$3,000
Team Member + Spouse/Child(ren)	$12,000	$12,000		$12,000		$9,000	$12,000	$6,000
Team Member + Family	$14,500	$14,500		$14,500		$11,500	$14,500	$6,000
What You Pay for Medical Care
Coinsurance (Team Member Share)	20%	20%	40%	20%	40%	10%	20%	20%
Preventive Care	$0	$0	$0	$0	$0	$0	$0	$0
Primary Care Office Visit	20%*	$25 copay	$60 copay	$30 copay	$75 copay	$15 copay	$30 copay	$20 copay*
Specialist Office Visit	20%*	$50 copay	$120 copay	$50 copay	$125 copay	$30 copay	$50 copay	$20 copay*
Telehealth	$0	$0	$0	$0	$0	$0	$0	$0
Urgent Care	20%*	$75 copay	$75 copay	20%*	40%*	$50 copay		$20 copay*
Emergency Room	20%*	20%*	20%*	$250 copay + 20%*	$250 copay + 20%*	$250 copay + 10%*	$250 copay + 10%*	20%*
Retail Clinic	20%*	$25 copay	$60 copay	$30 copay	$75 copay	$15 copay	$30 copay	$20 copay*
Hospital Care & Mental Health	20%*	20%*	40%*	20%*	40%*	10%	20%	20%
Routine Prenatal Care	20%*	$25 (PCP) $50 (SPC)	$60 (PCP) $120 (SPC)	$30 (PCP) $50 (SPC)	$75 (PCP) $125 (SPC)	10%	20%	$0
Birth Delivery	20%*	20%*	40%	20%*	40%*	10%	20%	20%
Important: This table shows what you pay for services if you use incentive options and in-network providers. For full plan information, including cost information for out-of-network providers, please review the Summaries of Benefits and Coverage for each plan available in the Document Library. All maximums are indicated as plan year maximums. (*Indicates what you pay after the annual plan deductible is met.)

*Indicates what you pay after the annual plan deductible is met. Visit the Medical page for more information.

Search for In-Network Physicians & Specialists

It’s easy to find high quality, cost-efficient physicians that are in the BCBSTX CareWay network. Use Provider Finder to get started.

Search Now

Helpful Links

Plan Administrator

Blue Cross Blue Shield of Texas (BCBSTX)

Medical Insurance (PPO & HSA Plans)

Phone: 877-269-1180

Beginning July 1, 2026, Michaels is introducing the Blue Cross Blue Shield of Texas (BCBSTX) CareWay Tiered Network for those enrolled in the Basic PPO and Enhanced PPO medical plans. Use the toggle below to display information about this new program for 2026–2027 and visit the Open Enrollment page for guidance on enrolling in benefits beginning May 11, 2026.

This benefit is available at no cost to all full-time Team Members and dependents aged 18 and over enrolled in a Michaels BCBSTX or Imagine360 medical plan.

Cancer Screening, Care & Support

Color can help you prevent cancer, get care for it, and live your life after it. Two out of every five Americans will get cancer in their lifetime, and early detection can more than triple survival rates. Knowing your risk and following screening guidelines is the best way to catch cancer early.

With Color, this is simple and personalized, making it easier than ever to prioritize your health. Whether you’re focused on prevention, navigating a current diagnosis, managing your health after cancer treatment, or caring for a loved one with cancer, Color is here to help every step of the way.

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Expert Care & Cancer Screening Options

Color’s team of cancer experts (including doctors, genetic counselors, care advocates, cancer risk experts, and mental health experts) are here to support you in navigating your screening – with options for at-home screening and help scheduling in-person screenings on your behalf.

Color offers at-home screening kits for colorectal cancer, prostate cancer, cervical cancer, genetic testing, and skin cancer screenings.

Support for Whatever's Next

You can access your Color benefit any time. Color’s team of experts is available 7 days a week for questions, help scheduling or finding a provider. Color will remind you when you’re due for screening and keep you up to date, so you can focus on the rest of your life.

Get Started with Color

Create Your Color Account

First, visit color.com/michaels and create a Color account. You’ll answer a few questions and create an account using your email and password.

Complete Your Cancer Risk Assessment

After you create your account, you’ll be prompted to complete your cancer risk assessment, which takes around 5-10 minutes to complete. This includes questions about your health history, your lifestyle, and more to help Color understand your personalized cancer screening and care needs.

Video Overview

Get Started

Visit color.com/michaels

Provider

Color

Cancer Screenings

Phone: 844-352-6567

Beginning July 1, 2026, this benefit will be available at no cost to all full-time Team Members and dependents aged 18 and over enrolled in a Michaels BCBSTX or Imagine360 medical plan. Use the toggle below to display information about this new benefit for 2026–2027 and visit the Open Enrollment page for guidance on enrolling in benefits beginning May 11, 2026.

Starting July 1, non-urgent/non-emergent MRIs and CT scans must be scheduled through OneImaging to be covered under Michaels BCBSTX medical plans. If you don’t coordinate your imaging through OneImaging, your medical plan will not cover the services.

OneImaging Services

OneImaging makes it easy and convenient to get medical imaging — like MRIs, CT scans, X-rays, ultrasounds, and mammograms — without the long wait times and high costs often found elsewhere.

Available May 1, 2026

While contacting OneImaging will soon be required for non-urgent MRI and CT scans, this benefit is available* starting May 1, 2026, for all your imaging needs.

With OneImaging, you get:

Clear pricing and savings of 60% to 80% on imaging services
Access to a nationwide network of accredited facilities
Easy scheduling online or with help from OneImaging’s support team
Hands-on support for your imaging needs and answers to your questions

*Must be enrolled in a BCBSTX Michaels medical plan. If you don’t coordinate your imaging through OneImaging, your medical plan will not cover the services.

OneImaging is your exclusive network provider for non-urgent MRIs and CT scans.

Get Started with OneImaging

Provider

OneImaging

Medical Imaging Services

Phone: 833-619-0837 (Call or Text)

Email: help@oneimaging.com

Visit Website

You must be enrolled in a Michaels BCBSTX or Imagine360 medical plan to use OneImaging services. Non-urgent/non-emergent MRIs and CT scans must be scheduled through OneImaging to be covered under your Michaels BCBSTX or Imagine360 medical plan. If you don’t coordinate your imaging through OneImaging, your medical plan will not cover the services.

OneImaging Services

OneImaging makes it easy and convenient to get medical imaging — like MRIs, CT scans, X-rays, ultrasounds, and mammograms — without the long wait times and high costs often found elsewhere.

With OneImaging, you get:

Savings of up to 60%-80% on imaging services
Access to a nationwide network of accredited facilities
Easy scheduling online or with help from OneImaging’s support team
Hands-on support for your imaging needs and answers to your questions

To learn more about OneImaging’s clear pricing and payment support, review the member overview and FAQs linked below.

OneImaging is your exclusive network provider for non-urgent MRIs and CT scans.

Get Started with OneImaging

Provider

OneImaging

Medical Imaging Services

Phone: 833-619-0837 (Call or Text)

Email: help@oneimaging.com

Visit Website

Select your medical plan provider below to access your pharmacy benefit information.

Prescription Drug Coverage for BCBSTX Plan Members

Pharmacy Plan Information

If you are enrolled in a Michaels BCBSTX medical plan, your pharmacy benefit is administered by Prime Therapeutics.

You and your covered family members have access to $0 preventative maintenance medications – with no deductibles – when prescriptions are filled from the preventive drug list: HSA Preventive List | PPO Preventive Drug List.
Prime Therapeutics uses a drug formulary, which is a list of preferred medications available at a lower cost to you. Learn more by visiting MyPrime.com.
When your doctor prescribes medication, you’re encouraged to confirm it’s on the formulary list. If not, ask your doctor if a comparable medication on the formulary will work for you.
Depending on the medical plan, you may also use your pretax account funds, like a Health Savings Account or Healthcare Spending Account, to help pay for your prescription expenses.

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Maintenance Medications

Maintenance medications are prescriptions that you need on a regular basis for an ongoing condition, such as high blood pressure. Maintenance medications on the preventive drug list are available for $0 copay with no deductible.

When starting a maintenance medication, ask your doctor to write the prescription for a 90-day supply instead of a 30-day supply.

You may fill an initial 30-day supply of a maintenance medications at a retail pharmacy. After that, ongoing prescriptions must be filled as a 90-day supply at a 90-day retail pharmacy or through home delivery:

90-day Retail Pharmacy: Over 55,000 participating pharmacies which include CVS, Wal-Mart, Kroger, etc. Check out MyPrime Pharmacies to find a location near you.
Home Delivery: It can take up to two weeks for you to receive your medication using this method. If you need medication immediately, ask your doctor for a 30-day prescription at a local pharmacy.
- Medications may take up to 5 business days or more to deliver after order verification.
- Your doctor may be able to upload your prescription directly to the prescription drug provider. Otherwise, you must complete a Home Delivery Service Form in the BCBSTX member portal and send in your written prescription.

Specialty Drugs

Specialty drugs are prescribed to treat complex and/or chronic conditions, such as multiple sclerosis, cancer, hepatitis C and rheumatoid arthritis. These drugs often have special handling or storage needs and may only be filled at select pharmacies. It is also vital to closely follow the drug care plan from your health care provider or pharmacist.

Michaels offers Advocate+ Pharmacy Match for all specialty medications. This new program aims to make your health care journey easier. This specialty drug program matches you to the best-fit pharmacy to fill your specialty drug prescription. A dedicated customer service team will be by your side throughout your care plan.

Your Advocate+ Pharmacy Match Care Specialist will make sure you get the care you need by:

Connecting you with the pharmacy that will be filling your specialty drug(s).
Offering one-on-one support for a smooth process with the first prescription fill and beyond. Answering any questions and providing resources to help pay for your drug(s).
Assisting with prior authorization submissions, if needed.

Get Started

To speak to an Advocate+ Pharmacy Match Care Specialist, call 833-950-3858, Monday through Friday, 8 a.m. to 10 p.m. ET.

Split-Fill Program for Select Specialty Drugs

If you receive a new prescription for certain specialty drugs, you may try a smaller quantity of the drug before the full supply is filled. This may help cut down on waste of unused medications by making sure the newly prescribed medication works for you.

Drug Lists

Preventative Drug List

Other Drug Lists

Performance Select Biosimilar Drug List Formulary (includes Dispensing Limits, Prior Authorization Programs, and Step Therapy Programs)
Contraceptive List (ACA)
Drug List (ACA)
Specialty Drug List

Helpful Resources

Prescription Drug Coverage for Imagine360 Plan Members

Pharmacy Plan Information

If you are enrolled in a Michaels Imagine360 medical plan, your pharmacy benefit is administered by Prime Therapeutics.

You and your covered family members have access to $0 preventative maintenance medications – with no deductibles – when prescriptions are filled from the preventive drug list.
Prime Therapeutics uses a drug formulary, which is a list of preferred medications available at a lower cost to you. Learn more by visiting MyPrime.com.
When your doctor prescribes medication, you’re encouraged to confirm it’s on the formulary list. If not, ask your doctor if a comparable medication on the formulary will work for you.
Depending on the medical plan, you may also use your pretax account funds, like a Health Savings Account or Healthcare Spending Account, to help pay for your prescription expenses.

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Maintenance Medications

When starting a maintenance medication, ask your doctor to write the prescription for a 90-day supply instead of a 30-day supply.

90-day Retail Pharmacy: Over 55,000 participating pharmacies which include CVS, Wal-Mart, Kroger, etc. Check out MyPrime Pharmacies to find a location near you.
Home Delivery: It can take up to two weeks for you to receive your medication using this method. If you need medication immediately, ask your doctor for a 30-day prescription at a local pharmacy.
- Medications may take up to 5 business days or more to deliver after order verification.
- Your doctor may be able to upload your prescription directly to the prescription drug provider. Otherwise, you must complete a Home Delivery Service Form in the forms section of your MyPrime.com account and send in your written prescription.

Specialty Drugs

Michaels offers Advocate+ Pharmacy Match for all specialty medications. This new program aims to make your health care journey easier. This specialty drug program matches you to the best-fit pharmacy to fill your specialty drug prescription. A dedicated customer service team will be by your side throughout your care plan.

Your Advocate+ Pharmacy Match Care Specialist will make sure you get the care you need by:

Connecting you with the pharmacy that will be filling your specialty drug(s).
Offering one-on-one support for a smooth process with the first prescription fill and beyond. Answering any questions and providing resources to help pay for your drug(s).
Assisting with prior authorization submissions, if needed.

Get Started

To speak to an Advocate+ Pharmacy Match Care Specialist, call 833-950-3858, Monday through Friday, 8 a.m. to 10 p.m. ET.

Split-Fill Program for Select Specialty Drugs

Drug Lists

Performance Select Biosimilar Drug List Formulary (includes Dispensing Limits, Prior Authorization Programs, and Step Therapy Programs)
Preventive Drug Benefit Program Employee Guide
ACA Preventive Drug List
Specialty Drug List

Prescription Drug Coverage for Kaiser Plan Members

If you’re enrolled in the Michaels Kaiser HRA plan, you must fill your prescriptions at a Kaiser-associated pharmacy in order for them to be covered. You can use your HRA to pay for prescription drugs.

Search for Kaiser Pharmacies

Medical

Michaels offers several medical plan options, all with prescription drug coverage. Here you’ll find information about how each plan works, what costs to expect, and the resources available to you once you’ve enrolled.

Medical Insurance Plan Options

Already enrolled in a medical plan? Go to Member Resources & Programs.

Choice HSA

You pay the plan rate for doctor visits, services, and prescriptions until your annual deductible is met.

You can choose any provider, but you’ll save money when you use providers in the BCBSTX network.

Summary of Benefits and Coverage (SBC)

Provider Search

Basic PPO

You pay a flat fee for doctor visits, services, and prescriptions. These expenses count toward your annual deductible.

You can choose any provider, but you’ll save money when you use providers identified in Tier 1 of the CareWay network.

Summary of Benefits and Coverage (SBC)

Provider Search

Enhanced PPO

You pay a flat fee for doctor visits, services, and prescriptions. These expenses count toward your annual deductible.

You can choose any provider, but you’ll save money when you use providers identified in Tier 1 of the CareWay network.

Summary of Benefits and Coverage (SBC)

Provider Search

360 Protect Plan

You pay a flat fee for doctor visits, services, and prescriptions, often at lower prices than a typical PPO. These expenses will count toward your annual deductible.

You can choose any provider, but you’ll save money when you use select or national select or national Imagine360 providers.

Summary of Benefits and Coverage (SBC):
Select | National

Provider Search

Kaiser HRA

California Only

Team Members in California may choose to enroll in the Kaiser HRA plan, which functions similarly to a PPO plan.

You must use a provider in the Kaiser network in order for the plan to pay benefits.

Summary of Benefits and Coverage (SBC):
North | South

Provider Search

Understanding How the Plans Work

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PPO vs. HDHP Plans

If you are deciding between a Preferred Provider Organization (PPO) plan, or our Choice HSA High-Deductible Health Plan (HDHP), it’s important that you understand the basic components of each plan type. Use this comparison chart to help you identify which plan type may be best for you and your family.

Which plan may be right for me?

PPO if: You prefer predictable, fixed costs at the doctor’s office and want individual deductibles for your family because a member needs more care.
Choice HSA if: You generally only visit the doctor for annual check-ups and want to build long-term savings for healthcare.

	Basic PPO, Enhanced PPO, and 360 Protect Plan	BCBSTX Choice HSA (HDHP)
Premiums	Variable Premiums: There are four PPO plans available to choose from. The Basic PPO plan offers the lowest per-paycheck cost of all plans.	Moderate Premiums: Higher per-paycheck cost than the Basic PPO. Offers long-term savings opportunity with a health savings account (HSA).
Copays	Predictable Fees with Copays You pay flat fees for doctor visits and prescriptions from day one, without having to first meet a deductible.	No Copays: You pay for services and prescriptions until your deductible is met; then the plan will pay a portion of the cost.
Deductibles	Individual-Focused: Once one person on the plan meets their deductible, the plan coinsurance starts paying for that person. Best for those with chronic conditions or frequent specialist visits.	Family-Focused: The entire family deductible must be met before the plan coinsurance begins sharing costs. Best for those who mainly need preventive care and are generally healthy.
Coinsurance	Ongoing Care: Once deductibles are met, the plan (Michaels) pays a portion of the cost for services.	Ongoing Care: Once deductibles are met, the plan pays a portion of the cost for services.
Out-of-Pocket Maximum	Total Protection: Once you hit your annual limit, the plan pays 100% of all eligible medical costs. Vary by PPO plan.	Total Protection: Once you hit this limit, the plan pays 100% of all eligible medical costs.
Pre-Tax Accounts	Healthcare FSA: Use-it-or-lose-it" account. Best for predictable, annual medical expenses. You contribute pre-tax dollars from your paycheck, Michaels does not.	HSA: Yours to keep. Michaels contributes funds and you can contribute pre-tax dollars from your paycheck to pay for eligible expenses, and the balance rolls over every year.

	Basic PPO, Enhanced PPO y 360 Protect Plan	BCBSTX Choice HSA (HDHP)
Primas	Primas variables: Hay cuatro planes PPO disponibles para elegir. El plan PPO básico ofrece el costo por nómina más bajo de todos los planes.	Primas moderadas: Costo por nómina más alto que el PPO básico. Ofrece la oportunidad de ahorrar a largo plazo con una cuenta de ahorros para la salud (HSA).
Copagos	Predictable Fees with Copays You pay flat fees for doctor visits and prescriptions from day one, without having to first meet a deductible.	Tarifas predecibles con copagos Usted paga tarifas fijas por las visitas al médico y las recetas desde el primer día, sin tener que cumplir primero con un deducible.
Deducible	Enfoque individual: Una vez que una persona en el plan alcanza su deducible, el coseguro del plan comienza a cubrir los gastos de esa persona. Ideal para quienes padecen enfermedades crónicas o realizan visitas frecuentes a especialistas.	Enfoque familiar: Se debe cubrir el deducible familiar completo antes de que el plan de coseguro comience a compartir los costos. Ideal para quienes necesitan principalmente atención preventiva y gozan de buena salud en general.
Coaseguro	Atención continua: Una vez que se alcanzan los deducibles, el plan (Michaels) paga una parte del costo de los servicios.	Atención continua: Una vez que se alcanzan los deducibles, el plan del país cubre una parte del costo de los servicios.
Gasto máximo de bolsillo	Protección total: Una vez que alcance su límite anual, el plan del país cubrirá el 100% de todos los gastos médicos elegibles. Varía según el plan PPO.	Protección total: Una vez que alcance este límite, el plan del país cubrirá el 100% de todos los gastos médicos elegibles.
Cuentas antes de impuestos	Cuenta de Gastos Médicos Flexibles (FSA): Cuenta de "úsala o piérdela". Ideal para gastos médicos anuales predecibles. Usted aporta dinero antes de impuestos de su nómina; Michaels no.	HSA: Es tuya para siempre. Michaels aporta fondos y tú puedes aportar dinero antes de impuestos de tu nómina para pagar gastos elegibles, y el saldo se acumula cada año.

Deductibles & Coinsurance

Coinsurance and deductibles function differently depending on the plan you choose.

PPO & HRA Plans: If you enroll yourself and at least one (1) dependent, once you or one of your dependents meet the deductible, coinsurance applies for that member. Any additional family members must meet their own deductible before coinsurance applies, or until the family deductible is met, then coinsurance applies to all.

HSA Plan: If you enroll yourself and at least one (1) dependent, there is no individual deductible. The total family deductible must be met before coinsurance applies for any family member.

Michaels Contributions to HRA & HSA Plans

To help you pay for eligible health care expenses, Michaels contributes to either a Health Savings Account (HSA) if you enroll in the Choice HSA plan, or a Health Reimbursement Account (HRA) if you enroll in the Kaiser HRA plan.

The two types of accounts work differently. Follow the links for a closer look at each account to help you choose.

For additional ways to contribute pretax dollars to pay for eligible healthcare expenses, visit our Spend & Save page.

Medicare Eligibility

Are you turning 65 and eligible for Medicare? Contact Medicare Transition Services for information and assistance.

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Plan Costs & Coverage

What You'll Pay

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	Choice HSA	Basic PPO		Enhanced PPO		360 Protect Plan		Kaiser HRA (Calif. Only)
	In-Network	CareWay Tier 1 Provider	CareWay Tier 2 or 3 Provider	CareWay Tier 1 Provider	CareWay Tier 2 or 3 Provider	Select Tier 1 Provider	National Tier 2 or 3 Provider	In-Network
Plan Deductible
Team Member Only	$2,500	$3,000		$1,500		$1,000	$1,500	$1,500
Team Member + Spouse/Child(ren)	$5,000	$6,000		$3,000		$2,000	$3,000	$3,000
Team Member + Family	$5,000	$6,000		$3,000		$2,000	$3,000	$3,000
Out-of-Pocket Maximum
Team Member Only	$6,000	$6,000		$6,000		$4,500	$6,000	$3,000
Team Member + Spouse/Child(ren)	$12,000	$12,000		$12,000		$9,000	$12,000	$6,000
Team Member + Family	$14,500	$14,500		$14,500		$11,500	$14,500	$6,000
What You Pay for Medical Care
Coinsurance (Team Member Share)	20%	20%	40%	20%	40%	10%	20%	20%
Preventive Care	$0	$0	$0	$0	$0	$0	$0	$0
Primary Care Office Visit	20%*	$25 copay	$60 copay	$30 copay	$75 copay	$15 copay	$30 copay	$20 copay*
Specialist Office Visit	20%*	$50 copay	$120 copay	$50 copay	$125 copay	$30 copay	$50 copay	$20 copay*
Telehealth	$0	$0	$0	$0	$0	$0	$0	$0
Urgent Care	20%*	$75 copay	$75 copay	20%*	40%*	$50 copay		$20 copay*
Emergency Room	20%*	20%*	20%*	$250 copay + 20%*	$250 copay + 20%*	$250 copay + 10%*	$250 copay + 10%*	20%*
Retail Clinic	20%*	$25 copay	$60 copay	$30 copay	$75 copay	$15 copay	$30 copay	$20 copay*
Hospital Care & Mental Health	20%*	20%*	40%*	20%*	40%*	10%	20%	20%
Routine Prenatal Care	20%*	$25 (PCP) $50 (SPC)	$60 (PCP) $120 (SPC)	$30 (PCP) $50 (SPC)	$75 (PCP) $125 (SPC)	10%	20%	$0
Birth Delivery	20%*	20%*	40%	20%*	40%*	10%	20%	20%
Important: This table shows what you pay for services if you use incentive options and in-network providers. For full plan information, including cost information for out-of-network providers, please review the Summaries of Benefits and Coverage for each plan available in the Document Library. All maximums are indicated as plan year maximums. (*Indicates what you pay after the annual plan deductible is met.)

	Choice HSA	Basic PPO		Enhanced PPO		360 Protect Plan		Kaiser HRA (Solo en Calif.)
	Dentro de la red	CareWay Proveedor de nivel 1	CareWay Proveedor de nivel 2 o 3	CareWay Proveedor de nivel 1	CareWay Proveedor de nivel 2 o 3	Seleccionar Proveedor de nivel 1	Nacional Proveedor de nivel 2 o 3	Dentro de la red
Plan de deducible
Solo para miembros del equipo	$2,500	$3,000		$1,500		$1,000	$1,500	$1,500
Miembro del equipo + Cónyuge/Hijo(s)	$5,000	$6,000		$3,000		$2,000	$3,000	$3,000
Miembro del equipo + Familia	$5,000	$6,000		$3,000		$2,000	$3,000	$3,000
Gasto máximo de bolsillo
Solo para miembros del equipo	$6,000	$6,000		$6,000		$4,500	$6,000	$3,000
Miembro del equipo + Cónyuge/Hijo(s)	$12,000	$12,000		$12,000		$9,000	$12,000	$6,000
Miembro del equipo + Familia	$14,500	$14,500		$14,500		$11,500	$14,500	$6,000
Lo que pagas por la atención médica
Coaseguro (Participación del miembro del equipo)	20%	20%	40%	20%	40%	10%	20%	20%
Atención preventiva	$0	$0	$0	$0	$0	$0	$0	$0
Visita al consultorio de atención primaria	20%*	Copago de $25	Copago de $60	Copago de $30	Copago de $75	Copago de $15	Copago de $30	Copago de $20*
Visita al consultorio del especialista	20%*	Copago de $50	Copago de $120	Copago de $50	Copago de $125	Copago de $30	Copago de $50	Copago de $20*
Telesalud	$0	$0	$0	$0	$0	$0	$0	$0
Atención de urgencias	20%*	Copago de $75	Copago de $75	20%*	40%*	Copago de $50		Copago de $20*
Sala de emergencia	20%*	20%*	20%*	Copago de $250 + 20%*	Copago de $250 + 20%*	Copago de $250 + 10%*	$250 copay + 10%*	20%*
Clínica minorista	20%*	Copago de $25	Copago de $60	Copago de $30	Copago de $75	Copago de $15	$30 copay	Copago de $20*
Atención hospitalaria y salud mental	20%*	20%*	40%*	20%*	40%*	10%	20%	20%
Rutina de atención prenatal	20%*	$25 (PCP) $50 (SPC)	$60 (PCP) $120 (SPC)	$30 (PCP) $50 (SPC)	$75 (PCP) $125 (SPC)	10%	20%	$0
Parto	20%*	20%*	40%	20%*	40%*	10%	20%	20%
Importante: Esta tabla muestra lo que pagará por los servicios si utiliza opciones de incentivos y proveedores dentro de la red. Para obtener información completa sobre el plan, incluyendo información sobre costos para proveedores fuera de la red, consulte los Resúmenes de Beneficios y Cobertura de cada plan disponibles en la Biblioteca de Documentos. Todos los máximos se indican como máximos anuales del plan. (*Indica lo que pagará después de alcanzar el deducible anual del plan).

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Tap or click the content below and scroll to access all the information.

	Choice HSA	Basic PPO	Enhanced PPO	360 Protect Plan	Kaiser HRA (California Only)
Team Member Only	$72.11	$52.14	$138.10	$110.48	$89.15
Team Member + Spouse¹	$193.45	$140.63	$347.16	$277.73	$213.24
Team Member + Child(ren)	$142.45	$94.81	$264.68	$211.74	$168.58
Team Member + Family	$239.17	$164.32	$421.97	$337.58	$251.38
¹By law, if a domestic partner does not qualify as a tax dependent, the cost for their benefits cannot be paid pre-tax, and the “value” of Team Member and employer-provided domestic partner contributions is taxable.

	Choice HSA	Basic PPO	Enhanced PPO	360 Protect Plan	Kaiser HRA (Solo en California)
Solo para miembros del equipo	$72.11	$52.14	$138.10	$110.48	$89.15
Miembro del equipo + Cónyuge¹	$193.45	$140.63	$347.16	$277.73	$213.24
Miembro del equipo + Hijo(s)	$142.45	$94.81	$264.68	$211.74	$168.58
Miembro del equipo + Familia	$239.17	$164.32	$421.97	$337.58	$251.38
¹Por ley, si una pareja de hecho no califica como dependiente fiscal, el costo de sus beneficios no puede pagarse antes de impuestos, y el «valor» de las contribuciones realizadas por el Miembro del Equipo y por el empleador para la pareja de hecho está sujeto a impuestos.

For more pharmacy information and resources included in each medical plan, visit the Pharmacy Benefits page.

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Tap or click the content below and scroll to access all the information.

	Choice HSA	Basic PPO	Enhanced PPO	360 Protect Plan	Kaiser HRA (California Only)
Preventative Drugs¹
Retail & Mail Order	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay
Retail²
Generic	20%*	$14 copay	$10 copay	$10 copay	$10 copay
Preferred Brand	20%*	25% of cost ($50 min; $130 max)	$35 copay	$35 copay	$30 copay
Non-Preferred Brand*	50%* ($100 min; $250 max)	50%* ($100 min; $250 max)	50%* ($100 min; $250 max)	50%* ($100 min; $250 max)	$30 copay
Maintenance/Home Delivery³
Generic	20%*	$35 copay	$20 copay	$20 copay	$20 copay
Preferred Brand	20%*	$125 copay	$70 copay	$70 copay	$60 copay
Non-Preferred Brand*	50%* ($100 min; $250 max)	50%* ($100 min; $250 max)	50%* ($100 min; $250 max)	50%* ($100 min; $250 max)	$60 copay
Specialty Pharmacy⁴
Generic	20%* ($200 max)	$14 copay	$10 copay	$10 copay	$30 copay
Preferred Brand	20%* ($250 max)	25% cost ($50 min; $130 max)	$35 copay	$35 copay	Not Covered
Non-Preferred Brand*	20%* ($350 max)	50% of cost ($350 max)	50% of cost ($350 max)	50% of cost ($350 max)	Not Covered
Out-of-Pocket Maximum⁵
Individual	Included in medical out-of-pocket max	$2,050	Included in medical out-of-pocket max	Included in medical out-of-pocket max	Included in medical out-of-pocket max
Family	Included in medical out-of-pocket max	$4,100	Included in medical out-of-pocket max	Included in medical out-of-pocket max	Included in medical out-of-pocket max
¹For BCBSTX and Imagine360 plans: Up to 30-day supply for retail, and up to a 90-day supply for CVS mail order. For Kaiser plan: applies only to medications on ACA list. ²Up to a 30-day supply. ³For BCBSTX and Imagine360 plans: up to a 90-day supply through CVS. For Kaiser plan: up to a 100-day supply. ⁴Up to a 30-day supply. Costs apply toward out-of-pocket maximum. ⁵The out-of-pocket maximum is the most you'll pay before the plan covers 100% of the remaining eligible prescription drug costs for the remainder of the plan year. (*Indicates what you pay after the annual plan deductible is met.)

	Choice HSA	Basic PPO	Enhanced PPO	360 Protect Plan	Kaiser HRA (Solo en California)
Medicamentos preventivos¹
Venta minorista y por correo	Copago de $0	Copago de $0	Copago de $0	Copago de $0	Copago de $0
Comercio minorista²
Genérico/a	20%*	Copago de $14	Copago de $10	Copago de $10	Copago de $10
Marca preferida	20%*	25% del costo ($50 mín.; $130 máx.)	Copago de $35	Copago de $35	Copago de $30
Marca no preferida*	50%* ($100 min; $250 max)	50%* (mínimo $100; máximo $250)	50%* (mínimo $100; máximo $250)	50%* (mínimo $100; máximo $250)	Copago de $30
Mantenimiento / Entrega a domicilio³
Genérico/a	20%*	Copago de $$35	Copago de $20	Copago de $20	Copago de $20
Marca preferida	20%*	Copago de $$125	Copago de $70	Copago de $70	Copago de $60
Marca no preferida*	50%* (mínimo $100; máximo $250)	50%* (mínimo $100; máximo $250)	50%* (mínimo $100; máximo $250)	50%* (mínimo $100; máximo $250)	Copago de $60
Farmacia especializada⁴
Genérico/a	20%* (máximo $200)	Copago de $14	Copago de $10	Copago de $10	Copago de $30
Marca preferida	20%* (máximo $200)	25% del costo (mín. $50; máx. $130)	Copago de $35	Copago de $35	No cubierto
Marca no preferida*	20%* (máximo $200)	50% del costo (máx. $350)	50% del costo (máx. $350)	50% del costo (máx. $350)	No cubierto
Gasto máximo de bolsillo⁵
Individual	Incluido en el tope de gastos médicos de bolsillo	$2,050	Incluido en el tope de gastos médicos de bolsillo	Incluido en el tope de gastos médicos de bolsillo	Incluido en el tope de gastos médicos de bolsillo
Familia	Incluido en el tope de gastos médicos de bolsillo	$4,100	Incluido en el tope de gastos médicos de bolsillo	Incluido en el tope de gastos médicos de bolsillo	Incluido en el tope de gastos médicos de bolsillo
¹Para los planes de BCBSTX e Imagine360: hasta un suministro para 30 días en farmacias minoristas, y hasta un suministro para 90 días mediante el servicio de pedidos por correo de CVS. Para el plan de Kaiser: se aplica únicamente a los medicamentos incluidos en la lista de la ACA. ²Hasta un suministro para 30 días. ³Para los planes de BCBSTX e Imagine360: hasta un suministro para 90 días a través de CVS. Para el plan de Kaiser: hasta un suministro para 100 días. ⁴Hasta un suministro para 30 días. Los costos se aplican al máximo de desembolso personal. ⁵El máximo de desembolso personal es la cantidad máxima que usted pagará antes de que el plan cubra el 100% de los costos elegibles restantes de medicamentos recetados durante el resto del año del plan. (*Indica lo que usted paga una vez que se ha cumplido el deducible anual del plan.)

PPO CareWay Network

To access more detailed benefits documentation, including plan summaries and required legal notices, head over to the Document Library.

Not sure which medical plan is right for you? The eValuate tool can help you choose the medical coverage that's best suited for you and your family.

Why use eValuate?

eValuate is a free resource to help full-time Team Members choose the best medical plan for their needs.

Let the eValuate Health Plan Selector help you decide which medical plan makes the most financial sense for you and your family. Just answer a few questions and eValuate will calculate the tax savings you can expect on premiums and Health Care FSA contributions for each medical plan. Then you’ll get a summary highlighting which option works best for you.

eValuate doesn’t store any of your personal information, or share it with Michaels or anyone else – it’s totally private and confidential.

You can access and utilize eValuate 24/7 from any smartphone, tablet, or computer.

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Member Resources & Programs

Select your medical plan administrator below for access to the member resources available to you all year long.

Resources for BCBSTX Plan Members

Your BCBSTX medical plan includes access to a wide variety of medical resources and programs available to you at no additional cost – use the links below to learn more.

Blue Cross Blue Shield Select Networks

Michaels partners with BCBSTX for our high-quality medical plans and broad network of providers to choose from. Effective July 1, 2025, BCBSTX and Michaels will implement new networks in the locations listed below. The same Michaels benefit plans will continue to be offered across all networks.

Depending on your location, you’ll have access to either the BCBS Select Network or the BCBS BlueCard PPO Network. Team Members located in the below locations can go to the specific websites to search for your provider. While some providers may no longer be considered in network, a majority of Team Members should not experience disruption in their healthcare services. For Team Members located outside of the locations below you will continue to access the Michaels BCBSTX website to search for your provider.

BCBSTX Select Network Provider Finder Links:

California – Tandem PPO

Colorado – Pathway

Florida – Network Blue

Georgia – Blue Open Access POS

Illinois – Blue Choice PPO (BCS)

Minnesota – High Value Network

Kansas City, Missouri – Preferred Care

St. Louis, Missouri – Blue Access Choice

New Jersey – Horizon Managed Care Network

Wisconsin – Blue Preferred POS

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Group Numbers for BCBSTX Medical Plans

Enhanced Plan: 363243
Basic Plan: 363244
Choice Plan: 363245

Community Resource Directory

BCBSTX members have access to an online directory with information regarding community resources (i.e. financial assistance, food pantries, medical care, and other free or reduced-cost help) in all states, not just Texas.

Find Services Near You

Helpful Links for BCBSTX Members

Member Welcome: English | Spanish

Blue Access for Members: We’re With You Wherever You Go | Your Health at Your Fingertips

Services: Preventative Services | Virtual Visits | Breast Cancer Screenings

Flu Season Resources: English | Spanish

Travel Coverage with Global Core

Like your passport, always carry your Blue Cross and Blue Shield of Texas (BCBSTX) ID card with you when you travel or live abroad.

Through the Blue Cross and Blue Shield Global Core program, you have access to doctors, hospitals and other health services in nearly 200 countries and territories around the world.

Provider

Blue Cross Blue Shield of Texas (BCBSTX)

Medical Insurance (PPO & HSA Plans)

Phone: 877-269-1180

Resources for Imagine360 Plan Members

Your Imagine360 medical plan includes access to a wide variety of medical resources and programs available to you at no additional cost – use the links below to learn more.

Search for Doctors & Specialists

After opening the link below, enter the provider search code, RJENV, and your zip code to locate providers in the Imagine360 network.

Provider Search

Your Michaels 360 Protect Plan group number is V100013.

Plan Administrator

Imagine360

Medical Insurance (360 Protect Plan)

Phone: 844-403-2348

When searching for a provider online, use code RJENV.

Resources for Kaiser Plan Members

Below are links to helpful resources and programs available to you as part of your Kaiser medical plan.

Kaiser Open Enrollment Self-Guide

Plan Administrator

Kaiser Permanente

Medical Insurance (HRA Plan)

Phone: 800-464-4000 (TTY 711)

Visit Website

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Select your medical plan provider below to access your surgical care coverage information.

Specialty Surgical Care for BCBSTX Plan Members

For planned, non-emergency surgeries, Lantern (formerly SurgeryPlus) provides a personalized concierge experience through a dedicated Care Advocate as well as access to quality care through a network of credentialed health care providers. By using the program, you may be able to save money through reduced financial responsibility.

When you need to plan a surgery, make Lantern your first call: 855-200-2099.

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Eligibility

Lantern Surgical Care Coverage is a supplemental benefit offered at no additional cost to Michaels Team Members enrolled in a BCBSTX medical plan.

What's Covered

Lantern covers the most expensive costs associated with surgery, so you’ll pay less for your procedure. Your coverage includes:

Dedicated support and guidance
Access to our network of thousands of highly qualified and carefully selected surgeons
Consults and appointments with your Lantern surgeon
Anesthesia, procedure and facility (hospital) fees

Covered Surgical Procedures

Knee
Hip
Shoulder
Foot & Ankle
Wrist & Elbow
Spine
General Surgery
Gastroenterology
GYN
Bariatric
Cardiac
ENT

Coinsurance & Travel Coverage

Michaels waives your coinsurance for your surgical procedure and travel is covered for you and a companion, as needed.

For more information, including a complete list of available surgeries offered under the Lantern benefit, log in to the Lantern portal or call 855-200-2099 to speak with a Care Advocate.

Surgeon Quality

With Lantern, you have access to the Surgeons of Excellence Network. All Lantern surgeons are:

Licensed
Board certified
Saving money on healthcare
Screened for malpractice, sanctions, and criminal records
Fellowship trained

Full-Service Concierge

Lantern provides access to a dedicated Care Advocate throughout your health care journey. This full-service concierge will help you:

Locate the best-fitting Surgeon of Excellence
Schedule timely appointments
Coordinate transfer medical records
Schedule follow-up as necessary

Call 855-200-2099 to speak with a Care Advocate today.

Transparency in Coverage Information

If you would like would like to see pricing information for covered items and services for Lantern network provider rates, follow this link: Provider Pricing Transparency. This link is being provided to you as a fulfillment of our requirement to you to provide transparent pricing information, effective July 1, 2022.

Get Started

To learn more about what’s covered under your Lantern benefit, log in to the Lantern portal.

Member Portal Login

Contact Your Provider

Lantern

Surgical Care

(Formerly SurgeryPlus)

Phone: 855-200-2099

Specialty Surgical Care for Imagine360 Plan Members

For planned surgeries and specialty care, you and your covered family members (ages 18+) have access to Carrum Health as part of your Imagine360 medical plan. While Imagine360 manages your day-to-day healthcare and network, Carrum Health connects you with top-tier specialists and dedicated support for specific, eligible procedures.

When you use Carrum Health, you’ll receive:

Better Health Outcomes: Care designed to help you recover, feel better, and get back  to everyday life.
Top-Quality Care: Care from top-rated doctors, experts, and trusted facilities across the country.
Dedicate Care Support: A care specialist guides you through planning and paperwork, so you can focus on your health.

Carrum Health Surgical Care Coverage is a supplemental benefit offered at no additional cost to Michaels Team Members enrolled in the Imagine360 medical plan.

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What Carrum Health Can Help With

Hip, knee, and shoulder
Neck and back care
Heart surgery
Hysterectomy
Cancer care
Addiction treatment
Weight loss surgery
And more

World-Class Care

We work with the top 10% of surgeons and specialists nationwide. With advanced training and a commitment to the latest medical research, they focus on providing only the care you truly need to recover.

Support Every Step of the Way

If you are referred by Imagine360 for an eligible procedure, a dedicated Carrum care specialist will guide you through each step of your specialty care journey—from planning and preparation to paperwork and recovery.

Your Carrum care specialist can help you:

Understand your benefit and what’s covered
Explore top-quality surgeons, cancer, GI, and addiction specialists
Coordinate medical records and appointments
Prepare for care and recovery

Standard member cost-sharing applies under your health plan. Per IRS rules, a portion of any covered travel expenses will be reported as taxable income to the covered member.

Get Started

Contact Your Provider

Carrum Health

Surgical Care

Phone: 888-855-7806

This benefit is not available for Kaiser medical plan members.

This page provides information about choosing and managing your FSA, identifying eligible expenses, and how to file claims for reimbursement. More FSA resources can be accessed at HealthEquity.com.

What Is an FSA?

A flexible spending account (FSA), administered by HealthEquity, allows you to set aside tax-free money to help pay for eligible out-of-pocket expenses.

There are three types of FSAs that you can choose from: Health Care FSA, Limited Purpose FSA, and Dependent Care FSA.
Your FSA paycheck deductions are tax-free, which may help reduce your taxable income.
If you enroll in a Health Care or Limited Purpose FSA, you will receive a debit card from HealthEquity to use when paying for eligible expenses.

FSA-Eligible Expenses

To help you determine what you can pay for with your FSA, you can search a list of eligible expenses and use the store locator to find merchants that offer FSA-eligible items.

Health Care FSA (HCFSA) List of Eligible Expenses available when enrolled in a Basic PPO, Enhanced PPO, 360 Protect Plan, Kaiser, or not enrolled in a medical plan.
Limited Purpose FSA (LPFSA) List of Eligible Expenses available when enrolled in Choice HSA plan.
Dependent Care FSA (DCFSA) List of Eligible Expenses no requirement to be enrolled in a medical plan.

Contact Your Provider

HealthEquity

FSA & HSA

HSA: 866-346-5800
FSA: 877-924-3967

Types of FSAs: Comparing Your Options

Use the information below to help you decide which type of FSA is right for you. Health Equity also offers guides for Comparing FSA Options and Things to Know About the FSA.

Note: If you are enrolled in an HSA medical plan, you may also enroll in a Limited Purpose FSA (LPFSA) for eligible dental and vision expenses.

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Health Care FSA

Your Title Goes Here

How it Works

How much can I contribute?

$100 minimum
$3,400 maximum

How do I access and use the FSA money?

You will receive a debit card to use for eligible expenses. Funds are immediately available in January 2026, If you enroll in an FSA during the calendar year, funds will be available within 2-3 weeks of your effective date in the plan.

Who can enroll in an FSA?

If you are enrolled in the Basic PPO Plan, Enhanced PPO Plan, 360 Protect Plan, Kaiser, or even if you do not elect to enroll in a Michaels medical plan, you can use the money to pay for eligible medical, prescription drug, dental, and vision expenses.

This applies to:

You
Any dependents you claim on your federal tax return
Your children under age 26, even when they are not covered by a Michaels benefit plan

Under IRS rules, expenses for domestic partners cannot be paid from an FSA.

Dates & Deadlines

You can incur expenses until Dec. 31 of the current plan year.
You have until March 31 of the following plan year to submit any reimbursement claims for expenses not previously reimbursed.

Health Care FSA Guide

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Limited Purpose FSA

The Limited Purpose FSA (LPFSA) can be used to pay for dental and vision expenses only. It is compatible with a health savings account (HSA).

Your Title Goes Here

How it Works

How much can I contribute?

$100 minimum
$3,400 maximum

How do I access and use the LPFSA money?

You will receive a debit card from HealthEquity to use for eligible expenses. Funds are immediately available in January 2026. If you enroll in an FSA during the calendar year, funds will be available within 2-3 weeks of your effective date in the plan.

Who can use the LPFSA money?

If you are enrolled in the Michaels Choice HSA medical plan, you may use the Limited Purpose FSA.

You can use your LPFSA to pay for eligible dental and vision care expenses.
By using your LPFSA to pay for routine dental and vision expenses, you can avoid tapping into your HSA for these expenses allowing you to let your HSA savings continue to grow. You can then use your HSA for larger, unexpected medical expenses, or save it for healthcare costs in retirement.

This applies to:

You
Any dependents you claim on your federal tax return
Your children under age 26, even if they are not covered by a Michaels benefit plan

Under IRS rules, expenses for domestic partners cannot be paid from an LPFSA.

Dates & Deadlines

You can incur expenses until Dec. 31 of the current plan year.
You have until March 31 of the following plan year to submit any reimbursement claims for expenses not previously reimbursed.

Limited Purpose FSA Guide



Dependent Care FSA

The Dependent Care FSA (DCFSA) can be used to pay for dependent care for eligible children under age 13 and for adult dependents who are physically or mentally incapable of self-care.

Your Title Goes Here

How it Works

How much can I contribute?

$100 minimum
$7,500 maximum (or $3,750 maximum if married but filing separately from your spouse)

How do I access and use the Dependent Care FSA money?

You submit claims for reimbursements directly to HealthEquity. Funds are available after contributions to your DCFSA have been made from your paycheck.

How can I use the Dependent Care FSA money?

You do not need to be enrolled in a Michaels medical plan to participate.

You can use the Dependent Care FSA for dependent care expenses incurred with certain care providers, allowing you and your spouse to work.

This includes:

Nursery schools
Licensed day care centers (including adult day care facilities and centers for disabled dependents)
In-home day care providers
Before- and after-school care (if not already included in tuition)
Summer day camp, but not overnight camp

Who are eligible dependents to use with a DCFSA?

You can use the money to pay for eligible dependent care expenses for:

Children under age 13 you claim on your federal tax return as dependents (or for whom you are the custodial parent if divorced, regardless of who claims the tax exemption).
Your spouse or other tax dependent (regardless of age) who is mentally or physically incapable of self-care. This person must live with you for more than half the year.

Under IRS rules, expenses for domestic partners cannot be paid from a Dependent Care FSA.

Dates & Deadlines

DCFSA is an annual use-it-or-lose-it account, therefore all expenses must be incurred in the current plan year and submitted for reimbursement prior to March 31 of the following year.
Any unused funds are forfeited.

Dependent Care FSA Guide

Member Resources

Keep Your Receipts!

HealthEquity has various ways in which they verify FSA card transactions: some do not require a receipt for substantiation, while other times a receipt is required.

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When You Don’t Need a Receipt

IIAS store or pharmacy purchases (the IIAS is a required approval system the IRS requires to list all merchants who sell goods that have FSA-eligible items; find more information at seg-is.org)
Prescription or eligible over-the-counter (OTC) purchases
Copays
Flat copay amounts at a doctor, dentist, vision provider, or hospital where said flat copays were provided
Recurring transactions
Payment made at the same location and for the same dollar amount as a prior payment for which the receipt was already approved by Health Equity at least once

When a Receipt May Be Required

Doctor’s office, hospital, dentist, or vision provider where the health plan has a deductible or coinsurance amount
Coinsurance and deductibles (assuming carrier files, if applicable, are unable to exactly substantiate the expense)
Purchases at 90% pharmacies
An odd dollar amount that does not match one of the flat copay amounts provided

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Filing Claims for Reimbursement

When you do not use your debit card and need to file for an FSA reimbursement for eligible expenses, claims can be filed online, via fax, or via US mail. Claims will be processed within two (2) business days after receipt. To check the status of your claim, log in to your account.

File Claims Online

For faster service, file your claim online. Simply log in to your account to submit your claim electronically and upload any required documentation.

File Claims via Fax or US Mail

Claims can be submitted via fax or US mail. First, download and fill out the Reimbursement Claim Form. Then, print and send the completed form and any required documentation as follows:

Fax: 877-353-9236
US Mail: CLAIMS ADMINISTRATOR, P.O. Box 14053, Lexington, KY, 40512

Flexible Spending Accounts (FSA)

This benefit is not available to Part-Time, Seasonal, or Temporary Team Members.

This page provides information about choosing and managing your FSA, identifying eligible expenses, and how to file claims for reimbursement. More FSA resources can be accessed at HealthEquity.com.

What is an FSA?

A flexible spending account (FSA), administered by HealthEquity, allows you to set aside tax-free money to help pay for eligible out-of-pocket expenses.

There are three types of FSAs that you can choose from: Health Care FSA, Limited Purpose FSA, and Dependent Care FSA.
Your FSA paycheck deductions are tax-free, which may help reduce your taxable income.
If you enroll in a Health Care or Limited Purpose FSA, you will receive a debit card from Health Equity to use when paying for eligible expenses.

FSA-Eligible Expenses

To help you determine what you can pay for with your FSA, you can search a list of eligible expenses and use the store locator to find merchants that offer FSA-eligible items.

Search the Store Locator for FSA-Eligible Items

Keep a copy of your receipts! Health Equity has various ways in which they verify FSA card transactions: some do not require a receipt for substantiation, while other times a receipt is required.

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When You Don't Need a Receipt

IIAS store or pharmacy purchases (the IIAS is a required approval system the IRS requires to list all merchants who sell goods that have FSA-eligible items; find more information at seg-is.org)
Prescription or eligible over-the-counter (OTC) purchases
Copays
Flat copay amounts at a doctor, dentist, vision provider, or hospital where said flat copays were provided
Recurring transactions
Payment made at the same location and for the same dollar amount as a prior payment for which the receipt was already approved by Health Equity at least once

When a Receipt May Be Required

Doctor’s office, hospital, dentist, or vision provider where the health plan has a deductible or coinsurance amount
Coinsurance and deductibles (assuming carrier files, if applicable, are unable to exactly substantiate the expense)
Purchases at 90% pharmacies
An odd dollar amount that does not match one of the flat copay amounts provided

Member Resources

Contact Your Provider

HealthEquity

FSA & HSA

HSA: 866-346-5800
FSA: 877-924-3967

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Filing Claims for Reimbursement

File Claims Online

For faster service, file your claim online. Simply log in to your account to submit your claim electronically and upload any required documentation.

File Claims via Fax or US Mail

Claims can be submitted via fax or US mail. First, download and fill out the Reimbursement Claim Form. Then, print and send the completed form and any required documentation as follows:

Fax: 877-353-9236
US Mail: CLAIMS ADMINISTRATOR, P.O. Box 14053, Lexington, KY, 40512

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Types of FSAs: Comparing Your Options

Use the information below to help you decide which type of FSA is right for you. Health Equity also offers guides for Comparing FSA Options and Things to Know About the FSA.

Note: If you are enrolled in an HSA medical plan, you may also enroll in a Limited Purpose FSA (LPFSA) for eligible dental and vision expenses.



Health Care FSA

The Health Care FSA (HCFSA) can be used to pay for eligible medical, prescription drug, dental, and vision expenses and other expenses not covered by your insurance, such as some over-the-counter medicines. Team Members enrolled in a Michaels PPO plan or no medical plan may participate in a HCFSA.

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How it Works

How much can I contribute?

$100 minimum
$3,400 maximum

How do I access and use the FSA money?

Who can enroll in an FSA?

If you are enrolled in the Basic PPO Plan or Enhanced PPO Plan, or even if you do not elect to enroll in a Michaels medical plan, you can use the money to pay for eligible medical, prescription drug, dental, and vision expenses.

This applies to:

Yourself
Any dependents you claim on your federal tax return
Your children under age 26, even when they are not covered by a Michaels benefit plan

Under IRS rules, expenses for domestic partners cannot be paid from an FSA.

Dates & Deadlines

You can incur expenses until Dec. 31 of the current plan year.
You have until March 31 of the following plan year to submit any reimbursement claims for expenses not previously reimbursed.

Health Care FSA Guide

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Limited Purpose FSA

The Limited Purpose FSA (LPFSA) can be used to pay for dental and vision expenses only.

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How it Works

How much can I contribute?

$100 minimum
$3,400 maximum

How do I access and use the LPFSA money?

You will receive a debit card from Health Equity to use for eligible expenses. Funds are immediately available in January 2026. If you enroll in an FSA during the calendar year, funds will be available within 2-3 weeks of your effective date in the plan.

Who can use the LPFSA money?

If you are enrolled in the Michaels Choice HSA medical plan, you may use the Limited Purpose FSA.

You can use your LPFSA to pay for eligible dental and vision care expenses.
By using your LPFSA to pay for routine dental and vision expenses, you can avoid tapping into your HSA for these expenses allowing you to let your HSA savings continue to grow. You can then use your HSA for larger, unexpected medical expenses, or save it for healthcare costs in retirement.

This applies to:

Yourself
Any dependents you claim on your federal tax return
Your children under age 26, even if they are not covered by a Michaels benefit plan

Under IRS rules, expenses for domestic partners cannot be paid from an LPFSA.

Dates & Deadlines

You can incur expenses until Dec. 31 of the current plan year.
You have until March 31 of the following plan year to submit any reimbursement claims for expenses not previously reimbursed.

Limited Purpose FSA Guide

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Dependent Care FSA

The Dependent Care FSA (DCFSA) can be used to pay for dependent care for eligible children under age 13 and for adult dependents who are physically or mentally incapable of self-care.

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How it Works

How much can I contribute?

$100 minimum
$7,500 maximum (or $3,750 maximum if married but filing separately from your spouse)

How do I access and use the Dependent Care FSA money?

You submit claims for reimbursements directly to Health Equity. Funds are available after contributions to your DCFSA have been made from your paycheck.

How can I use the Dependent Care FSA money?

You can use the Dependent Care FSA for dependent care expenses incurred with certain care providers, allowing you and your spouse to work.

This includes:

Nursery schools
Licensed day care centers (including adult day care facilities and centers for disabled dependents)
In-home day care providers
Before- and after-school care (if not already included in tuition)
Summer day camp, but not overnight camp

Who are eligible dependents to use with a DCFSA?

You can use the money to pay for eligible dependent care expenses for:

Children under age 13 you claim on your federal tax return as dependents (or for whom you are the custodial parent if divorced, regardless of who claims the tax exemption).
Your spouse or other tax dependent (regardless of age) who is mentally or physically incapable of self-care. This person must live with you for more than half the year.

Under IRS rules, expenses for domestic partners cannot be paid from a Dependent Care FSA.

Dates & Deadlines

DCFSA is an annual use-it-or-lose-it account, therefore all expenses must be incurred in the current plan year and submitted for reimbursement prior to March 31 of the following year.
Any unused funds are forfeited.

Dependent Care FSA Guide

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