Medical

Employees who work fewer than 30 hours a week can choose from two health insurance options. These are limited coverage medical insurance plans that meet the coverage requirements under the Affordable Care Act (ObamaCare). They provide basic coverage for regular checkups, no-cost phone or online access to doctors, and discounts on pharmacy and other health care services. One of the options includes minimal coverage for doctors’ office visits and hospitalization.

Public health care options are also available. These plans provide comprehensive coverage, at a low cost, or even at no cost to you, if you qualify for subsidies.

Take the time to explore all your health care options—those available through BAYADA, the public health exchange, Medicaid, or through a spouse or partner.

Option D: Minimum Coverage Plan

The Minimum Coverage Plan is a limited coverage insurance plan that covers regular checkups (preventive care) through a national PPO network—First Health—administered by Nationwide. This plan meets the government requirement to have individual health care coverage. Enrolling in it means you avoid the government penalty ($695 per individual/$347.50 per child).

The Minimum Coverage Plan is actually three benefit plans:

  1. You get 100% coverage for regular checkups when you see a First Health network provider. This may include:
    • Blood pressure, cholesterol, and cancer screenings; gynecological exams and mammograms for women; vaccines for adults and children; and more.
    • See all the covered services.
  2. You get a Discount Health Savings Card that provides discounts on other services:
    • Up to 85% off the cost of prescriptions through the Neighborhood Pharmacy discount program, which includes more than 60,000 pharmacies in the U.S.
    • Discounts on lab services, dental, chiropractic advanced imaging, durable medical equipment, and more.
    • Help with lowering out-of-pocket costs on medical or dental bills over $400 through negotiation with your provider.

    Note: The Discount Health Savings plan is not available in Washington and Vermont.

  3. You and your dependents get free, 24/7 telephone or online care through Teladoc—a national network of U.S. board-certified physicians. Teladoc doctors can diagnose and treat many medical issues right over the phone, and even prescribe medications. You can request to see a doctor as soon as one is available (doctors usually respond within 16 minutes), or make an appointment. There are no limits on how many times you can use the service.

    To use the service, you’ll need to first set up an account with MyMemberPortal.com, then Teladoc:
    • On your first visit to MyMemberPortal.com, register as a new user and create a user ID and password. Then log in to MyMemberPortal to create your Teladoc account.
    • Click My Benefits > Doctors by Phone > Launch Program. Enter your name and member ID exactly as they appear on your Minimum Coverage Plan or Enhanced Minimum Coverage Plan ID card. Then create a user ID and password (different from your MyMemberPortal ID and password).
    • You’ll need to complete the Medical History Disclosure before requesting to speak with a doctor.
    • To speak with a doctor, click Request a Consult or call 855-847-3627.

How it works

Show your Minimum Coverage Plan ID and Discount Health Savings Card at your doctor’s (or other provider’s) office. They’ll apply any available discounts. Regular checkups (preventive care) from First Health providers are covered at 100%. For other care, you’re responsible for paying any costs after the discount (if applicable) is applied at the time of service.

Option E: Enhanced Minimum Coverage Plan

This plan offers all the same services as the Minimum Coverage Plan, plus reimbursement for other care. For example, if you visit the doctor because you’re sick, you’ll pay for the visit and the plan will reimburse you $75 for each visit (for up to six visits per calendar year). There’s also reimbursement for vision, lab, X-rays, hospitalization, surgery, and more.

How it works


Show your Minimum Coverage Plan ID and Discount Health Savings Card at your doctor’s (or other provider’s) office. They’ll apply any available discounts and file a claim with the plan for services provided during the visit. The plan covers 100% of preventive care from providers in the First Health network (administered by Nationwide). For other services, you’re responsible for paying any costs after the discount (if applicable) is applied at the time of service. If it’s for a covered service (such as a doctor’s office visit), file a claim for reimbursement.

Note: The Enhanced Minimum Coverage Plan is not available in New Hampshire.

How the plans compare

Minimum Coverage Plan
Administered by Nationwide
First Health Network
Annual Checkups (Preventive Care) Plan pays 100% for preventive services for adults, women, and children
Primary Care Physician Office Visit No coverage for doctor’s office visits other than preventive care
Plan-Year Deductible None
Coinsurance None
Plan-Year Out-of-Pocket Maximum* None
Hospitalization Not Covered
For More Details Download details about covered services
Enhanced Minimum Coverage Plan
Annual Checkups (Preventive Care) Plan pays 100% for preventive services for adults, women, and children
Primary Care Physician Office Visit Plan covers $75 per visit for up to 6 visits per calendar year
Plan-Year Deductible None
Coinsurance None
Plan-Year Out-of-Pocket Maximum* None
Hospitalization Plan pays $100 per day, 500 day lifetime maximum
For More Details Download details about covered services

Cost of coverage

For cost information, go to the Benefits home page of the portal if you are an Office employee, or call the Benefits office at 877-291-3000. Click here for cost information if you work less than 30 hours a week.

Weekly Cost
Minimum Coverage Plan
Employee $8.19
Employee + Spouse $11.42
Employee + Child(ren) $11.20
Family $15.01
Enhanced Minimum Coverage Plan
Employee $18.29
Employee + Spouse $36.67
Employee + Child(ren) $29.38
Family $41.43
Annual Penalty for Not Having Health Coverage
$695 per adult $347.50 per child

Other coverage options

Health insurance marketplace

For some people, the health insurance marketplace—implemented in 2014 as part of health care reform—might be a better option for coverage. You could be eligible for low-cost coverage based on your family size and income. To shop the marketplace options, go to www.healthcare.gov. Or get help finding quality, affordable health insurance through a free service, such as HealthSherpa (855-772-2663) or Mylo (844-863-5950).

Medicaid

Health care reform also expanded eligibility for Medicaid. Depending on your income and family size, you might be eligible for low-cost care. Go to www.hhs.gov to see if you qualify.

A spouse’s or domestic partner’s employer

Check to see if coverage is available and what the cost would be to add you and/or your dependents to the plan.

Children’s Health Insurance Program (CHIP)

CHIP provides low-cost health coverage to children in families who earn too much to qualify for Medicaid. Each state program has its own rules about who qualifies. For details about what’s available in your state, go to www.insurekidsnow.gov.