Please select your age group for the benefits that apply to you and your dependents.
Under 65
Retirees under 65 along with their spouse and or dependent children are eligible for the benefits described below.
- Medical (spouse, and/or children up to age 26)
- scroll down for medical plan information
- Dental (spouse and/or children up to age 26)
- click here for the Dental Plan page
- Vision (spouse and/or children up to age 26)
- click here for the Vision Plan page
Medical Plan Comparison
New Castle County will continue to offer medical coverage. The below charts are a brief outline of the plan options.
Please CLICK HERE or scroll down for the Aetna or BCBS Retiree Plan.
Highmark BlueCross BlueShield Plans
| Highmark Blue Cross Blue Shield Highmark PPO |
Highmark Blue Cross Blue Shield Highmark EPO |
Highmark Blue Cross Blue Shield Highmark Comp 80 |
||||||
|---|---|---|---|---|---|---|---|---|
| In-Network Benefits |
Out-of-Network Benefits |
Schedule of Benefits | Schedule of Benefits | |||||
| Annual Deductible | ||||||||
| Individual | $200 | $200 | $0 | $200 | ||||
| Family | $400 | $400 | $0 | $400 | ||||
| Coinsurance | 100% | 80% | 100% | 80% | ||||
| Maximum Out-of-Pocket | ||||||||
| Individual | $9,450 | N/A | $9,450 | $9,450 | ||||
| Family | $18,900 | N/A | $18,900 | $18,900 | ||||
| Physician Office Visit | ||||||||
| Primary Care | $25 copay | 80% after deductible | $25 copay | 80% after deductible | ||||
| Specialty Care | $35 copay | 80% after deductible | $35 copay | 80% after deductible | ||||
| Preventive Care | ||||||||
| Adult Periodic Exams/ Well Child Care | 100% | Not covered | 100% | 100% | ||||
| Diagnostic Services | ||||||||
| X-ray and Lab Tests | 100% | 80% after deductible | 100% | 100% | ||||
| Complex Radiology | 100% | 80% after deductible | 100% | 100% | ||||
| Urgent Care Facility | $25 copay | 80% after deductible | $25 copay | 80% after deductible | ||||
| Emergency Room Facility Charges | $100 copay per visit; waived if admitted | $100 copay per visit; waived if admitted | $100 copay per visit; waived if admitted | 100% | ||||
| Inpatient Facility Charges | 100% | 80% after deductible | 100% | 100% | ||||
| Outpatient Facility and Surgical Charges | 100% | 80% after deductible | 100% | 100% | ||||
| Mental Health | ||||||||
| Inpatient | 100% | 80% after deductible | 100% | 100% | ||||
| Outpatient | 100% | 80% after deductible | 100% | 80% after deductible | ||||
| Substance Abuse | ||||||||
| Inpatient | 100% | 80% after deductible | 100% | 100% | ||||
| Outpatient | 100% | 80% after deductible | 100% | 80% after deductible | ||||
| Retail Pharmacy (30 Day Supply) | ||||||||
| Generic | $8 copay | Not covered | $8 copay | 20% after deductible | ||||
| Preferred | $30 copay | Not covered | $30 copay | 20% after deductible | ||||
| Non-Preferred | $50 copay | Not covered | $50 copay | 20% after deductible | ||||
| Mail Order Pharmacy (90 Day Supply) | ||||||||
| Generic | $16 copay | Not covered | $16 copay | 20% after deductible | ||||
| Preferred | $60 copay | Not covered | $60 copay | 20% after deductible | ||||
| Non-Preferred | $100 copay | Not covered | $100 copay | 20% after deductible | ||||
Note: Please consult plan documents for full benefits, exclusions, and limitations.
Medical Insurance (continued)
Highmark BlueCross BlueShield Plans
| Aetna Open Access Select | Highmark Blue Cross Blue Shield Highmark Co-Op 80 (Retiree Only) |
|||
|---|---|---|---|---|
| Schedule of Benefits | Schedule of Benefits | |||
| Annual Deductible | ||||
| Individual | $0 | $200 | ||
| Family | $0 | $400 | ||
| Coinsurance | 100% | 80% | ||
| Maximum Out-of-Pocket | ||||
| Individual | $9,450 | $9,450 | ||
| Family | $18,900 | $18,900 | ||
| Physician Office Visit | ||||
| Primary Care | $25 copay | 80% after deductible | ||
| Specialty Care | $35 copay | 80% after deductible | ||
| Preventive Care | ||||
| Adult Periodic Exams | 100% | 100% | ||
| Well-Child Care | 100% | 100% | ||
| Diagnostic Services | ||||
| X-ray / Lab Tests | 100% | 100% | ||
| Complex Radiology | 100% | 100% | ||
| Urgent Care Facility | $25 copay | 80% after deductible | ||
| Emergency Room Facility Charges | $100 copay; waived if admitted | 100% | ||
| Inpatient Facility Charges | 100% | $10 copay per day for first 7 days then 100% | ||
| Outpatient Facility and Surgical Charges | 100% | 100% | ||
| Mental Health | ||||
| Inpatient | 100% | $10 copay per day for first 7 days then 100% | ||
| Outpatient | 100% | 80% after deductible | ||
| Substance Abuse | ||||
| Inpatient | 100% | $10 copay per day for first 7 days then 100% | ||
| Outpatient | 100% | 80% after deductible | ||
| Other Services | ||||
| Chiropractic | 80% after deductible; 30 visits per year | 80%; 30 visits per year | ||
| Retail Pharmacy (30 Day Supply) | ||||
| Generic | $8 copay | 20% after deductible | ||
| Preferred | $30 copay | 20% after deductible | ||
| Non-Preferred | $50 copay | 20% after deductible | ||
| Mail Order Pharmacy (90 Day Supply) | ||||
| Generic | $16 copay | 20% after deductible | ||
| Preferred | $60 copay | 20% after deductible | ||
| Non-Preferred | $100 copay | 20% after deductible | ||
Note: Please consult plan documents for full benefits, exclusions, and limitations.
2024 Monthly benefit rates Pensioners
Highmark Plans
Highmark PPO
Highmark EPO
Comp 80 Flyer
COOP 80
Highmark 2024 High Level Open Enrollment Brochure, DE
Highmark Member Engagement
Highmark Urgent Care
Highmark Seasonal Well360 Virtual Health
Highmark Coaching Program
Wellness Coaching
Highmark Sword Campaign
Highmark CRM Blue365
My Highmark Intro Flyer, DE
Diabetes Prevention Program
Video: Diabetes Prevention Program
Aetna Plan
AETNA Summary of Benefits
24-Hour Nurse Line
Aetna Health App
Preventive Care Schedule
Achieving a Healthy Weight
Aetna Hinge Health
LifeMart Discounts Program
Weight-Management Discounts
Prescription Plan
CLICK HERE to view the Prescription Plan page for Retirees Under 65.
Over 65
Retirees over 65 along with their spouse and or dependent children are eligible for the benefits described below.
- Medical (spouse, and/or children up to age 26)
- scroll down for medical plan information
- Dental (spouse and/or children up to age 26)
- click here for the Dental Plan page
- Vision (spouse and/or children up to age 26)
- click here for the Vision Plan page
Aetna Medicare Advantage: Video
Medicare Information
2024 Medicare Open Enrollment
Aetna Medicare Presentation
NCC Retirees Announcement
Medicare Benefits and
Information Guide
Medicare 2024 Formulary
List of Covered Drugs
2024 Monthly Rates Post 65
2024 Monthly Rates Post 65
Aetna Preferred Medical Plans
Summary of Benefits
Preferred Medical with Base RX
Preferred Medical with Mid RX
Preferred Medical with High RX
Aetna Classic Medical Plans
Summary of Benefits
Classic Medical with Mid RX
Classic Medical with High RX
Meals At Home
Get Active with SilverSneakers
Cruising Ahead
Achieving a Healthy Weight
Aetna Discount Program – Medicare Solutions
Qualifying Life Event
Certain life events provide you a 30-day window to elect benefits or change your covered dependents.
What is a Qualifying Life Event? If you experience any of the scenarios below, you may be eligible to update your benefit elections mid-year:
- Marriage, divorce, or legal separation
- Birth or adoption of a child
- Commencement or termination of adoption proceedings
- Change in child’s dependent status
- Death of a dependent
- Loss or gain of other health coverage for you and/or dependents
- Change in employment status
- Change in Medicaid/Medicare eligibility for you or a dependent
- Receipt of a Qualified Medical Child Support Order
Remember, dependent verification will be required.
If you have questions about your eligibility or enrollment process, contact HR benefits 302-395-5180 or HRbenefits@newcastlede.gov
