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 | $9,200 | N/A | $9,200 | $9,200 | ||||
| Family | $18,400 | N/A | $18,400 | $18,400 | ||||
| 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)
Aetna and 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 | $9,200 | $9,200 | ||
| Family | $18,400 | $18,400 | ||
| 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.
Benefit Plan Monthly Rates
2025 Health Premiums For Pensioners
Highmark Plans
New Castle County - Blue Choice PPO - January 2025
New Castle County - EPO - January 2025
New Castle County - Comprehensive 80 - January 2025
New Castle County - Co-Op 80 - January 2025
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 Select SBC 010125
NCC_Aetna OpenAcess Plan Summary_010125
24-Hour Nurse Line
Aetna Health App
Preventive Care Schedule
Behavior Health Programs and Services
Achieving a Healthy Weight
Aetna Hinge Health
LifeMart Discounts Program
