Retirees under 65 along with their spouse and or dependent children are eligible for the benefits described below.
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Medical (spouse, and/or children up to age 26)
- scroll down for medical plan information
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Dental (spouse and/or children up to age 26)
- click here for the Dental Plan page
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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.
New Castle Offers Plans through Highmark Blue Cross Blue Shield and Aetna.
- To view Aetna Medical Plans, CLICK HERE.
- To view Highmark Blue Cross Blue Shield, CLICK HERE.
Highmark BlueCross BlueShield Plans
Under 65
| UNDER 65 | Highmark Blue Cross Blue Shield Highmark PPO |
Highmark Blue Cross Blue Shield Highmark EPO |
Highmark Blue Cross Blue Shield Highmark Passive PPO |
|||||
|---|---|---|---|---|---|---|---|---|
| In-Network Benefits |
Out-of-Network Benefits |
Schedule of Benefits | Schedule of Benefits | |||||
| Annual Deductible | ||||||||
| Individual | $0 | $200 | $0 | $200 | ||||
| Family | $0 | $400 | $0 | $400 | ||||
| Coinsurance | 100% | 80% | 100% | 80% | ||||
| Maximum Out-of-Pocket | ||||||||
| Individual | $12,000 | N/A | $12,000 | $12,000 | ||||
| Family | $24,000 | N/A | $24,000 | $24,000 | ||||
| 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.
Highmark Plan Documents
Medical Plan Summaries - Under 65
2027 Highmark PPO Plan Summary
2027 Highmark EPO Plan Summary
2027 Highmark Passive PPO Plan Sumary (formerly Comp80
Reference - Under 65
2024 High Level Open Enrollment Brochure, DE, MX2455665
Highmark Member Engagement
Highmark Urgent Care
Seasonal Well360 Virtual Health Individual Flyer, DE, MX1722595
Highmark Coaching Program
WELLNESS COACHING - 47 LB. WEIGHT LOSS (1)
Highmark Sword Campaign
Highmark CRM Blue365
My Highmark Intro Flyer, DE, MX2249801 (1)
Diabetes Prevention Program
Video: Diabetes Prevention Program
Under 65 - Benefit Plan Monthly Rates
2027 Total Monthly Premium Rates Pre 65 Retirees
Aetna Medical Plans
Medical Plan Comparison (Under 65)
| FULL-TIME & UNDER 65 | AetnaOpen Access Select | Aetna Aetna PPO |
Aetna Medical QHDHP HSA Compatible |
|||||
|---|---|---|---|---|---|---|---|---|
| Schedule of Benefits | In-Network Benefits | Out-of-Network Benefits | Schedule of Benefits | |||||
| Annual Deductible | ||||||||
| Individual | $0 | $0 | $200 | $2,500 | ||||
| Family | $0 | $0 | $400 | $5,000 | ||||
| Coinsurance | 100% | 100% | 80% | 100% | ||||
| Maximum Out-of-Pocket | ||||||||
| Individual | $12,000 | $12,000 | N/A | $12,000 | ||||
| Family | $24,000 | $24,000 | N/A | $24,000 | ||||
| Physician Office Visit | ||||||||
| Primary Care | $25 copay | $25 copay | 80% after deductible | $25 copay after deductible | ||||
| Specialty Care | $35 copay | $35 copay | 80% after deductible | $25 copay after deductible | ||||
| Preventive Care | ||||||||
| Adult Periodic Exams | 100% | 100% | Not Covered | 100% | ||||
| Well-Child Care | 100% | 100% | Not Covered | 100% | ||||
| Diagnostic Services | ||||||||
| X-ray / Lab Tests | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Complex Radiology | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Urgent Care Facility | $25 copay | $25 copay | 80% after deductible | $25 copay after deductible | ||||
| Emergency Room Facility Charges | $100 copay; waived if admitted | $100 copay | $100 copay; waived if admitted | $100 after deductible | ||||
| Inpatient Facility Charges | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Outpatient Facility and Surgical Charges | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Mental Health | ||||||||
| Inpatient | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Outpatient | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Substance Abuse | ||||||||
| Inpatient | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Outpatient | 100% | 100% | 80% after deductible | 100% after deductible | ||||
| Other Services | ||||||||
| Chiropractic | 80% after deductible; 30 visits per year | 100% after deductible | ||||||
| Retail Pharmacy (30 Day Supply) | ||||||||
| Generic | $8 copay | $8 copay | Not Covered | $8 copay after deductible | ||||
| Preferred | $30 copay | $30 copay | Not Covered | $30 copay after deductible | ||||
| Non-Preferred | $50 copay | $50 copay | Not Covered | $50 copay after deductible | ||||
| Mail Order Pharmacy (90 Day Supply) | ||||||||
| Generic | $16 copay | $16 copay | Not Covered | $16 copay after deductible | ||||
| Preferred | $60 copay | $30 copay | Not Covered | $60 copay after deductible | ||||
| Non-Preferred | $100 copay | $90 copay | Not Covered | $100 copay after deductible | ||||
Note: Please consult plan documents for full benefits, exclusions, and limitations.
Aetna Plan Documents
Medical Plan Summaries (Under 65)
2027 Aetna Open Access Select Plan Summary
2027 Aetna PPO Plan Summary
2027 Aetna High Deductible Plan Summary
Summary of Benefits and Coverage (Under 65)
2027 Aetna Open Access® Aetna Select SBC
2027 Aetna PPO SBC
2027 Aetna HDHP SBC
Aetna Resources
24-Hour Nurse Line Member Flyer Post-Enrollment
Aetna Health App
Preventive Care Schedule
Behavior Health Programs and Services
Achieving a healthy weight
Aetna Hinge Health
LifeMart Discounts Program
Weight Management Discounts
Under 65 - Benefit Plan Monthly Rates