Medical plans

New this year: All eligible team members may choose from any of our three medical plans. Each offers a different balance of cost of coverage, out-of-pocket expenses and provider choice.

BSWH EPO Plan

Previously offered as the SEQA and EQA plans

What it is: An exclusive provider organization (EPO) plan

What it offers: Lower out-of-pocket costs (deductibles, copays and coinsurance) to help make healthcare costs more predictable.

Where you can receive care: The BSWH Premier Network (Tier 1) is the only network available with this plan. 
Note: Urgent and emergency care are covered wherever you receive care if services are billed as urgent or emergency care.

Additional feature: Election in this plan allows participation in the general-purpose flexible spending accounts (FSAs), which can be used to pay for qualified healthcare expenses with pre-tax dollars.

BSWH PPO Plan

Previously offered as the Premium Plan

What it is: A preferred provider organization (PPO) plan

What it offers: Low deductibles, copays and coinsurance with more flexibility in choosing healthcare providers outside of the Tier 1 Network.

Where you can receive care: This plan includes the BSWH Premier Network (Tier 1), BSWH Plus Network and UnitedHealthcare Options PPO Network (Tier 2) and out-of-network benefits (Tier 3). 
Note: If you live 40+ miles from a Tier 1 acute care facility, Tier 2 providers are covered at the Tier 1 benefit level after a one-time activation with BSWHP Customer Service.

Additional feature: Election in this plan allows participation in the general-purpose Flexible Spending Accounts (FSAs), which can be used to pay for qualified healthcare expenses with pre-tax dollars.

BSWH HDHP Plan

Previously offered as the High-Deductible Health Plan (HDHP)

What it is: A high-deductible health plan

What it offers: Lower monthly premiums with a higher annual deductible. Preventive care is covered at 100%. For most other medical and prescription drug expenses, you pay the full cost until you meet the deductible. The plan then begins sharing costs through coinsurance.

Where you can receive care: This plan includes the BSWH Premier Network (Tier 1), BSWH Plus Network and UnitedHealthcare Options PPO Network (Tier 2) and out-of- network benefits (Tier 3). 
Note: If you live 40+ miles from a Tier 1 acute care facility, Tier 2 providers are covered at the Tier 1 benefit level after a one-time activation with BSWHP Customer Service.

Additional features: Election in this plan allows participation in the limited-purpose Flexible Spending Accounts (FSAs) and a Health Savings Account (HSA), which can be used to pay for qualified healthcare expenses with pre-tax dollars.

Know your network options

Depending on which medical plan you choose, you’ll have access to one or more provider networks.

Medical cost and coverage

Your cost for care depends on your medical plan, services received and where you go for care. With every plan, you get preventive care at no cost when you visit in-network providers.

How your deductible, copays and coinsurance work together

You pay a portion of the cost for care, and the plan pays the rest. Here’s an example of how it all fits together during a plan year.

Key terms

  • Deductible: The amount you pay for certain covered services before the plan starts to pay.
  • Copay: A fixed amount you pay for certain services (such as a primary care visit). You pay a portion of the cost for care, and the plan pays the rest.
  • Coinsurance: A percentage of the cost you pay after the deductible is met.
  • Out-of-pocket maximum: The most you’ll pay in a plan year for covered in-network care.

Where to go for care

Make the most of your benefits. For non-emergency care, starting with an eVisit, video visit, primary care, or urgent care can help you get the right care at the right time, at a lower cost than an emergency room visit.

Prescription drugs

Your prescription coverage is tied to your medical plan, but is managed by Rightway. Rightway is our pharmacy partner and can help you understand your prescription benefits, manage prior authorizations, review medication options and navigate formulary changes.

Note: Some controlled medications are not available through mail order and are limited to a 30-day supply. Examples include opioids, stimulants, and certain sedatives.

When filling prescriptions, you have two options:

BSW pharmacies

Save on copays and manage all of your prescription needs. BSW is the only option when filling specialty medications and mail order. Specialty medications are limited to a 30-day supply. Mail-order is limited to a 90-day supply.

Ask whether generic medications may be right for you.

Generic medications cost less than their brand-name equivalents, and the Rightway pharmacy team can help you compare covered options. Use the Rightway Formulary Navigator to search for covered medications.

Rightway Formulary Navigator(opens in new window)

Support for every step of your parenting journey

Whether you're expecting a child, growing your family through fertility treatment or preparing for life with a new baby, Baylor Scott & White Health offers resources and benefits to help support you along the way.

Preparing for your new child

Expecting the Best: Maternity case management

If you're enrolled in a BSW medical plan and expecting a baby, the Expecting the Best maternity case management program provides personalized support throughout your pregnancy. Connect with experienced care professionals who can help answer questions, provide resources, and guide you through each stage of your journey.

How to enroll

Need help? Contact the Baylor Scott & White Health Plan (BSWHP) to enroll in the program and learn about available maternity support services.

Get a free breast pump

Planning to breastfeed? Team members enrolled in a BSW medical plan may be eligible for a free breast pump beginning in the third trimester and up to one year after delivery.

Learn more by calling 1.844.843.3229

Infertility support and coverage

Every path to parenthood is unique. That's why our medical plans include coverage for certain infertility-related services and expenses to help support your family-building journey.

Questions about coverage? Call 1.844.843.3229

Additional emotional support

The Employee Assistance Program (EAP) provides confidential support and resources to help you navigate the emotional challenges that can accompany infertility and family planning.

Learn more about the Employee Assistance Program (EAP).

Labor and delivery resources

Welcoming a new child is an exciting milestone, and we're here to help you prepare. Explore resources designed to support you before, during and after delivery. Resources include maternity care information, hospital resources and childbirth education classes.

Available resources include:

  • Labor and delivery services
  • Pregnancy support resources
  • Childbirth and parenting classes
  • Hospital and maternity care information

Explore labor and delivery services

Quick contacts

We're here to support you and your family through every stage of the journey, from planning and pregnancy to welcoming your new child home.

Baylor Scott & White Health Plan (BSWHP)

Phone: 1.844.843.3229

Maternity Case Management

Email: CaseManagement@BSWHealth.org

Manage your benefits

Quit tobacco

Quitting tobacco is one of the best things you can do for your health. That's why BSW offers the YesQuit® Tobacco Cessation Program at no cost to eligible team members and covered dependents.

Visit YesQuit.org

We're here to help

Whether you're ready to quit now or just getting started, support and resources are available to help you take the next step toward better health.

Helpful resources

Understand benefits terminology

Benefit terms can be confusing! That's why we made this resource to help you define key benefit terms and acronyms.

Benefits terminology(opens in new window)

Need help choosing a medical plan?

ALEX can help. Answer a few questions and get a custom recommendation in minutes.

Ask ALEX(opens in new window)

Navigating Medicare?

Whether you're exploring Medicare options for yourself or a loved one, ALEX Medicare can help you understand the options.

ALEX Medicare(opens in new window)

This site summarizes the programs and benefits available to employees and their eligible dependents. Official plan documents, policies and certificates of insurance that contain the details, conditions, maximum benefit levels and restrictions on benefits govern our benefits program and are available on this site. In case of a conflict between this site and the official documents, the official documents prevail. The information on this site isn't a guarantee of benefits. Baylor Scott & White reserves the right to modify or terminate its employee benefit plans and programs at any time for any reason.

Please contact us if you have feedback on the website or need to report an issue.