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Medical coverage and costs
Take a closer look at your coverage and costs in this chart. Aetna Machine Readable File (MRF)
2026
With our Core PPO Plan, you pay the lowest premium and the highest deductible. This plan also has copays for a doctor’s visit and mail order prescriptions. For all other services, you fully pay the cost until you meet your deductible before your plan pays 70% for services. Use it with a Healthcare Flexible Spending Account (FSA) for maximum pretax savings.
Office visits: For an in-network primary care visit, your copay is $40 with no deductible. For an in-network specialist visit, your copay is $60 with no deductible. For an emergency room visit, you pay 30% coinsurance after you meet your deductible.
$5.89
Biweekly premium
$6,000
Deductible*
$7,900
Out-of-pocket max**
$70.70
Biweekly premium
$9,000
Deductible*
$11,850
Out-of-pocket max**
$12.79
Biweekly premium
$9,000
Deductible*
$11,850
Out-of-pocket max**
$12.79
Biweekly premium
$12,000
Deductible*
$15,800
Out-of-pocket max**
$77.60
Biweekly premium
$12,000
Deductible*
$15,800
Out-of-pocket max**
** This plan has an individual out-of-pocket maximum. You only need to meet your individual $7,900 out-of-pocket maximum before the plan pays your covered network expenses at 100% (even if your family maximum hasn’t been met). You pay a total family maximum of $15,800.
Through our High-Deductible Health Plan (HDHP), you pay full price for all non-preventive care and prescriptions until you meet your deductible. It’s the only plan that also pairs with a Health Savings Account for maximum pretax savings.
Office visits: Your copay cost for an in-network primary care, specialist or emergency room visit is 20% coinsurance, after you meet your deductible.
$9.34
Biweekly premium
$2,000
Deductible*
$4,000
Out-of-pocket max**
$500
Cox contribution to HSA
$106.23
Biweekly premium
$3,400
Deductible*
$6,800
Out-of-pocket max**
$850
Cox contribution to HSA
$20.35
Biweekly premium
$3,400
Deductible*
$6,800
Out-of-pocket max**
$850
Cox contribution to HSA
$20.35
Biweekly premium
$4,000
Deductible*
$8,000
Out-of-pocket max**
$850
Cox contribution to HSA
$117.25
Biweekly premium
$4,000
Deductible*
$8,000
Out-of-pocket max**
$1,000
Cox contribution to HSA
** You’ll want to note that the HDHP Plus has true family out-of-pocket maximums. You must meet the maximum costs listed for your level of coverage before the plan pays 100% of covered network services for anyone in your family. For example, if you cover both you and your spouse, you must meet the $6,800 maximum before the plan pays 100% of covered network services for either you or your spouse.
Our Premium PPO Plan has the highest premium and the lowest deductible. This plan also has co-pays for a doctor’s visit and mail order prescriptions. Use it with a Healthcare FSA for maximum pretax savings.
Office visits: For an in-network primary care visit, your copay is $30 with no deductible. For an in-network specialist visit, your copay is $50 with no deductible. For an emergency room visit, your copay is $150, and then you pay 20% coinsurance after you meet your deductible.
$58.04
Biweekly premium
$800
Deductible*
$3,200
Out-of-pocket max*
$217.68
Biweekly premium
$1,600
Deductible*
$6,500
Out-of-pocket max**
$120.07
Biweekly premium
$1,600
Deductible*
$6,500
Out-of-pocket max**
$120.07
Biweekly premium
$2,400
Deductible*
$9,750
Out-of-pocket max**
$279.71
Biweekly premium
$2,400
Deductible*
$9,750
Out-of-pocket max**
** This plan has an individual out-of-pocket maximum. You only need to meet your individual $3,250 out-of-pocket maximum before the plan pays your covered network expenses at 100% (even if your family maximum hasn’t been met). You pay a total family maximum of $9,750.
Employees in California have access to a medical plan through Kaiser Permanente. Pair it with a Healthcare FSA for maximum pretax savings.
$92.20
Biweekly premium
$0
Deductible*
$1,500
Out-of-pocket max**
$345.80
Biweekly premium
$0
Deductible*
$3,000
Out-of-pocket max**
$233.41
Biweekly premium
$0
Deductible*
$3,000
Out-of-pocket max**
$233.41
Biweekly premium
$0
Deductible*
$3,000
Out-of-pocket max**
$444.34
Biweekly premium
$0
Deductible*
$0
Out-of-pocket max**
Oral surgery is not covered.
2027
With our Core PPO Plan, you pay the lowest premium and the highest deductible. This plan also has copays for a doctor’s visit and mail order prescriptions. For all other services, you fully pay the cost until you meet your deductible before your plan pays 70% for services. Use it with a Healthcare Flexible Spending Account (FSA) for maximum pretax savings.
Office visits: For an in-network primary care visit, your copay is $40 with no deductible. For an in-network specialist visit, your copay is $60 with no deductible. For an emergency room visit, you pay 30% coinsurance after you meet your deductible.
$6.45
Biweekly premium
$6,000
Deductible**
$7,900
Out-of-pocket max**
$77.42
Biweekly premium*
$9,000
Deductible**
$11,850
Out-of-pocket max**
$14.01
Biweekly premium
$9,000
Deductible**
$11,850
Out-of-pocket max**
$14.01
Biweekly premium
$12,000
Deductible**
$15,800
Out-of-pocket max**
$84.97
Biweekly premium*
$12,000
Deductible**
$15,800
Out-of-pocket max**
* Coverage for domestic partners is offered post-tax. Cox’s contribution is also considered taxable earnings by the IRS.
** This plan has an individual deductible and out-of-pocket maximum. You only need to meet your individual deductible before the plan pays based on your coinsurance (even if your family deductible hasn’t been met). You only need to meet your individual out-of-pocket maximum before the plan pays your covered network expenses at 100% (even if your family deductible hasn’t been met).
Through our High-Deductible Health Plan (HDHP), you pay full price for all non-preventive care and prescriptions until you meet your deductible. It’s the only plan that also pairs with a Health Savings Account for maximum pretax savings.
Office visits: Your copay cost for an in-network primary care, specialist or emergency room visit is 20% coinsurance, after you meet your deductible.
$10.23
Biweekly premium
$2,000
Deductible**
$4,000
Out-of-pocket max**
$116.32
Biweekly premium*
$3,500
Deductible**
$7,000
Out-of-pocket max**
$22.28
Biweekly premium
$3,500
Deductible**
$7,000
Out-of-pocket max**
$22.28
Biweekly premium
$4,000
Deductible**
$8,000
Out-of-pocket max**
$128.39
Biweekly premium*
$4,000
Deductible**
$8,000
Out-of-pocket max**
* Coverage for domestic partners is offered post-tax. Cox’s contribution is also considered taxable earnings by the IRS.
** These are true family deductibles and out-of-pocket maximums. You must meet the deductible listed as a group before the plan pays coinsurance for anyone in your family. For example, if you cover both you and your spouse, you must meet the $3,500 deductible before the plan starts paying coinsurance for either you or your spouse. You must meet the out-of-pocket maximum listed before the plan pays 100% of covered network services for anyone in your family. For example, if you cover both you and your spouse, you must meet the $7,000 maximum before the plan pays 100% of covered network services for either you or your spouse. NOTE: These maximums only apply to covered in-network services. Out-of network maximums are double the in-network.
Our Premium PPO Plan has the highest premium and the lowest deductible. This plan also has co-pays for a doctor’s visit and mail order prescriptions. Use it with a Healthcare FSA for maximum pretax savings.
Office visits: For an in-network primary care visit, your copay is $30 with no deductible. For an in-network specialist visit, your copay is $50 with no deductible. For an emergency room visit, your copay is $150, and then you pay 20% coinsurance after you meet your deductible.
$63.55
Biweekly premium
$800
Deductible**
$3,250
Out-of-pocket max**
$238.36
Biweekly premium*
$1,600
Deductible**
$6,500
Out-of-pocket max**
$131.48
Biweekly premium
$1,600
Deductible**
$6,500
Out-of-pocket max**
$131.48
Biweekly premium
$2,400
Deductible**
$9,750
Out-of-pocket max**
$306.28
Biweekly premium*
$2,400
Deductible**
$9,750
Out-of-pocket max**
* Coverage for domestic partners is offered post-tax. Cox’s contribution is also considered taxable earnings by the IRS.
** This plan has an individual deductible and out-of-pocket maximum. You only need to meet your individual deductible before the plan pays based on your coinsurance (even if your family deductible hasn’t been met). You only need to meet your individual out-of-pocket maximum before the plan pays your covered network expenses at 100% (even if your family deductible hasn’t been met).
Employees in California have access to a medical plan through Kaiser Permanente. Pair it with a Healthcare FSA for maximum pretax savings.
$98.74
Biweekly premium
$0
Deductible**
$1,500
Out-of-pocket max**
$370.33
Biweekly premium*
$0
Deductible**
$3,000
Out-of-pocket max**
$246.51
Biweekly premium
$0
Deductible**
$3,000
Out-of-pocket max**
$246.51
Biweekly premium
$0
Deductible**
$3,000
Out-of-pocket max**
$475.86
Biweekly premium*
$0
Deductible**
$3,000
Out-of-pocket max**
* Coverage for domestic partners is offered post-tax. Cox’s contribution is also considered taxable earnings by the IRS.
** Covered amounts apply only to in-network services. Out-of-network services and oral surgery are not covered under the Kaiser Medical Plan.
Plan options
We offer three medical plans to help you manage the cost of your care. A Core PPO (lowest premium, highest deductible), Premium PPO (highest premium, lowest deductible) and High-Deductible Healthcare Plan (HDHP) Plus, a high-deductible health plan (HDHP) that you can pair with a Health Savings Account (HSA). Cox cares about your well-being, which is why preventive care is always covered at 100% when you use an in-network provider.
Explore all our offerings to support your physical, mental and financial wellness on Aetna’s website in the expanded Benefits and wellness section.
Pharmacy benefits
With all three Aetna medical plans,* you have access to comprehensive prescription drug coverage with convenient mail order and retail supply options. CVS Caremark® administers our pharmacy plan with 60,000+ pharmacy locations nationwide.
CVS is partnering with Scripta, an app and website that helps you save on prescriptions by identifying lower-cost alternatives and working directly with your doctor to update pharmacy orders.
Free specialty medications to Aetna members enrolled in the Core PPO and Premium PPO plans can participate in PrudentRx to access select specialty medications at no cost. HDHP Plus is not eligible.
Visit Caremark.com for a full listing of covered prescriptions and pharmacy locations near you.
*If you are a resident of California and select the Kaiser medical plan, your prescription drug coverage will be provided through Kaiser.
