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Plan Coverage

Locate information about your SmartHealth plan including dental and vision coverage, pharmacy benefits, plan documents, and spending accounts

Understanding my Coverage

Insurance Information

Member Resources

Welcome to Member Resources. You can access everything you need as a Member and explore the full SmartHealth experience to make the most of your plan.

Featured Resources

Additional Benefits

Find A Doctor

Use the Find a Doctor search tool to locate in-network SmartHealth providers and locations near you.

Things to remember before visiting a provider:

1. Make sure your provider, referred doctor or specialist is part of the Tier 1 network or you may pay more out-of-pocket.

2. If you are being referred for lab services, make sure your lab is part of the Tier 1 network or you could pay more out of pocket.

Search for Care

More Options

Feature	High Deductible Health Plan (HDHP)	Preferred Provider Organization (PPO)
2025 Co-pays Deductible Out-of-Pocket Maximum	NO $2,500 15% $4,500	Some health services $1,000 20% $4,500
Example: $150 office visit $250 lab tests	What you pay: $150 for office visit $250 for lab tests Total = $400 Remaining deductible: $2,100 to meet deductible	What you pay: $30 office visit copay $250 lab tests Total = $280 Remaining deductible: $750 & OOP: $4,220
Example: $2,500 outpatient surgery	What you pay: $2,100 to meet your deductible The rest is 15% coinsurance ($400 X 15% = $60) Total = $2,160 Remaining deductible: $0 & OOP: $1,940	What you pay: $750 to meet your deductible The rest is 20% coinsurance ($1,750 X 20% = $350) Total= $1,100 Remaining deductible: $0 & OOP: $3,120
Example: $250 physical therapy $175 generic Rx	What you pay: $250 x 15% = $37.50 for PT $25 Rx copay Total= $62.50 Remaining deductible: $0 & OOP: $1,877.50	What you pay: $250 x 20% = $50 for PT $25 Rx copay Total= $75 Remaining deductible: $0 & OOP: $3,045
Total Cost:	$2,622.50	$1,455.00
	Your out-of-pocket cost is $2,622.50. Ascension contributes $500 to HSA, reducing cost to $2,122.50. When you add biweekly premiums for associate-only coverage (Band 1) for the year, your total cost is $3,173.44. Important Considerations: To receive Ascension contributions, you must contribute at least $26 per year. Contributions from Ascension are typically deposited in equal installments throughout the year. You'll pay an Rx copay or coinsurance after your deductible is met. All other health services are subject to coinsurance until you reach your out-of-pocket maximum. HDHP typically has lower biweekly premiums. Your savings can be contributed to your HSA to cover your out-of-pocket costs.	Your out-of-pocket cost is $1,455. When you add biweekly premiums for associate-only coverage (Band 1), your total cost is $2,476.80. Important Considerations: Copays only count toward your out-of-pocket maximum and don’t count toward your deductible. PPO typically has higher biweekly premiums, but you benefit from lower, more predictable expenses when you seek care for office visits, ER visits, and urgent care. This example pertains to associate-only coverage and services within the Ascension Network (Tier 1), and assumes you will fill your prescription at an Ascension Rx pharmacy.