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MyHealth360

MyHealth360 provides a comprehensive suite of health and wellbeing benefits including: two medical plans, prescription drug, dental and vision coverage, and Flexible Spending Accounts (FSAs). If eligible, you can select one of four coverage levels: Employee Only, Employee + Child(ren), Employee + Spouse/Domestic Partner or Family.

What to know

  • Choice of medical plans—the Piedmont Choice Plan and the Piedmont Exclusive Plan
    • If you enrolled in a MyHealth360 medical plan, HRA rollover funds can continue to be used in 2023
  • Provider networks based on the medical plan you choose
  • Participate in wellbeing activities to earn points to apply towards sweepstakes

Piedmont Choice Plan

In the Piedmont Choice Plan, your bi-weekly premiums are higher than the Piedmont Exclusive Plan because we’re offering you and your family more choice when it comes to providers and where you receive care.

What about the HRA?

For eligible employees, the HRA feature of the former Piedmont Choice + HRA Plan is discontinued. If you enrolled in a MyHealth360 medical plan for 2023 and have HRA dollars remaining, you can continue to use your balance through Dec. 31 2023 to pay for eligible out-of-pocket medical, dental, vision and prescription drug expenses for yourself and your eligible family members.

Provider Networks and Directories

The level of benefits you will receive depends on where you choose to receive care. In the Piedmont Choice Plan, you can choose to receive care in any of these three networks or tiers.

You will receive high-quality care at the most affordable price possible when you use Piedmont Preferred Network (Tier One) providers and services. This includes: All Piedmont Clinic physicians, Piedmont Healthcare facilities, Piedmont-branded urgent care centers, Children’s Healthcare of Atlanta (CHOA) facilities, The Children’s Health Network (TCHN) pediatricians, Kids First Health pediatricians, Middle Georgia Pediatrics, Primary Pediatrics and others, as well as emergency care.

To locate a provider, use one of the following options:

Note: Not all physician offices located on Piedmont campuses are in the Piedmont Clinic.

You will have higher out-of-pocket costs when seeing providers or receiving services at the Tier Two level, except for select services. Providers or facilities within the Cigna OAP Network include Emory, WellStar Health Systems and others.

To locate a provider, use one of the following options:

When you select an Out-of-Network (Tier Three) provider, you will incur the highest out-of-pocket expenses. Providers and facilities are those not included in Tier One or Tier Two.

How the Piedmont Choice Plan Works

This example shows coverage using Piedmont Preferred Network (Tier One) providers:

What else should I know about the Piedmont Choice Plan?

Questions about the MyHealth360 medical plans?

If you have questions about your two medical plan options, contact Cigna at 877-601-3835 or visit mycigna.com.

Not sure which plan to choose? Scroll through these examples:

Meet William

Plan: Piedmont Exclusive Plan
Who’s Covered: Employee Only
Premium: $51.37 (full-time, bi-weekly)
Out-of-Network Coverage: Emergency Only
Deductible: $500 (Tier One: Piedmont Preferred Network)
Out-of-Pocket Maximum: $4,000 (Tier One: Piedmont Preferred Network)

Situation:

Since William’s doctor is in the Piedmont Preferred Network, the Piedmont Exclusive Plan offers lower costs across the board. William is on vacation and gets into an accident. His four-day, out-of-state hospital stay costs $900 in copays (emergencies are covered at the highest benefit level). William also needs a wheelchair for $800. He pays the $500 deductible (copays don’t count toward the deductible), and he and the plan split the remaining $300 (he pays 15% – $45).

Meet Martha

Plan: Piedmont Choice Plan
Who’s Covered: Employee + Spouse
Premium: $267.67 (full-time, bi-weekly)
Out-of-Network Coverage: Yes
Deductible: $8,550 (Tier Two: Cigna OAP Network)
Out-of-Pocket Maximum: $17,100 (Tier Two: Cigna OAP Network)
HRA: Spending down

Situation:

Martha is undergoing cancer treatment at Emory. She has seen the same doctor for two years, and she doesn’t want to switch. Martha chooses the Piedmont Choice Plan because she wants to continue receiving care from her cancer doctor, who is in the Cigna Open Access Plus (OAP) Network (Tier Two). Martha knows the HRA is going away for 2023, but she wants to make sure she can use the rest of her available HRA dollars from 2022 to help fund her treatment.

Meet Jill

Plan: Piedmont Exclusive Plan
Who’s Covered: Employee + Family
Premium: $270.06 (full-time, bi-weekly)
Out-of-Network Coverage: Emergency Only
Deductible: $1,000 (Tier One: Piedmont Preferred Network)
Out-of-Pocket Maximum: $6,850 (Tier One: Piedmont Preferred Network)

Situation:

Since the family’s doctors and pediatricians are in the Piedmont Preferred Network, the Piedmont Exclusive Plan offers lower costs across the board for Jill and her family, including most healthcare services being covered with copays.

Prescription Drugs

Prescription drug coverage through Cigna is provided automatically when you enroll in one of Piedmont’s medical plan options. The coverage for your medications is the same regardless of the medical plan you choose.

When it comes to prescriptions, there are five easy guidelines to follow:

  1. Use generic drugs when you can. Be sure to ask your physician or pharmacist if a generic substitute is available—it could save you money!
  2. Take advantage of preventive medication at no cost to you. To help you maintain a steady treatment regimen, certain preventive medicines are paid at 100% with no deductible when you visit an in-network pharmacy. This includes many diabetes, cholesterol, blood pressure and other select medication categories.
  3. When you use the broad Cigna/Express Scripts network of retail pharmacies, including Piedmont pharmacies, Oconee Drugs, Walgreens, Kroger, and Walmart retail pharmacies, you can get a 90-day supply of your medication for just two times your 30-day copay amount.
  4. Consider using Cigna’s Home Delivery Pharmacy mail-order option for your maintenance medications—for 2.5x the 30-day copay for a 90-day supply, rather than receiving refills at a retail pharmacy. Review the Home Delivery FAQs for more details.
  5. Remember to explore drug options with your physician to avoid costly name-brand and specialty drug copays that may not be necessary. If you must use brand or specialty drugs, to help offset the cost, take advantage of manufacturer coupons.

How the prescription drug deductible works:

  • You must meet a $150 (per member) annual deductible for brand-name prescriptions (preferred and non-preferred) before benefits begin.
  • This is a separate deductible from the medical plan deductible.
  • You will not need to meet this deductible for generic prescriptions.
Piedmont Direct Pharmacy

We offer life-changing specialty pharmacy services designed to simplify every aspect of your care. From obtaining financial assistance, to navigating through your insurance benefits, coordinating with providers, and managing refills, Piedmont Specialty Pharmacy patient liaisons are ready to help you and your family.

Our team can answer and address insurance-related questions and conduct prior authorizations for complex, rare and chronic medical conditions that require specialized medication therapy.

For more information, visit Piedmont Direct Pharmacy, call 833-551-2024 (Monday through Friday, 8am – 4:30pm) or email piedmontdirect@piedmont.org.

Other Benefits to Consider

Dental Coverage

Vision Coverage

Flexible Spending Accounts (FSAs)

Location Selection

Current Location:Primary

Notifications

Events