Medical & Rx
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Medical Plan Options
Administered by Blue Cross Blue Shield of Texas (BCBSTX)
Neighborly’s medical plan offers multiple options so you can choose the coverage level best suited to your needs and budget.
Each of our medical plan options gives you access to the same network of high-quality medical providers and covers in-network preventive care at 100% when your care is received in a physician’s office. The rest of your health care costs depend on the plan you choose, the services you need, and where you receive your care.
Before you choose your plan, check to make sure your doctors participate in the plan’s network, if it is important to continue seeing a particular provider. To find a participating provider go to www.bcbstx.com or call BCBSTX Member Services at 800-521-2227.
Medical Overview
Our medical coverage provides you and your family the protection you need for everyday health issues or when the unexpected happens.
Neighborly offers two medical plan options through Blue Cross Blue Shield of Texas. With both plans, you’ll pay a negotiated cost for care until you meet the plan’s deductible. Then the plan will share costs with you, until you reach the plan’s out-of-pocket maximum:
- BCBS PPO Plan: You’ll pay higher premiums (or more from your paycheck) for coverage in this plan, but because its deductible is lower, the plan will start sharing costs with you sooner.
- BCBS HSA Plan: A High Deductible Health Plan (HDHP) which allows you to pay lower premiums and save pre-tax dollars for health care expenses, now or in the future, using a Health Savings Account. Generally, you pay all costs from providers up to the deductible amount before this plan begins to share your costs. In-network preventive care is fully covered before you meet your deductible.
Save When You Use an In-network Provider
You may visit any medical provider you choose, but in-network providers offer the highest level of benefits and lower out-of-pocket costs. In-network providers charge members reduced, contracted fees instead of their typical fees.
Providers outside the plan’s network set their own rates, so you may be responsible for the difference if a provider’s fees are above the Reasonable and Customary (R&C) limits. We use the nationwide Blue Cross Blue Shield of Texas (BCBSTX) provider network for all medical plan options.
To find a participating provider go to www.bcbstx.com or call BCBSTX Member Services at 800-521-2227.
Tobacco Surcharge
If you are covered under a Neighborly medical plan and are currently using tobacco when you enroll, you will pay $40 per month more for medical coverage.
You can have this surcharge removed by engaging with resources on Smokefree.gov and submitting proof (such as a screen capture) to benefits@nbly.com by the 15th of any month. The reduction in monthly medical premium contributions will be applied on the first payroll of the following month.
Medical Plan Option Comparison
| BCBS PPO Plan | BCBS HSA Plan | |||
|---|---|---|---|---|
| Coverage Type | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Annual Deductible (Ind./Fam.) | $1,500 / $3,000 | $3,000 / $6,000 | $3,500 / $7,000 | $8,000 / $16,000 |
| Annual Out-of-Pocket Max (Ind./Fam.) | $6,250 / $12,500 | $12,000 / $24,000 | $5,000 / $10,000 | $12,000 / $24,000 |
| Preventive Care | $0 | 40% after deductible | $0 | 30% after deductible |
| Regular Office Visit | $25 copay | 40% after deductible | 20% after deductible | 30% after deductible |
| Specialist Office Visit | $70 copay | 40% after deductible | 20% after deductible | 30% after deductible |
| Urgent Care | $70 copay | 40% after deductible | 20% after deductible | 30% after deductible |
| Emergency Room Visit | $350 copay | 20% after deductible | ||
| Coinsurance | 20% after deductible | 20% after deductible | ||
What You’ll Pay for Coverage*
| BCBS PPO Plan | BCBS HSA Plan | |
|---|---|---|
| Coverage Tier | Bi-Weekly | Bi-Weekly |
| Associate Only | $72.04 | $46.38 |
| Associate + Spouse/DP* | $256.13 | $184.93 |
| Associate + Child(ren) | $232.84 | $168.12 |
| Associate + Family | $392.86 | $266.97 |
*By law, if a domestic partner does not qualify as a tax dependent, the cost for their benefits cannot be paid pre-tax, and the “value” of associate and employer-provided domestic partner contributions is taxable.
Note: Tobacco user rates increase by $40 monthly for all tiers of coverage.
RXBenefits (Express Scripts) Member Services
Prescription drug coverage is provided through Express Scripts (ESI) and RxBenefits. RxBenefits Member Services representatives are available to assist you, your physician, and your pharmacy with questions about your network, prescription coverage, mail-order medications, prior authorization, and more.
Contact RxBenefits Member Services Team at 1-800-334-8134 (M-F 7am-8pm CT) or email RXHelp@rxbenefits.com.
Express Scripts Formulary Go to ExpressScripts.com
What You’ll Pay for Prescriptions
| Prescription drugs | BCBS PPO Plan | BCBS HSA Plan | |
|---|---|---|---|
| 30-day supply | 90-day mail-order | ||
| Generic | $15 | $37.50 | 20% after deductible |
| Preferred Brand | $30 | $75 | |
| Non-Preferred Brand | $60 | $150 | |
| Specialty | $120 | $300 | |
Note: The copay amounts listed above apply to drugs that are included in your plan’s formulary. To view the list of covered medications, please download the 2025 Express Scripts National Preferred Formulary List.
Telehealth with HealthJoy
Both medical plans offer free 24/7 virtual consultations with healthcare professionals. With HealthJoy, you and your enrolled family members can also search for providers, book appointments, and access additional services—all at no cost.
The HealthJoy mobile app puts healthcare guidance and support at your fingertips. This app will help you save time and money, and make the most of your Neighborly benefits. It’s at no cost to Neighborly Associates and their family members enrolled in a Neighborly medical plan!
Download and create your profile to see all your benefits displayed in HealthJoy’s benefits wallet. The app features:
- 24/7 virtual consults with a medical professional who can diagnose and even write prescription drugs
- Expert personal healthcare concierge to help with Associate benefits or healthcare questions
- Virtual provider search and appointment booking
- Medical bill review
- Prescription savings
- And much more
Preventive Care
Regular checkups, screenings, vaccines, and counseling play a vital role in staying healthy. Preventive care can help reduce your risk of disease, catch health issues early, improve quality of life, and lower long-term medical costs. Since recommendations vary based on your health and risk factors, talk to your doctor about a screening schedule that’s right for you.
GeoBlue Global
If you travel outside the United States for work, two plans can protect you while you’re abroad:
- GeoBlue Global Traveler plan: If you are on assignment outside the U.S. for up to 180 consecutive days, this plan can protect you in the event of accidental injury or illness. The coverage extends to your traveling spouse and unmarried, dependent children accompanying you, while on a business trip or business sojourn (leisure trip directly connected before, after or during a business trip).
- BlueCard Worldwide: If you’re covered under a Neighborly Medical plan with BlueCross BlueShield of Texas, this plan can reimburse you for any emergency medical services you receive outside the U.S.
Global TeleMD Traveler Registration BlueCard Worldwide Global Traveler FAQ
Tips for Saving on Your Health Care Expenses
- Use network providers. Your medical plan will cover more of the costs if you use providers who participate in the plan’s network.
- Request generic rather than brand-name prescription drugs. Generic medications, while just as effective as brand-name, are considerably less expensive.
- Exercise and maintain a proper diet. The healthier you are the less vulnerable you are to disease, reducing doctor’s visits and prescription medicines.
Reasonable Alternatives
Your health plan is committed to helping you achoeve your best health. Rewarsa for participating in a wellness program are available to all eligible employees. If you think you might be unable to meet a standard for a reward under the Neighborly wellness program, you might qualify for an opportunity to earn the same reward by different means.
Contact benefits@nbly.com and we will work with you (and if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status.