Thomas Jefferson University

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Medical, Prescription &
Dental Benefits

Jefferson offers eligible employees the choice of two medical plans, both of which use Independence Blue Cross (IBC) provider networks.  Each is designed to meet different needs:

  1. ACO Plus Point of Service Plan – The Keystone Point of Service (POS) Plan is similar to an HMO, but provides more flexibility through 4 levels of coverage. Like an HMO, you must select a Primary Care Physician (PCP) for this plan. Click here for instructions on how to select your PCP. You will save the most money if you select a PCP within the ACO Network (www.jeffnetworks.org) and have your care provided by or referred by your ACO PCP. The plan also has a self-referred level of benefit that allows you to receive care without a referral from any provider and pay more out-of-pocket.
  2. Personal Choice PPO – The PPO allows complete freedom of choice of providers from three networks: Jefferson, JeffPLUS and IBC’s Personal Choice network, although your costs will be lower at a Jefferson or JeffPLUS facility. The plan also provides coverage at a lower level for providers who do not participate in any of these networks. PPO members share the cost of services through deductible and co-insurance. No referrals are required although some services do require pre-certifications.

The OPTUMRx prescription drug program is included with each of the above health plans. 
If you enroll, you will receive separate ID cards for each plan. 

You may review and evaluate the benefits of each plan by selecting the
comparison charts below:

2015 Jefferson POS Comparison Chart (PDF)
2015 Jefferson PPO Comparison Chart (PDF)
 

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Networks

You will have the lowest out-of-pocket costs when you use Jefferson facilities. Consult the web site for an up-to-date listing of participating providers at www.jeffnetworks.org.

Jefferson Network Hospitals:
 

POS
ACO Plus Hospitals:

  • TJUH
  • Methodist Hospital Campus, TJUH
  • Bryn Mawr Hospital
  • Bryn Mawr Rehab Hospital
  • Holy Redeemer Hospital
  • Lankenau Hospital
  • Magee Rehabilitation Hospital
  • Mirmont Treatment Center
  • Nemours/Alfred I. duPont
  • Paoli Memorial Hospital
  • Riddle Memorial Hospital

PPO
JeffPLUS “home” Hospitals:

  • TJUH
  • Methodist Hospital Campus, TJUH
  • Bryn Mawr Hospital
  • Bryn Mawr Rehab Hospital
  • Holy Redeemer Hospital
  • Lankenau Hospital
  • Magee Rehabilitation Hospital
  • Mirmont Treatment Center
  • Paoli Memorial Hospital
  • Riddle Memorial Hospital

Other Network Hospitals: out-of-pocket costs are higher than your home hospital but lower than if you use a hospital participating in the insurance company’s network:

  • Nemours/Alfred I. duPont
  • Virtua Hospitals (for inpatient stays only) at Berlin, Marlton, Memorial and Voorhees

To get the best coverage use an ACO Plus or JeffPLUS provider. Please be aware that not all physicians who practice at Jefferson facilities are in the ACO Plus or JeffPLUS networks. In the event that you receive services from a non ACO Plus or non JeffPLUS doctor your benefits will be paid as follows:

  • For physicians who participate in the insurance company’s network benefits are paid at “in-network” levels
  • For  physicians who do not participate in the insurance company’s network benefits are paid at the “out-of-network” levels

For more information, please contact the HR Service Center at (215) 503-HRSC or HRQuestions@jefferson.edu.