Premier Plan
Simple copays and a low cost per paycheck.
Pay for doctor visits with simple copays, get lots of extras to keep you healthy, and enjoy the lowest cost of our national plans.

Our most popular plan.

Doctor_visits

Doctor visits
 

Know exactly what you’ll pay:
$35 for primary care, $75 for
specialists or urgent care.

Complete_coverage

Complete coverage
 

The plan pays 75% of all
in-network costs once you meet
your deductible for the year.

Save_time_and_money

Low costs
 

The Premier Plan gives you the lowest

cost per paycheck of all our national plans.

Preventive care

You get 100% coverage for preventive care when you see doctors in your network. Preventive care includes things like annual checkups, vaccinations, mammograms, and other routine tests to help keep you well.

Simple copays

Copays make it easy to plan for medical costs. Plus, you don’t need to meet your deductible first.

  • $0 for video doctor visits through Doctor On Demand because of COVID-19.
  • $35 for primary care
  • $75 for specialists
  • $75 for urgent care
Other care

You pay the full cost for any additional care you receive until you meet your deductible. After that, in most locations the plan pays 75% of all covered in-network costs, and 50% of all covered out-of-network costs. A few exceptions:

  • If you work in central Florida, Dallas/Fort Worth, Texas, or northwest Arkansas, see below for special features in your area.
  • The Centers of Excellence program provides 100% coverage for many serious medical procedures like spine surgery and heart surgery.
Affordable prescriptions

All generic prescriptions are just $4 at a Walmart or Sam’s Club pharmacy. You can also skip the pharmacy and get eligible prescriptions by mail. Call OptumRx at 844-705-7493 to learn more.

Annual deductible

Your annual deductible is $2,750 for yourself, or $5,500 for yourself and your dependents. This is the amount you’ll have to spend each year before the plan starts paying 75% of the cost.

Emergency room

There’s a $300 emergency room copay for ER services. You also have to meet your annual deductible before plan coverage kicks in. If you’ve already met the deductible, you’ll just pay the $300 copay.

Your total cost

The maximum amount you can spend out of pocket is $6,850 for yourself or $13,700 for yourself and your dependents. Once you reach this amount, all your in-network visits and other costs will be covered at 100%.

Rates

To get a breakdown of your costs, see our Compare Plans page.

When can I enroll?
  • During your initial enrollment period. This is when you first become eligible for benefits, and depends on your job. Check your enrollment options.
  • During Annual Enrollment, when all eligible associates can sign up or make changes.
  • When you have a status change event, like marriage or divorce, birth or adoption, or changes in your employment that affect benefits coverage. Keep in mind you can only make changes that are directly related to the event. You’ll find details in the 2020 Associate Benefits Book with 2021 Summary of Material Modifications.
  • If you’re enrolled in Medicare Part D, you’re not eligible to enroll in any Walmart-sponsored medical plan.

When it’s time, enroll online.

Do you work in central Florida, Dallas/Fort Worth, Texas, or northwest Arkansas?

 

In 2021, we’re launching pilots in three areas to connect associates with quality care in their local communities. By identifying doctors who have consistently given patients the best care, it’s easy for you to find the best doctors.

 

In central Florida and Dallas/Fort Worth our medical plans have built-in incentives to seek care from a network of preferred providers you’ll find in the Provider Guide. The amount your plan will pay for covered services varies depending on whether you choose a preferred or non-preferred doctor in your network. In central Florida, care provided by an out-of-network provider is covered at 50%, while in Dallas/Fort Worth there is no coverage except in cases of emergency.

 

 In northwest Arkansas you can still see any in-network provider in 2021. Starting in January, you’ll be able to use the Provider Guide to find highly rated doctors.

 

More resources

Need help?

Call People Services at 800-421-1362.

What’s changing for 2021?

In most areas, there are no big changes to the Premier Plan for 2021, so all the details on this page apply to your current plan except your cost for coverage. Here are the 2020 rates.

 

In central Florida and Dallas/Fort Worth, Texas there are important changes to your network coverage for 2021. Right now, your plan is different from other areas in just three ways:

  • You can find network doctors with the Provider Guide website instead of Grand Rounds.
  • In central Florida, care you receive from an out-of-network provider is covered at 50% for out-of-network providers. In Dallas/Fort Worth, out-of-network care is not covered except in an emergency, so expect to pay more.
  • The cost you pay for covered services in 2021 will depend on whether you choose preferred providers.

Contacts and related plans