Premier Plan
Premier Plan
Simple copays that make it easy to get care with a low cost per paycheck.

How the plan works

Preventive care

You’ll get 100% coverage for preventive care when you use doctors in your network. Preventive care means things like annual checkups, vaccinations, mammograms and other screenings.

Simple copays

You’ll have simple copays so you can easily predict your costs. And with copays, there’s no need to meet your deductible first.

$4 for video doctor visits
$35 for primary care
$75 for specialists
$75 for urgent care

 

Other care

You’ll pay the full cost for any additional care you receive until you meet your deductible. After that, the plan pays 75% of all in-network costs and 50% of all out-of-network costs. However, the Centers of Excellence program provides 100% coverage for most serious medical procedures like spine surgery and heart surgery.

Easy, affordable prescriptions

All generic prescriptions are just $4.

Annual deductible

Your annual deductible will be $2,750 for yourself and $5,500 for yourself and your dependents.

Emergency room copay

In addition to your annual deductible, you will also have a $300 emergency room copay that will apply to out-of-pocket maximum.  Once you’ve met your annual deductible, you will only pay the $300 copay until your out-of-pocket is met. 

Total out-of-pocket costs

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

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

In these areas you’ll find network doctors with the Provider Guide website instead of Grand Rounds. Care received by an out-of-network provider is not covered except in an emergency, so expect to pay more.

 

Other benefits

$4 doctor visits
Ever wish you could see a doctor without leaving your house? With Doctor On Demand™ you can video chat with a doctor 24/7 for just a $4 copay. Simply download the app or go online to speak with a board-certified physician, licensed psychologist or psychiatrist today.
World-class care centers
For serious conditions, the Centers of Excellence program offers you and your family world-class care, often at zero cost. (limited to certain conditions).
Find the right doctor
Don’t spend all day searching the web for the right in-network doctor when Grand Rounds will do it for you. Get expert second opinions and much more at no cost. To find the best in-network doctors and specialists, just visit grandrounds.com/walmart

Important information

The Premier Plan will cost:

$29.20 per paycheck for associates

$147.70 per paycheck for associates plus their spouse/partner

$46.80 for associates plus their children

$173.30 for associates plus their family

 

The Premier Plan will cost more if you and/or your spouse/partner use tobacco products and choose not to enroll in and complete a Quit Tobacco program. The plan will also cost more for using doctors outside the network.

 

To check out all the rates for the Premier Plan, including tobacco user rates, and all costs of all our plans, please see our rate sheet.

If you are enrolled in Medicare Part D, you are not eligible to enroll in any Walmart-sponsored medical plan.

2019 HRA Plan

Here are some details about the current plan, which are still in effect until Jan. 1, 2020.

HOW IT WORKS

Walmart dollars

  • If you’re enrolled in the HRA plan, Walmart automatically credits money up front to an account to help you pay for your eligible medical expenses: $300 if you cover yourself only, or $600 if you cover dependents.
  • Because this plan will be replaced by the new Premier Plan, no more Walmart dollars will be credited.
  • If you don't use all of your HRA money by Jan 1, 2020, your available HRA balance automatically will still be available for Premier Plan copays (except emergency room) through the end of 2021.

Medical expenses

  • When you get care, eligible medical expenses (excluding prescriptions) are paid from your HRA account until all the money is spent. Payment is automatic—you don’t have to decide whether to use HRA dollars.
  • Eligible network preventive care is covered at 100 percent, even before you reach your annual deductible. Eligible out-of-network preventive care is covered at 50 percent before you reach your annual deductible.
  • Once you use all of your HRA dollars, you pay the full cost of non-preventive care yourself until you reach your annual deductible.
  • Once you meet your network annual deductible, Walmart pays 75 percent of eligible network expenses until you meet your out-of-pocket maximum.
  • Once you meet your out-of-network annual deductible, Walmart pays 50 percent of eligible out-of-network expenses.
  • Once you reach your annual network out-of-pocket maximum, Walmart pays 100 percent of your eligible network expenses. There is no lifetime maximum.

More about your HRA

  • Your HRA dollars count toward your annual deductible, and your annual deductible counts toward your out-of-pocket maximum.
  • The money in your HRA doesn't earn interest. If you leave Walmart or choose a medical plan other than the Premier Plan, you'll lose any HRA money you’ve been credited.

For complete details about the 2019 plan, including deductibles and other details, see the 2018 Associate Benefits Book with 2019 Summary of Material Modifications.

Resources