Medical
Rakuten International offers different medical plans for different needs and budgets. Here are some considerations when selecting the right medical plan for you and your family:
High Deductible Health Plan (HDHP)
Plan Option: Aetna HDHP
Consider an HDHP if:
- You want to be able to see any provider, even a specialist, without a High Deductible Health Plan referral
- You want to reduce your healthcare payroll deductions
- You are willing to pay more to see out-of-network providers
- You want tax-free savings on your healthcare costs
- You want to build a savings account for future healthcare costs for you and your eligible family members
Preferred Provider Option (PPO)
Plan Option: Aetna PPO
Consider a PPO if:
- You want to be able to see any provider, even a specialist, without a referral
- You are willing to pay more to see out-of-network providers
Health Maintenance Organization (HMO)
Plan Option: Kaiser HMO (CA)
Consider an HMO if:
- You want lower, predictable out-of-pocket costs
- You like having one doctor to manage your care
- You are happy with the selection of network providers
- You don’t see any doctors that are out-of-network
- You have convenient access to Kaiser facilities
To get started: visit Aetna’s or Kaiser’s website to register or download the app via the Apple App Store (Aetna, Kaiser) or Google Play Store (Aetna, Kaiser).
For information on how to contact each vendor, download the vendor app, navigate to the carrier’s website, or click Plan Contacts.
Aetna HDHP
Benefit Highlights
In-Network
Deductible (Individual/Individual Family/Family)
$2,500/$3,400/$5,000
Out-of-Pocket Max (Individual/Family)
$4,000 per individual, up to $8,000 per family
Preventive Care
$0 (deductible waived)
Primary Care Visit
10% after deductible
Specialist Visit
10% after deductible
Urgent Care
10% after deductible
Emergency Room
You pay 10% after deductible
Retail Rx (Up to 30-Day Supply)
Generic
$10 copay after deductible
Preferred Brand
$35 copay after deductible
Non-Preferred Brand
$50 copay after deductible
Mail-Order Rx (Up to 90-Day Supply)
Generic
$20 copay after deductible
Preferred Brand
$70 copay after deductible
Non-Preferred Brand
$100 copay after deductible
Out-of-Network
Deductible (Individual/Family)
$5,000/$10,000
Out-of-Pocket Max (Individual/Family)
$8,000/$16,000
Preventive Care
30% after deductible
Primary Care Visit
30% after deductible
Specialist Visit
30% after deductible
Urgent Care
30% after deductible
Emergency Room
10% after deductible
Retail Rx (Up to 30-Day Supply)
Generic
40% after applicable deductible and copay
Preferred Brand
40% after applicable deductible and copay
Non-Preferred Brand
40% after applicable deductible and copay
Retail Rx (Up to 90-Day Supply)
Generic
Not covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Per Pay Period Plan Cost
Employee Only: $25.00
Employee and Spouse/DP: $90.00
Employee and Child(ren): $75.00
Employee and Family: $145.00
Aetna PPO
Benefit Highlights
In-Network
Deductible (Individual/Family)
$500 per individual, up to $1,000 per family
Out-of-Pocket Max (Individual/Family)
$3,000 per individual, up to $6,000 per family
Preventive Care
$0 (deductible waived)
Primary Care Visit
$30 copay (deductible waived)
Specialist Visit
$50 copay (deductible waived)
Urgent Care
$35 copay (deductible waived)
Emergency Room
$150 copay plus 10% (deductible waived; copay waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$35 copay
Non-Preferred Brand
$50 copay
Mail-Order Rx (Up to 30-Day Supply)
Generic
$20 copay
Preferred Brand
$70 copay
Non-Preferred Brand
$100 copay
Out-of-Network
Deductible (Individual/Family)
$500 per individual, up to $1,000 per family
Out-of-Pocket Max (Individual/Family)
$6,000 per individual, up to $12,000 per family
Preventive Care
30% after deductible
Primary Care Visit
30% after deductible
Specialist Visit
30% after deductible
Urgent Care
30% after deductible
Emergency Room
$100 copay plus 10% (deductible waived; copay waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
30% after applicable deductible and copay
Preferred Brand
30% after applicable deductible and copay
Non-Preferred Brand
30% after applicable deductible and copay
Aetna PPO Mail-Order Rx
Generic
Not covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Per Pay Period Plan Cost
Employee Only: $85.00
Employee and Spouse/DP: $245.00
Employee and Child(ren): $205.00
Employee and Family: $370.00
Kaiser HMO (CA)
Benefit Highlights
In-Network Only
Deductible (Individual/Family)
$0
Out-of-Pocket Max (Individual/Family)
$1,500/$3,000
Preventive Care
$0
Primary Care Visit
$30 copay
Specialist Visit
$30 copay
Urgent Care
$30 copay
Emergency Room
$75 copay
Retail Rx (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$30 copay
Non-Preferred Brand
$30 copay
Mail-Order Rx (Up to 100-Day Supply)
Generic
$20 copay
Preferred Brand
$60 copay
Non-Preferred Brand
$60 copay
Per Pay Period Plan Cost
Employee Only: $90.00
Employee and Spouse/DP: $255.00
Employee and Child(ren): $200.00
Employee and Family: $320.00