Medical coverage options

Making the right health care choices for yourself and your family is important. This includes selecting the plan that works best for you when you enroll. Remember to consider both your contributions (the amount you pay for coverage) and your out-of-pocket costs when you receive care. Start by reviewing the summary information below. Then use the online tools available through the Dow U.S. Benefits Site to compare options based on your personal situation.

In-network medical benefits

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Prescription drug coverage

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Employee contributions

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In-network medical benefits

The summary below covers in-network benefits, which are generally the most cost-effective way to receive care. Note that the Low and High Deductible Plans also provide benefits for out-of-network services, offering additional flexibility.

Coverage option

High Deductible Medical Plan (Aetna)

Low Deductible Medical Plan (Aetna)

Blue Care Network of Michigan HMO

Cigna HMO National

Availability

Nationwide

Nationwide

Michigan

Illinois, Ohio, New Jersey, Texas

Contribution amount (see details)

$

$$

$

$$

Health Savings Account (HSA) eligible (save and pay for eligible expenses tax free ― learn more)

Yes

No

No

No

What you pay for care

Preventive care

◄ Covered 100% when you use in-network providers (no deductible) ►

Office visit copays (no deductible)

Copays do not apply ― you must first meet the deductible, then pay coinsurance

Primary care: $20

Specialist: $50

Dow Family Health Center: $10

Primary care: $15

Specialist: $30

Dow Family Health Center: $10

Primary care: $20

Specialist: $35

Dow Family Health Center: $10

Telemedicine

$56 consult fee

$20 copay

Same as office visit copays

Same as office visit copays

Deductible

Individual: $2,000

Family: $4,000 (max of $3,400 for one person)

Individual: $125

Family: $250 (EE+1) ― $375 (EE+2 or more)

None

Individual: $250

Family: $500

Coinsurance (after deductible)

You pay 20%

You pay 15%

N/A

You pay 10%

Out-of-pocket maximum (includes deductible)

Individual: $4,000

Family: $8,000

Individual: 4% of base salary up to max of $10,600

Family: 8% of base salary up to max of $21,200

Individual: $6,450

Family: $12,900

Individual: $3,000

Family: $6,000

Additional details (including other benefits such as maternity, hospital, mental health and substance use, as well as out-of-network coverage, if applicable)

Review detailed carrier summary [SBCs to come]

High Deductible Medical Plan

Low Deductible Medical Plan

Blue Care Network of Michigan HMO

Cigna HMO National

Contact information and apps

aetna.com

(888) 488-4488

Apple App Store Google Play

aetna.com

(888) 488-4488

Apple App Store Google Play

bcbsm.com

(800) 662-6667

Apple App Store Google Play

cigna.com

(800) 244-6224

Apple App Store Google Play

High Deductible Medical Plan (Aetna)

  • Availability: Nationwide
  • Contribution amount (see details): $
  • Health Savings Account (HSA) eligible (save and pay for eligible expenses tax free ― learn more): Yes

What you pay for care

  • Preventive care: Covered 100% when you use in-network providers (no deductible)
  • Office visit copays (no deductible): Copays do not apply ― you must first meet the deductible, then pay coinsurance
  • Telemedicine: $56 consult fee
  • Deductible: Individual: $2,000 | Family: $4,000 (max of $3,400 for one person)
  • Coinsurance (after deductible): You pay 20%
  • Out-of-pocket maximum (includes deductible): Individual: $4,000 | Family: $8,000

Additional details (including other benefits such as maternity, hospital, mental health and substance use, as well as out-of-network coverage, if applicable)

  • Review detailed carrier summary: High Deductible Medical Plan
  • Contact information and apps: aetna.com | (888) 488-4488 | Apple App Store | Google Play

Low Deductible Medical Plan (Aetna)

  • Availability: Nationwide
  • Contribution amount (see details): $$
  • Health Savings Account (HSA) eligible (save and pay for eligible expenses tax free ― learn more): No

What you pay for care

  • Preventive care: Covered 100% when you use in-network providers (no deductible)
  • Office visit copays (no deductible): Primary care: $20 | Specialist: $50 | Dow Family Health Center: $10
  • Telemedicine: $20 copay
  • Deductible: Individual: $125 | Family: $250 (EE+1) ― $375 (EE+2 or more)
  • Coinsurance (after deductible): You pay 15%
  • Out-of-pocket maximum (includes deductible): Individual: 4% of base salary up to max of $10,600 | Family: 8% of base salary up to max of $21,200

Additional details (including other benefits such as maternity, hospital, mental health and substance use, as well as out-of-network coverage, if applicable)

  • Review detailed carrier summary: Low Deductible Medical Plan
  • Contact information and apps: aetna.com | (888) 488-4488 | Apple App Store | Google Play

Blue Care Network of Michigan HMO

  • Availability: Michigan
  • Contribution amount (see details): $
  • Health Savings Account (HSA) eligible (save and pay for eligible expenses tax free ― learn more): No

What you pay for care

  • Preventive care: Covered 100% when you use in-network providers (no deductible)
  • Office visit copays (no deductible): Primary care: $15 | Specialist: $30 | Dow Family Health Center: $10
  • Telemedicine: Same as office visit copays
  • Deductible: None
  • Coinsurance (after deductible): N/A
  • Out-of-pocket maximum (includes deductible): Individual: $6,450 | Family: $12,900

Additional details (including other benefits such as maternity, hospital, mental health and substance use, as well as out-of-network coverage, if applicable)

  • Review detailed carrier summary: Blue Care Network of Michigan HMO
  • Contact information and apps: bcbsm.com | (800) 662-6667 | Apple App Store | Google Play

Cigna HMO National

  • Availability: Illinois, Ohio, New Jersey, Texas
  • Contribution amount (see details): $$
  • Health Savings Account (HSA) eligible (save and pay for eligible expenses tax free ― learn more): No

What you pay for care

  • Preventive care: Covered 100% when you use in-network providers (no deductible)
  • Office visit copays (no deductible): Primary care: $20 | Specialist: $35 | Dow Family Health Center: $10
  • Telemedicine: Same as office visit copays
  • Deductible: Individual: $250 | Family: $500
  • Coinsurance (after deductible): You pay 10%
  • Out-of-pocket maximum (includes deductible): Individual: $3,000 | Family: $6,000

Additional details (including other benefits such as maternity, hospital, mental health and substance use, as well as out-of-network coverage, if applicable)

  • Review detailed carrier summary: Cigna HMO National
  • Contact information and apps: cigna.com | (800) 244-6224 | Apple App Store | Google Play

Prescription drug coverage

All of the medical plans include coverage for prescription medications. To help you save money, remember that generic drugs typically cost significantly less than brand-name medications while offering the same effectiveness. Additionally, using mail-order pharmacy services for maintenance medications can often lead to further savings and added convenience.

Coverage option

High Deductible Medical Plan (Aetna)

Low Deductible Medical Plan (Aetna)

Blue Care Network of Michigan HMO

Cigna HMO National

What you pay for prescriptions

Deductible

Combined with medical deductible*

Individual: $125

Family: $200 (EE+1) ― $300 (EE+2 or more)

None

None

Retail (30-day supply)

Generic

You pay 20% after deductible*

You pay 20% after deductible**

You pay $10

You pay greater of $7 or 20% (up to $100 max)

Preferred brand name on formulary

You pay 20% after deductible*

You pay 20% after deductible**

You pay $20

You pay greater of $30 or 30% (up to $100 max)

Non-preferred brand name

You pay 20% after deductible*

You pay $30% after deductible**

Not covered

You pay greater of $50 or 40% (up to $100 max)

Dow Family Health Center (certain available and covered prescriptions only)

You pay $2 after deductible*

You pay $2**

You pay $2

You pay $2

Mail order (90-day supply)

Generic

You pay 20% after deductible*

You pay 20% (no deductible)**

You pay $20

You pay greater of $16 or 20% (up to $200 max)

Preferred brand name on formulary

You pay 20% after deductible*

You pay 20% (no deductible)**

You pay $40

You pay greater of $85 or 30% (up to $200 max)

Non-preferred brand name

You pay 20% after deductible*

You pay 30% (no deductible)**

Not covered

You pay greater of $145 or 40% (up to $200 max)

* You pay 20% with no deductible for certain preventive medications. If a generic drug is available, you are responsible for the generic coinsurance plus the difference in cost between the brand-name and generic drug, plus any deductible. Certain drugs require pre-certification and/or step therapy.

** If a generic drug is available, you are responsible for the generic coinsurance plus the difference in cost between the brand-name and generic drug, plus any deductible. After an initial retail prescription and two refills, coinsurance will go up to 50% unless you use mail order. This does not apply to your out-of-pocket maximum. Certain drugs require pre-certification and/or step therapy. Specialty drug cost sharing differs.

High Deductible Medical Plan (Aetna)

What you pay for prescriptions

  • Deductible: Combined with medical deductible*
  • Retail (30-day supply):
  • Generic: You pay 20% after deductible*
  • Preferred brand name on formulary: You pay 20% after deductible*
  • Non-preferred brand name: You pay 20% after deductible*
  • Dow Family Health Center (certain available and covered prescriptions only): You pay $2 after deductible*
  • Mail order (90-day supply):
  • Generic: You pay 20% after deductible*
  • Preferred brand name on formulary: You pay 20% after deductible*
  • Non-preferred brand name: You pay 20% after deductible*

Low Deductible Medical Plan (Aetna)

What you pay for prescriptions

  • Deductible: Individual: $125 | Family: $200 (EE+1) ― $300 (EE+2 or more)
  • Retail (30-day supply):
  • Generic: You pay 20% after deductible**
  • Preferred brand name on formulary: You pay 20% after deductible**
  • Non-preferred brand name: You pay $30% after deductible**
  • Dow Family Health Center (certain available and covered prescriptions only): You pay $2**
  • Mail order (90-day supply):
  • Generic: You pay 20% (no deductible)**
  • Preferred brand name on formulary: You pay 20% (no deductible)**
  • Non-preferred brand name: You pay 30% (no deductible)**

Blue Care Network of Michigan HMO

What you pay for prescriptions

  • Deductible: None
  • Retail (30-day supply):
  • Generic: You pay $10
  • Preferred brand name on formulary: You pay $20
  • Non-preferred brand name: Not covered
  • Dow Family Health Center (certain available and covered prescriptions only): You pay $2
  • Mail order (90-day supply):
  • Generic: You pay $20
  • Preferred brand name on formulary: You pay $40
  • Non-preferred brand name: Not covered

Cigna HMO National

What you pay for prescriptions

  • Deductible: None
  • Retail (30-day supply):
  • Generic: You pay greater of $7 or 20% (up to $100 max)
  • Preferred brand name on formulary: You pay greater of $30 or 30% (up to $100 max)
  • Non-preferred brand name: You pay greater of $50 or 40% (up to $100 max)
  • Dow Family Health Center (certain available and covered prescriptions only): You pay $2
  • Mail order (90-day supply):
  • Generic: You pay greater of $16 or 20% (up to $200 max)
  • Preferred brand name on formulary: You pay greater of $85 or 30% (up to $200 max)
  • Non-preferred brand name: You pay greater of $145 or 40% (up to $200 max)

Employee contributions (per pay period amounts for 2026)

The amount you pay to have medical coverage depends on a number of factors, including the coverage tier you elect, your tobacco use and your employment status ― full-time vs. less than full-time (LTFT). Per pay period contributions are shown in the table below. [2025 monthly rates shown; to be updated with 2026 per pay period amounts]

High Deductible Medical Plan (Aetna)
Low Deductible Medical Plan (Aetna)
Blue Care Network of Michigan HMO
Cigna HMO National
Employee Only
  • Full time
  • LTFT: 30-39 hours
  • LTFT: 20-29 hours

No tobacco / Tobacco

  • $43 / $93
  • $120 / $170
  • $241 / $291

No tobacco / Tobacco

  • $173 / $223
  • $228 / $278
  • $457 / $507

No tobacco / Tobacco

  • $100 / $150
  • $192 / $242
  • $384 / $434

No tobacco / Tobacco

  • $318 / $368
  • $349 / $399
  • $530 / $580

Employee + Spouse/ Domestic Partner (DP)

  • Full time
  • LTFT: 30 - 39 hours
  • LTFT: 20 - 29 hours

No tobacco / Tobacco

  • $100 / $150
  • $241 / $291
  • $483 / $533

No tobacco / Tobacco

  • $397 / $447
  • $457 / $507
  • $914 / $964

No tobacco / Tobacco

  • $230 / $280
  • $384 / $434
  • $769 / $819

No tobacco / Tobacco

  • $730 / $780
  • $803 / $853
  • $1,060 / $1,110

Employee + Child(ren)

  • Full time
  • LTFT: 30 - 39 hours
  • LTFT: 20 - 29 hours

No tobacco / Tobacco

  • $85 / $135
  • $207 / $257
  • $415 / $465

No tobacco / Tobacco

  • $341 / $391
  • $393 / $443
  • $786 / $836

No tobacco / Tobacco

  • $197 / $247
  • $330 / $380
  • $661 / $711

No tobacco / Tobacco

  • $627 / $677
  • $689 / $739
  • $911 / $961

Employee + Spouse/ DP + Child(ren)

  • Full time
  • LTFT: 30 - 39 hours
  • LTFT: 20 - 29 hours

No tobacco / Tobacco

  • $146 / $196
  • $356 / $406
  • $713 / $763

No tobacco / Tobacco

  • $584 / $634
  • $674 / $724
  • $1,348 / $1,398

No tobacco / Tobacco

  • $338 / $388
  • $567 / $617
  • $1,134 / $1,184

No tobacco / Tobacco

  • $1,075 / $1,125
  • $1,182 / $1,232
  • $1,563 / $1,613

The brief summaries of benefits in this communication are not intended to be complete descriptions of each of the respective benefit plans. If there are discrepancies between (a) information in this communication and any oral or written representations made by anyone regarding a plan and (b) the Summary Plan Descriptions (SPD) and other legal documents of any of the plans, the SPD and other legal documents will govern. Dow reserves the right to amend, modify, and terminate the plans described in this communication at any time in its sole discretion.

Content Steward: Dow North America Benefits | (833) 693-6947 (MYDOWHR)

October 2025