MSMA Health Insurance Program
Insurance Home
Since 1982 the
MSMA Group Insurance Trust has offered medical insurance coverage for
school districts. The program offers three different plans
designed to meet the differing individual health insurance needs of
members and their dependents. Participating school districts may offer any
or all of the three plans to their employees allowing for personal choice
for medical insurance coverage. This program is underwritten by Aetna
a national leader in health care. For retirees over the age of 65
with Medicare A&B, we offer a new PPO plan designed for their needs. Portfolio of Health Products: We offer our school district members a wide variety of
products to meet the insurance needs of their employees. Below is an
outline of products available to schools: Three Medical Plans
Point of Service:
This plan offers both a provider network benefit as well as an out of
network benefit. The in-network benefit requires the co-ordination of care
through the selection of a primary care physician. Members pay a
co-pay of $20.00 for services through their primary care physician or PCP. The
member also has the flexibility of selecting any physician regardless of
an Aetna network affiliation but will pay a deductible and
co-insurance.
HMO-1 (Flex Plan):
Under our most popular HMO plan, members select at PCP from a large
network of participating physicians and only pay $20.00 for office visits
and a flat co-pay for services such as outpatient surgeries and hospital
inpatient stays. There is no deductible to meet. The most that any
one family member would have to spend on co-pays in a calendar year is
$1500. HMO-2
(Super Value): Similar to the HMO Flex Plan, but the member would have
a $25.00 co-pay for many services and 20% co-insurance amount for services
such as outpatient surgeries and hospital in-patient stays. $2500 is
the maximum that any one family member would have to pay out of pocket in
any calendar year. Our
new PPO plan (Preferred Provider Option) offers our retirees the
flexibility of using either "preferred providers" and paying a
$20.0 co-pay, or choosing a "non-preferred provider" and having
a deductible and co-insurance to meet. Medicare will be the primary
payor with Aetna as the secondary insurer.
For Retirees Age 65 and Older with Medicare A
& B
Provider Directory
Prescription Formulary Information
Coverage Bulletins