ExxonMobil Medical Plan medical plan icon

The following chart compares coverage for services under the four medical plan options available.

  POS II A Option POS II B Option Aetna Select Cigna OAPIN
  In-network you pay Non-network you pay In-network you pay Non-network you pay Network only you pay Network only you pay
Annual deductible            
  • Individual
 $500 $700 $300 $400 $0 $0
  • Family
 $1,000 $1,400 $600 $800 $0 $0
Preventive Care $0 $0 $0 $0 $0 $0
  • Specialist
Office visit            
  • PCP
 $40 copay 45% $25 copay 40% $25 copay $25 copay
  • Specialist
 $60 copay 45% $40 copay 40% $40 copay $40 copay
Telemedicine $40 copay — $25 copay — $25 copay $25 copay
Urgent care $60 copay 45% $40 copay 40% $60 copay $60 copay
Emergency care $100 copay
+ 25%		 $100 copay
+ 25%		 $100 copay
+ 20%		 $100 copay
+ 20%		 $150 copay $150 copay
Inpatient care $300 deductible
+ 25%		 $600 deductible
+ 45%		 $200 deductible
+ 20%		 $400 deductible
+ 40%		 10% 10%
Outpatient care 25% after
deductible		 45% after
deductible		 20% after
deductible		 40% after
deductible		 10% 10%
Annual medical out-of-pocket maximum         (includes Rx) (includes Rx)
  • Individual
 $4,500 $18,000 $3,000 $15,000 $3,000 $3,000
  • Family
 $9,000 $36,000 $6,000 $30,000 $6,000 $6,000
Prescription drugs — Up to 34-day supply (from participating retail locations)
  • Generic
 30%
(up to $60 max)		 30%
(up to $50 max)		 $15 copay 20%
(up to $105 max)
  • Formulary brand
 30%
(up to $130 max)		 30%
(up to $125 max)		 30%
(up to $145 max)		 30%
(up to $125 max)
  • Non-Formulary brand
 50%
(up to $200 max)		 50%
(up to $200 max)		 45%
(up to $165 max)		 45%
(up to $135 max)
Prescription drugs — Up to 90-day supply (mail order or participating retail locations)
  • Generic
 25%
(up to $120 max)		 25%
(up to $100 max)		 $30 copay 20%
(up to $155 max)
  • Preferred brand
 25%
(up to $260 max)		 25%
(up to $250 max)		 30%
(up to $145 max)		 30%
(up to $175 max)
  • Non-Preferred brand
 45%
(up to $400 max)		 45%
(up to $400 max)		 45%
(up to $165 max)		 45%
(up to $200 max)
Annual prescription drug out-of-pocket maximum
  • Individual
 $2,500 $2,500 Included in the medical out-of-pocket maximum
  • Family
 $5,000 $5,000


For more detailed plan information, see the 2021 Benefits Coverage (SBC) at http://www.exxonmobilfamily.com/

What’s the difference between Network and Non-Network?
Is there a copay?
Is there a percentage?

Aetna and Cigna both negotiate with doctors, hospitals and other providers to charge less for their networks. When you choose a provider who is “in network,” it means you will pay less out of pocket.

POS II A & B: If you see a non-network provider, you will pay a higher coinsurance percentage and will have a higher out-of-pocket maximum. The Plan will only pay up to a maximum amount for each service, and you will be responsible for any outstanding balanced billed by your provider.

Aetna Select and Cigna OAPIN: You will pay the full cost for non-network services.

That’s all you pay. You don’t have to meet the deductible before the plan pays the remaining cost.

You will pay the full cost of the service until you meet your annual deductible (if applicable). Then, you’ll pay the percentage listed (also called coinsurance), and the plan generally pays the remaining cost.

Annual Deductible

The amount you must pay each year before the Plan begins to pay for covered health care expenses you use.

Out-of-Pocket Maximum

The amount of covered medical expenses you pay in one year before the Plan begins paying 100% of eligible expenses.

Preventive Care

Measures taken for disease prevention, as compared to disease treatment

Primary Care Physician (PCP) (Network Only Options)

A participating physician who supervises, coordinates and provides initial care and basic medical services as a general or family care practitioner, internist or pediatrician, to plan participants; initiates referrals for specialist care and maintains continuity of care.