Medical Cost and Coverage
To help you make an informed choice, we have provided a series of medical charts. The charts will outline the cost and coverage of the medical plans offered to Dow retirees and eligible family members.
- MAP Plus Option 1 Low Deductible / MAP Plus Option 2 High Deductible (36K PDF)
- With the MAP Plus Option 2 High Deductible Plan, the deductible does not apply to preventive medications. Examples of preventive medications include blood pressure medication and cholesterol medication. Click here to view the 2017 Preventive Medication List.
- MA PPO Plan (44K PDF)
- Dow Old and New Plan (16K PDF)
- HMOs: Access is determined by geographic location and Medicare eligibility status
Calculating Retiree Medical Premiums
To help calculate your monthly premium if you are on the Support Schedule:
Summary Plan Descriptions (SPD's)
Please select the summary plan description (SPD) applicable to you:
- MAP Plus Option 1 and Option 2 (1MB PDF)
- Appendix A for: Option 1 Low Deductible Plan – Pre-Medicare Retirees (1MB PDF)
- Appendix A for: Option 2 High Deductible Plan (1MB PDF)
- Appendix A for: Option 1 Low Deductible Plan - Post-Medicare Retirees
- Appendix A for: Medicare Advantage Plan
- Appendix A for: Aetna Medicare Rx
- Old Plan/New Plan (291K PDF)
- Cigna - International Medical and Dental Plan (3.58MB PDF)
The SPD's for the self-funded HMO's are comprised of two parts: 1) SPD Wrapper and 2) Appendix A:
- Self-Funded HMO SPD Wrapper (540K PDF) (applies to all self-funded HMO's)
- Appendix A for: Blue Cross Blue Shield of Michigan (for Illinois) Self Funded Plan (549K PDF)
- Appendix A for: Blue Care Network (Midland/Tri-Cities Michigan) Self-Funded Plan (993K PDF)
- Appendix A for: CIGNA Self Funded HMO (396K PDF)
- Appendix A for: Health Partners Minnesota Plan (247K PDF)
- Appendix A for: Humana Self-Funded Plan (350K PDF)
The SPD's for the insured HMO's are comprised of two parts: 1) SPD Wrapper and 2) HMO publication. The SPD wrapper is at the link below. Contact your HMO or the Retiree Service Center (800-344-0661) to obtain a copy of the HMO publication, which contains coverage details.
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