Medical Benefits
Medical EPO
The Medical EPO provides benefits for medical treatment from in-network physicians, facilities, and pharmacies. Care received from a provider outside the EPO network is not covered under this plan, except certain office visits to receive mental health services and emergency department visits for emergency treatment. You are not required to get a referral for specialist care.
Medical PPO
The Medical PPO is a health plan that provides benefits regardless of where you receive care, in- or out-of-network. But your out-of-pocket cost will be less if you use in-network providers.
Guide PPO
The Guide PPO offers in- and out-of-network benefits, but your out-of-pocket costs will be less if you take a little extra care to use in-network medical services and providers that are associated with better health outcomes.
High-Deductible Health Plan
The High-Deductible Health Plan (HDHP) with Health Savings Account (HSA) offers a PPO-style medical plan along with the HSA that lets you build savings with before-tax payroll contributions. You can use the HSA to pay health care expenses throughout the year or roll over a balance each year and build savings for future health care expenses.
Kaiser HMO
The Kaiser HMO plan is available only to employees in California. With the Kaiser HMO, you must receive care from a Kaiser provider or facility. The plan requires you to meet an annual deductible. You will pay a copay or coinsurance for most services.
SpaceX provides eligible employees with up to 5 medical plan options (depending on where you live).
Which medical plan is right for you?
Deciding which medical plan to enroll yourself or your family in takes some thinking and planning. Ask yourself, How much medical care do I and my family use each year? Is it worth the extra coverage cost to have more flexibility in choosing health care providers, or is it more important to save on premiums? What's Important to Me?
EPO
(generally in-network only)
PPO, Guide PPO, or HDHP
(in- and out-of-network)
I want the plan that has the lowest family deductible
EPO, PPO, or
Kaiser HMO
(Kaiser available in CA only)
Prescription Drugs
The prescription drug program for SpaceX’s EPO, PPO, Guide PPO, and HDHP medical plans includes four different copay levels based on the category of drug prescribed (generic or brand) and whether or not the drug is a preferred, nonpreferred, or specialty medication. The prescription drug program for SpaceX’s HMO medical plan with Kaiser Permanente is based on two copay levels (generic and brand) within the formulary.
In all five medical plans, you can receive prescriptions you take on a regular basis (called maintenance medications) through mail order. Mail order is convenient and less expensive — the medication arrives at your door, and you can receive a larger supply for less money per dosage. Please contact your carrier for more information on mail order. Under the EPO, PPO, Guide PPO, and HDHP medical plans, if you fill a maintenance medication at a retail pharmacy, you will receive notification from Collective Health that you will need to choose mail order or retail by your third refill. Remember, mail order will cost you less.
Please note, SpaceX is partnering with CapitalRx to administer your prescription benefits effective January 1, 2025. Please find more information here.
2024
2025
Specialty Medications
Specialty medications are not covered at retail
pharmacies. Collective Health’s Member Advocates are trained to guide you through the process and partner with Express Scripts’ Specialty Pharmacy Program to ensure proper fulfillment. Specialty medications are complex and used to treat conditions such as multiple
sclerosis, cancer, HIV, and certain forms of rheumatoid arthritis. Specialty Pharmacy Programs offer a complete support program including a team of nurses, pharmacists, and care coordinators to help members taking specialty medications achieve the best possible outcomes from their treatments.
Collective Health Member Advocates are available by calling (844) 803-0209
from 4:00 am to 6:00 pm Pacific Time, Monday – Friday; 7:00 am to 11:00 am Pacific Time, Saturday.
Note: If you enroll in the Kaiser HMO, specialty
medications are distributed through your physician.
Formulary Drugs
A formulary is a list of recommended brand and generic medications. These medications have been included in the formulary based on their therapeutic value, safety, and cost.
Collective Health Member Advocates will help you understand if your medications are on the formulary. Give them a call at (844) 803-0209 from
4:00 am to 6:00 pm Pacific Time, Monday – Friday; 7:00 am to 11:00 am Pacific Time, Saturday.
Collective Health, our benefits administrator, is your one-stop shop for all of your health benefits needs. They can help you monitor your claims, find local doctors, and simply understand how your benefits work. When you're trying to understand your medical, dental, and vision benefits - they've got your back.
📞 (844) 803-0209
⏰ 4AM - 6PM PT, Monday - Friday | 7AM - 11AM PT, Saturday
The Kaiser Permanente Health Maintenance Organization (HMO) plan is available only to employees in California. If you’re interested in enrolling in the Kaiser HMO, make sure a Kaiser facility is near you as Kaiser facilities are only available in certain regions within California.
📞 (800) 464-4000
⏰ 7AM - 7PM PT, Monday - Friday | 7AM - 3PM PT, Saturday - Sunday
💻 www.kp.org
