Prescription – T-Mobile Employee Benefits Site

Common Misconceptions Videos

Explore these quick videos to uncover the truth behind common benefits misconceptions and make more informed coverage decisions.
Note: To watch any of the videos in full-screen mode, double-click the video thumbnail.

Money on the Table

What You're Missing by Skipping Supplemental Health Plans

Buffet of Services

You're Already Paying for Your Health Plan–Here's How to Use It

Don't Wait for a Breakdown

Your Plan Covers More Than Just Being Sick

The Umbrella Effect

The Most Expensive Plan isn't Always the Best Fit

Virtual Care Delivers

Why the ER Isn't Always Your Best Option

Get to Know Your Health Plan Options

Every health plan offers something different. We’ve created a series of short videos to break down your options, explain important features, and help you feel more informed when choosing your coverage. Note: To watch any of the videos in full-screen mode, double-click the video thumbnail.

Surest

Know the Price Before You Walk In

PPO with Health Reimbursement Account

Freedom to Choose

High Deductible Health Plan with HSA

Built for the Long Game

EPO Plan

Predictable Costs, Strong Protection

Supplemental Health Plans

The Extra Layer of Protection

EPO Plan

Lower Deductible with In-Network-Only Coverage

The EPO Plan offers the lowest deductible and lowest out-of-pocket maximum of the available medical plans. In exchange, coverage for non-emergency care is limited to providers within the plan's network.

May Be Right for You If

You typically use in-network providers.
You want a lower deductible.
You don't expect to need out-of-network coverage.

At a Glance

Medical deductible: $750 individual / $1,500 enrolled dependents
T-Mobile funding: Not applicable
Out-of-pocket maximum: $3,750 individual / $7,500 enrolled dependents
How you pay: Copays or coinsurance
Out-of-network coverage: No, except for emergency care
Preventive care: Free

High Deductible Health Plan with Health Savings Account (HSA)

Tax-Advantaged Savings for Healthcare Expenses

The HSA Plan pairs a high-deductible medical plan with a Health Savings Account that you can use for eligible healthcare expenses today or save for the future. Because most non-preventive services are subject to the deductible, you'll typically pay more upfront before the plan begins sharing costs.

May Be Right for You If

You want to take advantage of HSA tax savings.
You'd like to build healthcare savings for future expenses.
You're comfortable taking on more responsibility for managing healthcare costs.

At a Glance

Medical deductible: $2,250 individual / $4,500 enrolled dependents.
T-Mobile funding: Up to $500 individual / $1,000 enrolled dependents.
Out-of-pocket maximum: $4,250 individual / $8,500 enrolled dependents.
How you pay: Pay the deductible first, then 20% in-network coinsurance.
Out-of-network coverage: Included.

PPO Plan with Health Reimbursement Account (HRA)

Employer-Funded Help with Healthcare Costs

The PPO with HRA combines broad provider choice with employer-funded account dollars that can help pay eligible healthcare expenses. You'll still have a deductible and coinsurance, but T-Mobile funding can help offset some of those costs.

May Be Right for You If

You want flexibility to use in-network or out-of-network providers.
You'd like T-Mobile funding to help offset healthcare expenses.
You prefer a traditional health plan with copays for common office visits.

At a Glance

Medical deductible: $2,250 individual / $4,500 enrolled dependents.
T-Mobile funding: Up to $500 individual / $1,000 enrolled dependents.
Out-of-pocket maximum: $4,250 individual / $8,500 enrolled dependents.
How you pay: Copays or coinsurance.
Out-of-network coverage: Included.

Surest Copay Only Plan

Simple, Predictable Costs for Care

With Surest, you'll generally pay a set copay for covered services instead of meeting a deductible before coverage begins. You'll know what you'll pay before receiving care, though the plan has a higher out-of-pocket maximum than the other medical plan options.

May Be Right for You If

You prefer predictable healthcare costs.
You want to know the cost of care upfront.
You don't want to manage deductibles and coinsurance.

At a Glance

Medical deductible: $0.
T-Mobile funding: Not applicable.
Out-of-pocket maximum: $6,500 individual / $13,000 enrolled dependents.
How you pay: Fixed copays for covered services.
Out-of-network coverage: Emergencies only.

Prescription Plan Comparison

Prescription Plans	Surest Copay Only	PPO Plan with Health Reimbursement Account (HRA Plan)	Exclusive Provider Organization (EPO Plan)	High Deductible Health Plan with Health Savings Account (HSA Plan)
Tier 1 (30 days)	$10 copay	10% ($5 copay min.-$20 copay max.)	$10 copay	Plan pays 80% after deductible
Tier 2 (30 days)	$75 copay	20% ($25 copay min.-$55 copay max.)	$35 copay	Plan pays 80% after deductible
Tier 3 (30 days)	$200 copay	30% ($45 copay min.-$80 copay max.)	$60 copay	Plan pays 80% after deductible
Mail Order/Retail (90 days)	2x monthly rate	2x monthly rate	2x monthly rate	Plan pays 80% after deductible
Preventive Medications	Subject to normal copay	Many are free	Subject to normal copay	Many are free
Weight loss Medications (anti-obesity and anorexiants)	2027: $100 copay max 2026: $55 copay max	2027: $100 copay max 2026: $55 copay max	2027: $100 copay max 2026: $55 copay max	Plan pays 80% after deductible
*The other differences are that in the HRA and HSA Plans, a robust list of preventive medications are FREE. You can review the covered preventive prescriptions and others, as well as costs at info.caremark.com/oe/t-mobile.

HMSA Bi-Weekly Employee Contributions for Dental and Vision Plans

Coverage Election	Dental				Vision
	PPO Network		Open Network		Vision
	Employee	Employer	Employee	Employer	Employee	Employer
Employee Only	$6.00	$7.31	$17.00	$6.95	$3.50	$0.00
Employee plus Spouse	$12.00	$12.62	$31.00	$13.31	$6.00	$0.00
Employee plus Children	$14.00	$15.28	$37.00	$15.69	$6.00	$0.00
Employee plus Family	$20.00	$20.59	$52.00	$21.05	$9.50	$0.00
Domestic Partner¹	$6.00	$5.31	$14.00	$6.36	$2.50	$0.00
Domestic Partner Child¹	$8.00	$7.97	$20.00	$8.74	$2.50	$0.00
¹Domestic Partner deductions are taken on a post-tax basis, and employee pays tax on the employer portion of the contribution.

2027 Health Plan Costs

Coverage Election	Surest Copay Only Plan	PPO Plan with Health Reimbursement Account	Exclusive Provider Organization (EPO) Plan	High Deductible Health Plan with Health Savings Account (HSA)
Employee	$10.25	$52.88-$100	$108.39-$162	$44.97-$91
Employee + Spouse	$36	$121.28-$216	$232.28-$340	$105.45-$198
Employee + Children	$26	$104.12-$189	$202.64-$300	$90.21-$174
Employee + Family	$42	$163.05-$304	$336.39-$498	$137.53-$275
Additional Working Partner Premium	$46.15	$46.15	$46.15	$46.15

Explore Your Benefits

The following benefits are only available during Open Enrollment, New Hire Enrollment, or if you have a mid-year qualifying event.

A T-Mobile employee taking a selfie in front of a gray T-Mobile decorated wall.

Dental Insurance

Explore two dental plan options offering the same benefits with different levels of flexibility and cost.

Learn More

Vision Insurance

Review vision coverage to cover eye exams and glasses or contact lenses.

Learn More

Two T-Mobile employees taking a selfie in front of a pink T-Mobile sign on a gray wall.

Healthcare FSA

Set aside tax-free money through payroll deductions to help cover eligible healthcare expenses.

Learn More

Two children in pink vests on a soccer field, one holding a ball, with others playing in the background.

Childcare Subsidy

Get help covering eligible childcare expenses with monthly employer-funded contributions based on your annual pay.

Learn More

A parent and child wearing heart-shaped glasses, sitting together and smiling indoors.

Dependent Care FSA

Set aside pretax money through payroll deductions to help cover eligible dependent care expenses.

Learn More

Commuter Program

Save on eligible transit and parking expenses by setting aside pretax money through convenient payroll deductions.

Learn More

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Disability Insurance

Protect your income with short- and long-term disability benefits if an illness or injury prevents you from working.

Learn More

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Life Insurance & AD&D

Protect your loved ones with company-provided life and AD&D insurance, plus options to purchase additional coverage.

Learn More

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Legal Insurance

Get affordable access to legal support for common needs, including family matters, estate planning, and more.

Learn More

Other Benefits

Take advantage of additional benefits and explore programs, services, and discounts designed to support you and your family at work and at home. The benefits below do not require open enrollment, so you can access them throughout the year. Click the links below to learn more about each program and the resources available to you.

Medical Updates for Hawaii Employees

HMSA HMO and PPO:

Prescription Drug Benefits: The annual copayment maximum for prescription drugs and supplies will change from $3,600 per person/$4,200 (maximum) per family to $5,000 per person/$7,500 (maximum) per family.
Covered Immunizations: Updates have been made to reflect current healthcare advancements, ensuring coverage of modern vaccines. Covered immunizations can be found at hmsa.com.
Non-Formulary Exceptions: If a drug outside of the formulary is approved, Tier 3 benefits apply for non-specialty drugs and Tier 5 benefits apply for specialty drugs.

HMSA Health Plan Hawaii Plus (HMO):

Annual Physical Exam: Coverage for an Annual Physical Exam (previously Annual Preventive Health Evaluation) includes one preventive visit per calendar year for ages 22+ and optional blood count and comprehensive metabolic panel screening tests. An exam from a network provider is covered at 100% of eligible charges, with no copayment.
Maternity Care: Delivery services from network providers will be covered at 100% of eligible charges, with no copayment.
Covered Immunizations: Updates have been made to reflect current healthcare advancements, ensuring coverage of modern vaccines. Covered immunizations can be found at hmsa.com.

HMSA Preferred Provider Plan (PPO):

Annual Physical Exam: Coverage for an Annual Physical Exam (previously Annual Preventive Health Evaluation) includes one preventive visit per calendar year for ages 22+ and optional blood count and comprehensive metabolic panel screening tests. An exam from a network provider is covered at 100% of eligible charges, with no copayment.
Maternity Care: Routine prenatal visits, delivery, and postpartum visits from participating providers will be covered at 100% of eligible charges, with no copayment. Postpartum visits will no longer be limited.
Cutting and Non-cutting Surgery: benefits will be combined into one surgery benefit with the same coverage as current Cutting Surgery benefits.
Urgent Care Visits: Urgent care visits will be separated from the physician visits benefit. The copayment at participating urgent care centers will change to $17.
Covered Immunizations: Updates have been made to reflect current healthcare advancements, ensuring coverage of modern vaccines. Covered immunizations can be found at hmsa.com.

Explore What's New and Changing for T-Mobile Benefits in 2027

New Lyra Support for You and Your Family

New Lyra enhancements give you and your family even more support:

Neurodiversity Center of Excellence

Specialized support for employees and families navigating neurodiverse needs, including neuropsychological evaluations; expert care for ADHD, autism, and more; parent and caregiver training; end-to-end support; tailored self-care resources; and medication management.*

For HSA-qualified HDHP households, neuropsychological evaluations must go through the T-Mobile medical plan.

*Medical plan enrollment is required for medication management.

Pediatric Mental Health Center of Excellence

Enhancements to all Aflac Plans

All Aflac Supplemental Health Plans have been enhanced to provide improved coverage at lower rates.

Aflac Accident

Aflac Hospital Indemnity

Aflac Critical Illness

Enhanced Virtual Musculoskeletal Care Benefit

Beginning Jan. 1, 2027, the virtual musculoskeletal care benefit, available to employees and covered dependents enrolled in Premera, UHC, and Surest medical plans, will have a new and improved experience through Hinge Health.

Hinge Health’s customized program is available at no additional cost and includes personalized exercise therapy, expert coaching, and motion-tracking technology to help prevent and relieve back, neck, joint, and muscle pain, all through a convenient mobile app.

Enhanced Decision-Making Tool

Enhancements to the decision support tool within the enrollment experience can help make choosing coverage for you and your family easier. Employees can now import claims data* from the previous year and receive personalized medical plan matches based on healthcare usage, anticipated costs, and individual coverage needs.

*Please note: This feature may not be available if you have fewer than 12 months of claims history under a T-Mobile medical plan.

Expanded Family-Building and Maternity Support

As part of our commitment to supporting employees and their families, T-mobile is enhancing the Pregnancy and Postpartum Support Program through Progyny.

Beginning Jan. 1, 2027: Eligible employees and family members can choose a Progyny network doula, with costs fully covered through the program and no need to pay out of pocket and seek reimbursement. Alternatively, the option to choose an out-of-network doula through the reimbursement process, is still available.

New LightCare Vision Benefit

Employees enrolled in a T-Mobile vision plan and covered dependents can now use their frame and lens benefit toward ready-made non-prescription sunglasses or blue-light filtering glasses in place of prescription eyewear.

Cost Per Pay Period Is Changing

For 2027, T-Mobile will continue to cover the majority of healthcare costs to help keep your contributions as low as possible. However, there will be an increase in per pay period costs for all medical plans except Surest. Review the impact to your plan when you log in to enroll at t-mobilebenefits.com.

Weight Loss Medication Cost Increase

Weight loss medications, including GLP-1s used to treat related underlying conditions, will have higher out-of-pocket costs. For most plans, you’ll pay up to $100 per month, per prescription. HSA members are subject to deductible and coinsurance requirements. GLP-1s used to treat diabetes will not have any cost changes.

Select Voluntary Benefits Now Available Through the Enrollment Experience

The MetLife Legal Plan and Aflac Supplemental Health Plans are now integrated into the enrollment experience. You can now enroll in these benefits directly through t-mobilebenefits.com without visiting a separate website.

New Health Savings Account (HSA) Limits Are Increasing

The annual HSA contribution limit is increasing to $4,500 for individuals and $9,000 for families.

Hawaii Medical Plan Changes

Employees enrolled in HMSA plans will see several plan updates for 2027, including changes to prescription drug benefits, maternity care coverage, preventive care benefits, immunization coverage, and other plan-specific provisions. See the Hawaii Medical Plans section for complete details.

What’s Not Changing for 2027:

Medical deductibles
Out-of-pocket maximums
Co-pays for office visits, ER, and most services
Prescription drug copays (except GLP-1 weight loss)
Plan options and carriers (Surest, HSA, HRA, EPO, Premera, UHC)
Fertility benefits (Progyny), mental health, and wellbeing programs
Dependent coverage and subsidy philosophy
401(k) match, childcare subsidy, tuition assistance, and all other non-medical benefits

To view complete plan details and changes, click the Learn More button below.

Learn More

2026 Health Plan Costs

Coverage Election	Surest Copay Only Plan	PPO Plan with Health Reimbursement Account	Exclusive Provider Organization (EPO) Plan	High Deductible Health Plan with Health Savings Account (HSA)
Employee	$10.25	$48.62-$91	$98.57-$147	$41.50-$83
Employee + Spouse	$36	$112.75-$198	$212.65-$310	$98.50-$182
Employee + Children	$26	$96.31-$173	$184.97-$272	$83.78-$159
Employee + Family	$42	$150.94-$278	$306.94-$453	$127.97-$252
Additional Working Partner Premium	$46.15	$46.15	$46.15	$46.15
If you have a domestic partner or child of your domestic partner enrolled on the medical plan, the amount T-Mobile pays for your domestic partner/child of domestic partner coverage is added to your paycheck as taxable income because the IRS does not consider either to be a tax dependent. For additional information, please log in to your account at www.t-mobilebenefits.com/login.

Medical Plan Comparisons

Medical Plans	Surest Copay Only	PPO Plan with Health Reimbursement Account (HRA Plan)	High Deductible Health Plan with Health Savings Account (HSA Plan)	Exclusive Provider Organization (EPO Plan)
Calendar Year Deductible
Individual	$0	$2,250	$2,250	$750
Enrolled dependents	$0	$4,500	$4,500	$1,500
T-Mobile Account Funding (coverage on Jan 1)
Individual	N/A	$500*	$500**	N/A
Enrolled dependents	N/A	$1,000*	$1,000**	N/A
T-Mobile Account Funding (coverage Feb 1 or after)
Individual	N/A	$41.66/month*	$19.23/pay period**	N/A
Enrolled dependents	N/A	$83.33/month*	$38.46/pay period***	N/A
Out-of-Pocket Max (includes the deductibles)
Individual	$6,500	$4,250	$4,250	$3,750
Enrolled dependents	$13,000	$8,500	$8,500***	$7,500
Coinsurance (starts after deductible is met)	N/A	80% in-network, 60% out-of-network up to R&C	80% in-network, 60% out-of-network up to R&C	80% in-network only, NO coverage out-of-network
Office Visits
Preventive	FREE	FREE	FREE	FREE
In-person primary care physician (or a virtual care physician, if available)	$25-$130	$35	Deductible + coinsurance	$20
24/7 virtual medical care with a designated provider in the following networks: Premera Blue Cross enrollees: Doctor on Demand and 98point6 UHC enrollees: Teladoc, Optum Virtual Care, Walmart Health Virtual Care, Amwell, Doctor on Demand Surest enrollees: Amwell, Doctor on Demand, Alma, Talkspace	FREE	FREE	Deductible + coinsurance	FREE
In-person specialist	$25-$130	$50	Deductible + coinsurance	$30
In-person behavioral health visit with a licensed therapist	$25-$130	$35 (in or out of network)	Deductible + coinsurance	$20
Virtual behavioral health care with licensed psychiatrists or therapists in the following networks: Premera Blue Cross enrollees: Doctor on Demand and Talkspace UHC enrollees: Amwell, Doctor on Demand and Talkspace	$0-$130	$35	Deductible + coinsurance	$20
Emergency room	$600 copay	$200 copay, then 80% after deductible (copay waived if admitted)	80% after deductible	$200 copay, then 80% after deductible (copay waived if admitted)
To view cost estimate comparisons for how much you might spend out of pocket for certain services under each plan, click here. Entire T-Mobile funding is available first day of coverage. Any balance rolls over to the next year, up to $6,000 as long as you remain in the plan. T-Mobile contributions are prorated and funded by the Friday following each pay date. Any funds in your HSA are yours to keep, even if you leave T-Mobile. **The High Deductible Health Plan with HSA Plan features a true family deductible. The family deductible is two times the individual deductible and requires that the entire family deductible is met before paying 80% of covered charges. Please note that the out-of-pocket maximum works the same way.

Prescription Plan Comparison

Prescription Plans	Surest Copay Only	PPO Plan with Health Reimbursement Account (HRA Plan)	High Deductible Health Plan with Health Savings Account (HSA Plan)	Exclusive Provider Organization (EPO Plan)
Prescription Drugs
Tier 1 (30 days)	$10 copay	10% ($5 copay min.-$20 copay max.)	Plan pays 80% after deductible	$10 copay
Tier 2 (30 days)	$75 copay	20% ($25 copay min.-$55 copay max.)	Plan pays 80% after deductible	$35 copay
Tier 3 (30 days)	$200 copay	30% ($45 copay min.-$80 copay max.)	Plan pays 80% after deductible	$60 copay
Mail Order/Retail (90 days)	2x monthly rate	2x monthly rate	Plan pays 80% after deductible	2x monthly rate
Preventive Medications	Subject to normal copay	Many are free	Many are free	Subject to normal copay
Weight loss Medications (anti-obesity and anorexiants)	$55 copay max	$55 copay max	Plan pays 80% after deductible	$55 copay max
Preventive Prescription Drugs*
Tier 1 (30 days)	$10	FREE	FREE	$10
Tier 2 (30 days)	$75	FREE	FREE	$35
Tier 3 (30 days)	$200	FREE	FREE	$60
Mail Order/Retail (90 days)	Copay x 2	FREE	FREE	Copay x 2
Lifetime Maximum	n/a	Unlimited	Unlimited	Unlimited
*The other differences are that in the HRA and HSA Plans, a robust list of preventive medications are FREE. You can review the covered preventive prescriptions and others, as well as costs at info.caremark.com/oe/t-mobile.

Prescription Coverage

Coverage That Works for You

Explore Your Prescription Drug Coverage

Explore Your Medical Benefits

Resources

Money on the Table

Buffet of Services

Don't Wait for a Breakdown

The Umbrella Effect

Virtual Care Delivers

Surest

PPO with Health Reimbursement Account

High Deductible Health Plan with HSA

EPO Plan

Supplemental Health Plans

HMSA HMO and PPO:

HMSA Health Plan Hawaii Plus (HMO):

HMSA Preferred Provider Plan (PPO):

New Lyra Support for You and Your Family

Enhancements to all Aflac Plans

Enhanced Virtual Musculoskeletal Care Benefit

Enhanced Decision-Making Tool

Expanded Family-Building and Maternity Support

New LightCare Vision Benefit

Cost Per Pay Period Is Changing

Weight Loss Medication Cost Increase

Select Voluntary Benefits Now Available Through the Enrollment Experience

New Health Savings Account (HSA) Limits Are Increasing

Hawaii Medical Plan Changes