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Medical & Prescription Benefits

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Oncor employees may choose among three medical plan options.

All three offer comprehensive coverage that includes free in-network preventive care services, virtual care for physical and mental health needs, and prescription drug coverage. In addition, Oncor makes a contribution to an account that you can use for eligible medical, prescription drug, dental and vision care expenses. With two of the medical plan options, you may contribute to the account with pretax contributions, too.

Take a close look at the options and discover which one will fit your current needs, future plans and budget. You can find medical in-network rates and out-of-network allowable amounts and billed charges under the Oncor welfare plan.

2026 Medical Benefits at a Glance

Medical + Rx

Medical + Rx

Medical Only

Annual Deductible

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

You Only / You + Family

$1,700 / $3,400

$3,400 / $6,800

$2,700 / $5,400

$5,400 / $10,800

$1,700 / $3,400

$3,400 / $6,800

Company Contributions(3)

You Only / You + Family

$250 / $500

Coinsurance Maximum

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

You Only / You + Family

$2,800 / $5,600

$5,600 / $12,200

$3,000 / $6,000

$6,000 / $12,000

$2,800 / $5,600

$5,600 / $11,200

Out-of-Pocket Maximum

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

You Only / You + Family

$4,500 / $9,000

$9,000 / $18,000

$5,700 / $11,400

$11,400 / $22,800

$4,500 / $9,000

$9,000 / $18,000

Services

You Pay

Preventive Care

$0, no deductible

Doctor Office Visits & Most Other Eligible Expenses Except Prescription Drugs

20% after deductible

40% after deductible

20% after deductible

40% after deductible

20% after deductible

40% after deductible

Lifetime Maximum
Medical Benefit

Unlimited

(1) If you have individual coverage (“You Only”), you must meet the individual deductible before the option starts paying benefits. An individual is responsible for no more than $4,500 if enrolled in the HSA Option 1 ($1,700/$3,300) or $5,700 if enrolled in the HSA Option 2 ($2,700/$5,400), in out-of-pocket in-network expenses. Refer to the SPD for details on how the family deductible works with individual deductible.
(2) Frozen to new participants as of January 1, 2022.
(3) The employer contribution is prorated based on the number of eligible full months remaining in the year upon enrollment in an HSA Medical Option.

When you enroll in an Oncor medical option, the company contributes to a health account in your name to help cover your care throughout the year.

You’ll get:

  • $250 when you enroll in You Only coverage
  • $500 for all other coverage levels

Use these funds for deductibles, copays, prescriptions, and other eligible medical or dental expenses.

Note: If you’re age 65 or older:

  • HSA contributions are added to your paycheck instead of an account
  • HRA contributions continue to go into your HRA account

Find out how much you can contribute to an HSA, along with more details.

Preventive Care

Preventive care is covered at 100% with no deductible when you use in-network providers, and at 100% of the non-contracting allowable amount (without a deductible) if you use out-of-network providers.

Contact BCBSTX for a full list of these benefits.

  • Physical exam
  • Cardiovascular screening
  • Prostate cancer screening (after age 40); includes digital rectal exam and PSA
  • Gynecological exam
  • Mammogram
  • Immunizations (includes immunizations for travel)
  • Female sterilization
  • Colorectal cancer screening (after age 50); includes fecal occult
  • Blood testing, as appropriate, plus one colonoscopy or sigmoidoscopy every five years
  • Pediatric exams on schedule appropriate for age and development of child
  • Legally required routine immunizations (includes immunizations for travel)
  • Screening test for hearing during the first 31 days following birth, and necessary diagnostic follow-up care related to the test results until the child reaches age two

Prescription Drug Coverage

Oncor’s medical options include benefits for prescription drugs and pharmacy services.

2026 Rx Coverage at a Glance

In-Network, You Pay

Annual Deductible (In-Network)

You Only

Included in medical deductible

$200

You + Family

Included in medical deductible

$400

Coinsurance Maximum

You Only

Included in medical out-of-pocket maximum

$2,000 (excludes Rx deductible)

You + Family

Included in medical out-of-pocket maximum

$4,000 (excludes Rx deductible)

Retail (up to a 30-day supply)

Value/Preventive Generic

$5 copay, no deductible

All Other Generic

20% after deductible

$10 copay, no deductible

Preferred Brand Name(2)(3)

20%, up to $75 max per Rx, after deductible

30%, up to $100 max per Rx, after Rx deductible

Non-Preferred Brand Name(2)(3)

20%, up to $120 max per Rx, after deductible

40%, up to $120 max per Rx, after Rx deductible

Mail Order (up to a 90-day supply)

Value/Preventive Generic

$10 copay, no deductible

All Other Generic

20% after deductible

$20 copay, no deductible

Preferred Brand Name(2)(3)

20%, up to $150 max per Rx, after deductible

30%, up to $200 max per Rx, after Rx deductible

Non-Preferred Brand Name(2)(3)

20%, up to $240 max per Rx, after deductible

40%, up to $240 max per Rx, after Rx deductible

Lifetime Maximum Rx Benefit

Unlimited

(1) Frozen to new participants as of January 1, 2022.
(2) If you are taking a brand name prescription with a generic equivalent and do not switch to the generic, you will pay the generic copay, plus the difference between the price of the generic and brand name drug.
(3) If a brand name drug (preferred or non-preferred) is less than the maximum copay, you pay the total cost of the prescription.

Maintenance Prescriptions

If you take medications regularly, use CVS for long-term refills after obtaining three 30-day prescriptions. You can:

  • Pick up 90-day supplies at any CVS Pharmacy (including Target locations), or
  • Have them delivered through CVS Caremark Mail Service Pharmacy

You can opt out and keep using other pharmacies for maintenance medications, but you must opt out every year.

How to Get the Lowest Price for Certain Generic Prescriptions

Use Caremark® Cost Saver™ powered by GoodRx to get the lowest price on non-specialty retail generic medications. Just show your CVS Caremark Member ID when you pick up your prescriptions.

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