Whether you’re staying on top of routine care or facing an unexpected health need, you want to know you and your family are supported. Tarsus offers three medical plan options, giving you the flexibility to choose the coverage that feels right for your life.
Help Is Here When You Need It
Insurance can be complicated. We want to make it easier, so we’ve teamed up with Alliant Employee Benefits to provide you with a personal Benefit Advocate.
Email tarsusbenefits@alliant.com or call (925) 357-6853 to reach your Benefit Advocate.
Choose the plan that fits your needs
Health Maintenance Organization (HMO)
This plan provides coverage through in-network doctors only. You will select a primary care physician (PCP) who will oversee your care and refer you to specialists, if needed. You are responsible for copays at the time of service. There is no out-of-network coverage with this plan.
Preferred Provider Organization (PPO)
This plan offers the flexibility to choose an in-network or out-of-network provider each time you need care. Keep in mind, you will save money when you visit in-network providers.
Health Savings Account (HSA)
With this plan, you can choose in-network or out-of-network providers. You must satisfy a higher deductible before the plan will begin paying toward your medical services. However, you may be eligible to enroll in a Health Savings Account (HSA) which allows you to pay for certain medical expenses with tax-free money.
Compare the Plans
The medical plans differ in how much you pay before coverage begins, what you pay when you receive care, and whether out-of-network services are covered. Use the table below to compare deductibles, out-of-pocket maximums, Tarsus HSA contributions, and costs for common services.
Viewing on a smaller screen? Choose one plan at a time for an easier view, or select View Full Coverage Table to compare all plans and network options side by side.
| Plan Features | Blue Shield HMO(CA only) | Blue Shield PPO | Blue Shield HSA | ||
|---|---|---|---|---|---|
| Plan Features | In-Network Only | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Annual DeductibleIndividual / Family | None | $500 / $1,5001 | $1,500 / $4,5001 | $1,7502 / $3,500 | $1,7502 / $3,500 |
| Annual Out-of-Pocket MaximumIndividual / Family | $2,000 / $4,0001 | $3,000 / $6,0001 | $5,000 / $10,0001 | $3,500 / $7,000 | $6,000 / $12,000 |
| Tarsus Annual HSA ContributionIndividual / Family | N/A | N/A | N/A | $1,100 / $1,700 | $1,100 / $1,700 |
| You pay: | |||||
| Preventive Care Visit | Covered in full | Covered in full | Not covered | Covered in full | Not covered |
| Telemedicine / Virtual VisitPrimary Care / Specialist | Covered in full | Covered in full | Not covered | Covered in full | Not covered |
| Primary Care Visit | $20 | $20 (deductible waived) | 40% after deductible | 10% after deductible | 40% after deductible |
| Specialist Visit | $20 / $30 Access+ | $25 (deductible waived) | 40% after deductible | 10% after deductible | 40% after deductible |
| Lab & X-ray | Covered in full | $20 | 40% after deductible | 10% after deductible | 40% after deductible |
| Advanced Imaging | Covered in full | 20% after deductible | — | — | — |
| Urgent Care | $20 | $20 (deductible waived) | 40% after deductible | 10% after deductible | 40% after deductible |
| Emergency RoomCopay waived if admitted | $150 | $150, then 20% after deductible | $150, then 20% after deductible | $150, then 10% after deductible | $150, then 10% after deductible |
| Inpatient Hospitalization | $250 | 20% after deductible | 40% after deductible (maximum $350) | 10% after deductible | 40% (Maximum $600) |
| Outpatient Surgery | $200 | 20% after deductible | 40% after deductible | 15% after deductible | 40% (Maximum $350) |
| Chiropractic | $10 30 visits/year | $20 20 visits/year | 40% after deductible | 10% after deductible 20 visits/year | 40% after deductible 20 visits/year |
| Acupuncture | $10 30 visits/year | $20 20 visits/year | 40% after deductible | 10% after deductible 20 visits/year | 40% after deductible 20 visits/year |
1 Family Deductible/Family Out-of-Pocket Maximum is embedded, meaning the plan will cover 100% for an individual member as soon as they reach their individual maximum.
2 Deductible for an individual in a family is $3,500.
Pharmacy Benefits
Your prescription drug coverage helps make medications more affordable. To save the most on your prescriptions, take a look at your plan’s list of covered medications (drug formulary). Each medication is grouped into cost tiers. Generic and preferred medications typically cost less than non-preferred or specialty drugs.
Before filling a prescription, ask your doctor if a lower-cost generic or alternative is available. To see if a medication is covered and which tier it falls under, visit your medical plan’s website or call the member services number on your ID card.
| Plan Features | Blue Shield HMO(CA only) | Blue Shield PPO | Blue Shield HSA | ||
|---|---|---|---|---|---|
| Plan Features | In-Network Only | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Prescription Drugs: Retail (up to a 30-day supply) | |||||
| Generic | $15 | $15 | In-network copay, then 25% | $10 after deductible | In-network copay, then 25% |
| Preferred Brand | $40 | $30 | In-network copay, then 25% | $25 after deductible | In-network copay, then 25% |
| Non-Preferred Brand | $70 | $50 | In-network copay, then 25% | $40 after deductible | In-network copay, then 25% |
| Specialty | 20% (up to $250 per prescription) | 30% (up to $250 per prescription) | In-network copay, then 25% | 30% after deductible (up to $250 per prescription) | In-network copay, then 25% |
| Prescription Drugs: Mail Order (up to a 90-day supply) | |||||
| Generic | $45 | $30 | Not covered | $20 after deductible | Not covered |
| Preferred Brand | $120 | $60 | Not covered | $50 after deductible | Not covered |
| Non-Preferred Brand | $210 | $100 | Not covered | $80 after deductible | Not covered |
| Specialty | 20% (up to $750 per prescription) | 30% (up to $500 per prescription) | Not covered | 30% after deductible (up to $500 per prescription) | Not covered |
Save Time with Mail Order
Get eligible prescriptions delivered to your door through Amazon Pharmacy, Blue Shield’s home delivery pharmacy. You can order up to a 90-day supply, when available.
Get started: Visit amazon.com/blueshieldca.
XDEMVY Access for Employees
If you’re enrolled in a Tarsus-sponsored healthcare plan, you and your covered family members have free access to XDEMVY (lotilaner ophthalmic solution) 0.25%.
To use this benefit, your prescription must be filled through Carepoint Pharmacy and receive prior authorization. The program works alongside your existing medical coverage, with Tarsus covering the cost. Email benefits@tarsusrx.com to get started.
Cost for Medical Coverage
Tarsus contributes toward the cost of coverage for you and your dependents. Below is your share of the monthly premiums for each plan.
| Coverage Tier | Blue Shield HMO (CA only) | Blue Shield PPO | Blue Shield HSA |
|---|---|---|---|
| Employee Only | $79.28 | $113.66 | $73.72 |
| Employee and Spouse | $173.39 | $249.28 | $162.45 |
| Employee and Child(ren) | $142.45 | $204.07 | $132.44 |
| Employee and Family | $243.97 | $350.02 | $227.38 |
For Your Good Health
The best way to stay healthy is to catch potential health concerns early. Annual preventive care visits and recommended screenings help you and your doctor monitor your health, identify risks, and detect issues before they become more serious.
When you visit an in-network provider, eligible preventive care services are covered at 100% under your medical plan.
Preventive care may include services such as:
Keep in mind: Not every exam or test is considered preventive. Visits to specialists and services related to diagnosing or treating a medical condition may be covered differently and could result in out-of-pocket costs. If you’re unsure whether a service qualifies as preventive care, contact your medical plan before your appointment.
Health questions don’t always come up during regular business hours. Whenever you need guidance, Blue Shield’s registered nurses are available to listen, help you understand your symptoms, and talk through where to go for care. Find more information here.
When you’re not feeling your best, getting care should be simple. Connect by phone or video with a board-certified doctor from the comfort of home—or wherever you happen to be—using your smartphone, tablet, or computer. Doctors are available 24/7 to discuss common health concerns, recommend treatment, and send a prescription to your local pharmacy when appropriate. No appointment or travel is needed. Find more information here.
Managing your health can feel like a lot, but you don’t have to do it alone. Through Shield Concierge, you can get support for a wide range of conditions from a team specially trained on the specific health benefits and programs available to you.
Every family’s journey is different. Whether you’re expecting a baby or adjusting to life after birth, Maven offers personalized virtual support throughout pregnancy and up to three months postpartum. Connect with experts such as midwives, doulas, and Care Advocates, explore helpful resources, and get guidance on preparing for birth and navigating early parenthood.
Which Medical Plan Is Right for You?
Choosing a medical plan is about more than just the cost per paycheck. Think about how you prefer to receive care, whether you want access to out-of-network providers, and how you’d prefer to pay when you need services. Use this chart to compare the plans at a glance and identify which features matter most to you.
| Features | Blue Shield HMO | Blue Shield PPO | Blue Shield HSA |
|---|---|---|---|
| Annual deductible to satisfy | – | ||
| Available in CA only | – | – | |
| Coinsurance for services | – | ||
| Copay for services | – | ||
| Out-of-network coverage | – | ||
| Virtual visits | |||
| Free in-network preventive care | |||
| HSA eligibility | – | – | |
| Health Care FSA eligibility | – | ||
| Dependent Care FSA eligibility |
Quick Links
Benefit Questions
Alliant Benefit Advocate
Monday–Thursday, 8 a.m. to 5 p.m. PST, or Friday, 8 a.m. to 4:30 p.m. PST
XDEMVY Access
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