Medical
Medical
CarMax offers you three medical plan options to choose from through Anthem. If you live in certain areas of California, a fourth option is available through Kaiser.
Eligibility & Enrollment
Eligibility
Associate: You are eligible to join the Medical Plan (“Plan”) on your thirtieth (30th) day of employment (this period is called the Waiting Period) if you are classified in Workday as a Full-Time Associate.
- If your status changes to Full-Time in Workday, you are eligible to join or re-enter the Plan as of the first of the month after the status change.
Dependents: Eligible Full-Time Associates may cover eligible dependents, which include a Spouse/Domestic Partner and children under age 26.
- Please refer to the Summary Plan Description (“SPD”) for more eligibility information. If you have any questions regarding dependent eligibility, please contact the CarMax Benefits Center.
Temporary Associates and Independent Contractors are not eligible to participate.
Enrollment
New Hire and Rehires: Enroll online at benefits.carmax.com within 30 days of your hire date. If enrolled in the Anthem Medical plan, you will be able to view your coverage on the Engage Wellbeing App. You will also receive a Medical/RX card in the mail.
Note: Generally, if you don’t enroll when first eligible, you may only be allowed to enroll if you experience a Qualified Change in Status Event (marriage, new baby, etc.) or during the next Open Enrollment.
You will receive your ID cards approximately three weeks after your effective date of coverage.
Getting Started with Enrollment
Plan Comparison Chart
Here's how you can compare the PPO to the High Deductible plan option. Watch a video here
| In-Network Benefits | HRA Plan | HSA Plan | PPO Plan | Kaiser Plan |
| Company contribution to the Health Reimbursement Account and the Health Savings Account | Associate Only: $300
Associate + Dependent(s) or Family: $600
|
Associate Only: $300
Associate + Dependent(s) or Family: $600
|
N/A | N/A |
| Deductible | Associate Only: $2,500
Associate + Dependent(s) or Family: $5,000
|
Associate Only: $1,750
Associate + Dependent(s) or Family: $3,500
|
Associate Only: $1,000
Associate + Dependent(s) or Family: $2,000
| Associate Only: $1,000
Associate + Dependent(s) or Family: $2,000
|
| Out-of-Pocket Maximum | Associate Only: $6,550
Associate + Dependent(s) or Family: $13,100
|
Associate Only: $6,550
Associate + Dependent(s) or Family: $13,100
|
Associate Only: $6,550
Associate + Dependent(s) or Family: $13,100
|
Associate Only: $6,550
Associate + Dependent(s) or Family: $13,100
|
*Family deductibles are calculated differently for each plan option.
Note: These plans are in-network only. Out-of-network providers are not covered.
| In-Network Benefits | HRA Plan | HSA Plan | PPO Plan | Kaiser Plan |
| Doctor's Office Visit | ||||
| Preventive Care | $0, no deductible | $0, no deductible | $0, no deductible | $0, no deductible |
| Primary Care Physician (PCP) | 40%, after deductible1 | 30%, after deductible1 | $30 copay1 | $30 copay |
| Specialist | 40%, after deductible | 30%, after deductible | $60 copay | $50 copay |
| Non-Preventive Lab/X-rays with Office Visits | 40%, after deductible | 30%, after deductible | 20%, after deductible | $10 Labs 20%, up to $150 Specialty Imaging, no deductible |
| Virtual Visits | $0, no deductible for LiveHealth Online and Hinge Health | $0, no deductible for LiveHealth Online and Hinge Health | $0, no deductible for LiveHealth Online and Hinge Health | $0, no deductible |
| Emergency Room | 40%, after deductible | 30%, after deductible | $2502 + 20%, after deductible | 20%, after deductible |
| Urgent Care | 40%, after deductible | 30%, after deductible | $60 copay | $30 copay |
| Mental Health | ||||
| Inpatient Care | 40%, after deductible | 30%, after deductible | 20%, after deductible | 20%, after deductible |
| Outpatient Individual Therapy Visits | 40%, after deductible | 30%, after deductible | $30 copay/visit | $30 copay/visit |
| Outpatient Group Therapy Visits | 40%, after deductible | 30%, after deductible | $30 copay/visit | $15 copay/visit |
| Substance Abuse | ||||
| Inpatient Detoxification | 40%, after deductible | 30%, after deductible | 20%, after deductible | 20%, after deductible |
| Outpatient Individual Therapy Visits | 40%, after deductible | 30%, after deductible | $30 copay/visit | $30 copay/visit |
| Outpatient Group Therapy Visits | 40%, after deductible | 30%, after deductible | $30 copay/visit | $5 copay/visit |
| Copays / Coinsurance | ||||
| For most covered services [In/Out Patient Hospital, Other Outpatient] | 40%, after deductible | 30%, after deductible | 20%, after deductible $40 copay/professional services office visit2 |
20%, after deductible $30/outpatient visit $15/chiropractic visit (no deductible, limit 30) |
1Including Mental Health office visits.
2Copay is waived if admitted to the hospital.
| Prescription Drugs | HRA Plan | HSA Plan1 | PPO Plan | Kaiser Plan |
| Retail: 30-day supply | ||||
| Generic | $10 | $10, after deductible | $10 | $10 Generic (up to 100-day supply) |
| Formulary (Preferred)2 | 30% ($40 min, $100 max) | 30% ($40 min, $100 max), after deductible | 30% ($40 min, $100 max) | $40 (up to 100-day supply) |
| Non-Formulary (Non-Preferred) | 30% ($60 min, $150 max) | 30% ($60 min, $150 max), after deductible | 30% ($60 min, $150 max) | Not covered |
| Specialty Prescriptions | Based on Formulary and Non-Formulary pricing | Based on Formulary and Non-Formulary pricing | 30% | $100 (up to 30 days) |
| Mail Order:90-day supply | ||||
| Generic | $20 | $20, after deductible | $20 | $10 Generic (up to 100-day supply) |
| Formulary (Preferred)2 | 30% ($80 min, $200 max) | 30% ($80 min, $200 max), after deductible | 30% ($80 min, $200 max) | $40 Brand (up to 100-day supply) |
| Non-Formulary (Non-Preferred) | 30% ($120 min, $300 max) | 30% ($120 min, $300 max), after deductible | 30% ($120 min, $300 max) | Not covered |
1Note, under the HSA Plan, your deductible applies to medical and prescription drug expenses, and you must pay the full cost of your medical and prescription drug expenses until you meet your deductible. However, certain prescriptions on the preventive drug list are not subject to the deductible. Also note that in the HSA plan, some eligible preventive care prescription drugs are available at no cost. See the Preventive Drug List on the CVS Caremark website. Note, the list is subject to change at any time.
2A list of formulary drugs can be found at caremark.com or kp.org
Out-of-pocket costs and negotiated rates
The Transparency in Coverage Final Rules (and related sub-regulatory guidance(see Q&A 1 and 2)) require group health plans to disclose on a public website information regarding: (1) the in-network provider rates for covered items and services (see “in-network-rates” in filename); and (2) the historical out-of-network allowed amounts and billed charges for covered items and services (see “allowed-amounts” in filename) in two separate machine-readable files (MRFs).The files must, in part, also include plan option/coverage identifier information; billing codes to identify items and services for claims processing; and all applicable rates.
The MRFs for the group health plan(s) in the CarMax, Inc. Health Plan, for the Anthem Self-Funded Options and the Kaiser Insured Options are linked below:
The MRFs were prepared using this technical implementation guide. Please refer to the guide for additional details regarding the format, data types, file naming convention, and schemas that were followed when creating and posting the MRFs linked above to help ensure they are publicly discoverable and maintain their integrity.
2026 Medical Plan Rates
| 2026 Medical Plan Bi-Weekly Rates | HRA Plan | HSA Plan | PPO Plan | Kaiser plan | |||
|---|---|---|---|---|---|---|---|
| Coverage Tier | Before Incentive | After Incentive2 | Before Incentive | After Incentive2 | Before Incentive | After Incentive2 | |
| Associate Only | $54.04 | $30.96 | $107.62 | $84.54 | $138.96 | $115.88 | $117.85 |
| Associate + Child | $161.04 | $137.96 | $174.36 | $151.28 | $242.06 | $218.98 | $222.70 |
| Associate + Children | $216.23 | $193.15 | $231.31 | $208.24 | $338.50 | $315.42 | $320.76 |
| Associate + Spouse / Domestic Partner | $229.08 | $182.93 | $243.76 | $197.61 | $317.32 | $271.17 | $275.76 |
| Associate + Family | $325.58 | $279.43 | $342.92 | $296.77 | $447.22 | $401.06 | $407.87 |
1Kaiser medical plan members (California Associates only) are not eligible to receive the Medical Plan Credit Incentive (MPC)
2You are your covered spouse/domestic partner can offset your medical plan per paycheck costs with CarMax MPC when you complete the required activities through Sharecare.
Medical Plan Credit (MPC)
All Associates who enroll in an Anthem option under the Medical Plan are asked to participate in our voluntary Medical Plan Credit. This program asks you and your covered Spouse/Domestic Partner to take the steps outlined in the Health and Wellness Rewards Program to receive a Medical Plan Credit (MPC) of $23.08 per paycheck (up to $600 each for the full Plan Year).
The MPC includes taking the RealAge test, an online questionnaire about your health history and personal habits (diet, exercise, etc.) to create a snapshot of your current health risks and watching a video to learn more about Sharecare support. Both activities should be completed to earn your MPC.
The Medical Plan Credit is administered by Sharecare. See the Health and Wellness Rewards Program for more information.
When Coverage Ends
If your employment with CarMax ends, coverage in this plan will end on your last day of employment. If you move from a Full-time position to a Part-time position, coverage in this plan will end at the end of the month in which you move to a Part-time position.
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), you and your qualified beneficiaries (that is, your enrolled Spouse and enrolled dependents) may continue group health coverage for a period of time if coverage under the Plan ceases. CarMax also extends a continuation of coverage option to enrolled Domestic Partners.
You will receive a COBRA notice approximately 2 weeks following your separation of service with instructions and the costs associated with the continuation of coverage. Please refer to the Plan’s SPD for more information.
Additional Health Programs
Lantern
Anthem members will have access to Lantern. Lantern connects you to excellent care at little to no cost.
Surgery Care - Lantern will match you with the best surgeon in Lantern’s network for planned, non-emergency surgery. They will answer your questions and provide support during your surgery process. Lantern covers more than 1500 procedures.
Cancer Care - Lantern is there to ensure you understand your diagnosis and treatment plan and, if necessary, assist you with getting a second opinion. They can answer questions and assist with getting appointments at local and national cancer centers faster. They can even help you find support options in your community.
Infusion Care - Lantern can help get you the care you need either at home or at an infusion center.
Lantern is available at no cost to you if you are enrolled in the PPO or HRA Plan and no cost to you after deductible if you are enrolled in the HSA Plan. We know from your feedback that medical affordability is really important.
Spring Health
The Spring Health Employee Assistance Program, or EAP, offers support and resources to support your overall well-being. In addition to high-quality mental health resources, the program includes counseling sessions, coaching sessions, legal, financial, and professional development services and resources.
Additionally, Spring Health’s quick and easy online scheduling system, self-guided assessments, and personalized care plans ensure that you can get the care you need when you need it.
Spring Health is available to all CarMax Associates, as well as spouses or domestic partners, members of your household, and dependents up to the age of 26.
Hinge Health
Free access to programs for back, knee, hip, neck, shoulder pain and more, including wearable sensors, coaching, and personalized exercise therapy.
This benefit is available at no cost to CarMax Associates age 18+, and their covered dependents who are enrolled in an Anthem Medical plan.
Rx Savings Solutions (RxSS)
CarMax works with RxSS to help you manage the rising cost of prescription drugs. This free and confidential service connects with your CarMax Athem Health plan to show you all the lower-cost options you have for your medications, where applicable.
RxSS doesn’t replace your current prescription plan; it’s an additional program designed to help you and your family save money.
This benefit is available at no cost to CarMax Associates and their covered dependents who are enrolled in an Anthem Medical plan.
LiveHealth Online
Anthem members have access to LiveHealth Online for virtual urgent, mental health, and primary care solutions. The program provides 24/7/365 access to providers by online video.
LiveHealth Online is a convenient and affordable option that allows you to talk to a doctor who can diagnose, recommend treatment, prescribe medication, when appropriate, and provide counseling for many of your medical or mental health concerns.
Building Healthy Families
Each pregnancy and parenting experience is unique. You or your covered Spouse/Domestic Partner who are enrolled in an Anthem medical plan are eligible to participate in Anthem’s Building Healthy Families Program. This is a voluntary, free, and personalized family support program to help you take care of yourself and your family during your family's unique journey. Additional information is available in the SPD.
24 Hour Nurse Hotline
Anthem offers Plan Members a free 24-Hour Nurseline to help you anytime day or night. To reach a nurse, call (800) 700-9184 and select the option to speak to a nurse. The nurses can help you:
- Learn about medical procedures and treatment options
- Prepare for a conversation with your doctor
- Determine if you need immediate care (e.g., the Emergency Room) or if you can wait to see your doctor during normal business hours
Retail Walk-In Clinics
Retail Walk-in Clinics are typically found in retail businesses such as CVS Pharmacies, Target stores, or Walgreens Pharmacies. These clinics are run by either RNs, Nurse Practitioners, or Physician Assistants. You should consider a Retail Walk-in Clinic when you have the need for immediate care that is not urgent – examples include the treatment of cold/flu symptoms, rashes, or basic infections. You can also get many wellness exams and routine physicals.
To find a Retail Walk-in Clinic near you, log into Anthem Engage Wellbeing online or using the mobile app and click Find Care and type “Retail Health Clinic” in the search field.
Cleveland Clinic Cardiac Concierge
Getting a second opinion can help you feel confident in your diagnosis, understand the pros and cons of treatment options, and make informed decisions.
The Cleveland Clinic Cardiac Concierge program is here to support you and your covered dependents - by ensuring you have access to top heart doctors, helping you learn about treatments that may be available to you only at Cleveland Clinic, and providing travel for you and a companion to see top heart doctors for surgery and other treatments.
For more information, contact Anthem at (833) 290-2480. The Cleveland Clinic Cardiac Concierge program is available to Associates enrolled in the medical plan administered by Anthem and their covered dependents.
Virta
CarMax is proud to offer Virta to eligible associates and family members who are enrolled in a CarMax-offered health plan through Anthem. Backed by science and trusted by thousands, Virta is a guided nutrition program to reverse diabetes, lose weight, and transform your health-available at $0 cost to you.
Through Virta, you'll have access to a dedicated care team, digital health tools, and personalized support. Your care plan may include nutrition therapy, weight loss medications, or a combination of both, designed to help you achieve long-term weight loss and naturally lower your blood sugar.
OneImaging
OneImaging is an integrated diagnostic imaging benefit that helps you save on health care by directing you to high-quality, lowercost radiology centers. OneImaging supports CT Scans, MRI’s, Ultrasounds, Mammograms, and X-Rays. Available at nocost for HRA and PPO plan members, and at no-cost after deductible for HSA members.
