Beginning in 2026, Duke staff and faculty will have a new medical plan option to consider among their benefits during annual Open Enrollment, which runs from Oct. 6-24.
Duke will continue to offer the same five medical plans as in 2025 but has added a high-deductible medical plan called Duke Advantage that is paired with a Duke Health Savings Account (Duke HSA). Enrollment in the Duke Advantage plan is required to open and contribute to the Duke HSA.
The Duke HSA, administered by Fidelity, allows participants to set aside pre-tax money to save and invest for use in covering eligible medical expenses.
The Duke HSA is separate and different from the Health Care Reimbursement Account that will continue to be offered by Duke and administered by HealthEquity.
Here are some factors to consider when deciding whether to sign up for the new Duke Advantage health plan and how a Health Savings Account functions.
Is a High Deductible Health Plan right for me?
The new Duke Advantage plan, like all High Deductible Health Plans, requires a deductible to be met before the plan pays for any medical expense, including office visits and prescription coverage. In 2026, that deductible is $3,000 for an individual and $6,000 for family coverage for Duke Advantage in-network care. Only preventative care and a limited number of preventative medications are covered prior to reaching those thresholds.
This new plan is designed with a lower monthly premium but a higher deductible, so it might not be suitable for those who are more frequent users of health care services.
"The purpose of a High Deductible Health Plan is to promote more mindful use of health care services," said Laura Panebianco, Duke's Associate Director of Benefits Administration.
The new Health Savings Account (Duke HSA) paired with a High Deductible Health Plan helps offset out-of-pocket expenses before care is covered.
What's a benefit of the new High Deductible Plan?
In addition to the Health Savings Account (Duke HSA), a key benefit of the Duke Advantage Plan is access to telehealth services through MDLive, offered at no cost to members. With MDLive, members can quickly receive care for common, non-emergency conditions such as the flu, sinus infections and ear pain, as well as access wellness services and support for a range of behavioral health concerns. The telehealth visits are fully covered by the Health Plan, even before the deductible is met. This benefit is exclusive to the Duke Advantage Plan. Additional information will be available during Open Enrollment .
Broadly, what is a Health Savings Account?
A Health Savings Account is a tax-advantaged way to save and pay for qualified medical expenses. Among the major benefits are that you maintain control of the account, even if you switch employers, and unspent money in the account rolls over each year.
Withdrawals are free from federal income tax when spent on a qualified medical expense and investment growth is tax-free.
How does the Duke HSA paired with the Duke Advantage plan work?
In 2026, up to $4,400 for an individual or $8,750 for a family can be set aside pre-tax in an investment account managed by Fidelity. You can contribute to your account, withdraw money to pay for qualified medical expenses or potentially grow your funds for future medical expenses tax-free by investing in a wide array of investment options.
Duke will also contribute to the Duke HSA $200 for an individual and $500 for a family in 2026.
"The big advantage is that any money put into an HSA can be invested, so it can grow your money over time," Panebianco said. "The second advantage is it's your money - it never reverts back to your employer."
