Here are your Aetna Advantage plan choices
For specifics on these health benefits and health insurance plans, see the charts beginning on page 5.
Managed Choice Open Access Plans, Point of Service Open Access Plans, MC* and POS** High Deductible Plans, MC* and POS** Value Plans and MC* and POS** First Dollar Plans include:
- You have access to Aetna’s network and your outof-pocket costs may be lower if you choose from among the many participating physicians and hospitals within this network
- Unlimited office visits to your primary care physician and specialists (copays, deductibles and coinsurance apply to MC* and POS** Value plans)
- No claim forms to fill out when you visit a network provider
- No referrals required to see a specialist
- No waiting period to access preventive health (routine physicals)
- 100% annual routine GYN exam coverage — no waiting period, no dollar maximum, and no copay or deductible when you visit a network provider
- Coverage for prescription drugs
- Routine physicals include lab work and X-rays n 100% coverage on in-network childhood immunizations
MC* and POS** First Dollar
- Freedom from deductibles when you choose an Aetna medical provider
- Lower copay for in-network provider visits n No deductible for generic prescription drugs
MC* and POS** High Deductible Plans (HSA Compatible)
- 100% coverage in network after your deductible is met
- Lower monthly premiums, higher annual deductibles (at least $3,000 for individuals and $6,000 for families) n Can be paired with a tax-advantaged Health Savings Account (HSA)
MC* and POS** Value Plans
- Lower monthly premiums (that’s the “Value” part)
- No deductible for generic prescription drugs
* Managed Choice Open Access **Point of Service Open Access
A Health Savings Account, or HSA, is a personal account that lets you pay for qualified medical expenses with tax-advantaged funds. You or an eligible family member make contributions to your HSA tax-free, and those dollars earn interest tax-free. Then, when you make withdrawals from your account to pay for qualified health care expenses, they’re tax-free, too.
To establish a Health Savings Account…
First enroll in an Aetna HSA-compatible High Deductible Health Plan. Then request HSA enrollment materials by calling to your broker or visiting www.aetnaindividualhsa.com to view and download the materials.
Why Choose an Aetna HealthFund HSA?
No set-up fees n No monthly administration fee n No withdrawal forms required n Convenient access to HSA funds via
debit card or checkbook n Track HSA activity through Aetna Navigator®
The HSA Investment Account allows you a number of different ways to invest for the future, complementing the interest earning HSA Cash Account.
Aetna Advantage Plans for individuals, families and the self-employed are underwritten by Aetna Life Insurance Company (Aetna) directly and/or through an out-of-state blanket trust and Aetna Health Inc.
In some states, individuals may qualify as a business group of one and may be eligible for guaranteed issue, small group health plans. These plans are medically underwritten and you may be declined coverage in accordance with your health condition.
Looking for a lower cost plan?
Our Preventive and Hospital Care plan include:
Preventive care n Annual GYN exams (annual Pap/Mammogram) n Well-child care (includes immunizations) n Routine physical exams n Coverage for: inpatient hospital care, outpatient surgery, skilled nursing or home health care in lieu of a hospital stay
Add Dental PPO Max
With the Aetna Advantage Dental PPO Max insurance plan, you can obtain services from either a participating or non-participating dentist. Participating dentists have agreed to provide services at a negotiated rate for both covered services, as well as non-covered services such as cosmetic tooth whitening and orthodontic care, so you generally pay less out-of-pocket. You also have the flexibility to visit a dentist who does not participate in Aetna’s network, though you will not benefit from negotiated fees. Dental is offered only if medical coverage is obtained.
Want to cover your children only?
All Aetna Advantage plans are available for children only, which means you can enroll your child even if no other family member enrolls. Coverage includes immunizations, well-child visits, emergency room and dental preventive services (if dental is selected). Note: when an HSA Compatible plan is selected for child only enrollment, an HSA account is not available for the child.
Is your doctor in the Aetna network?
Which local physicians, hospitals, pharmacies and eyewear providers participate in the Aetna Advantage Plan network? Visit www.aetna.com/ docfind/custom/advplans.