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��p:�� g�3�h�z�+{P��Aуr/�^�=(�U��/��E'�N�(;Qt��DщҬ0;1tb��F��o��F��o��F��o��F��o��+�/�9{f�W��J��y�p��}��6��Ϗ��l�T�]�z��*�� m The â¦ Policy forms issued in OK include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-23 and/or GR-29/GR-29N. Now that youâve met your deductible, your plan pays 80% of the rest. IN CT, THIS PLAN IS ISSUED ON AN INDIVIDUAL BASIS AND IS REGULATED AS AN INDIVIDUAL HEALTH INSURANCE PLAN. Selecting this plan will give you the freedom to continue seeing your current doctor if your doctor isn't part of the Aetna Choice POS II network. The SBC shows you how you and the plan would share the cost for covered health care services. 0000035776 00000 n You can get discounts for out-of-network care from NAP providers. endstream endobj 56 0 obj <> endobj 57 0 obj <>stream Some of our health plans pay for out-of-network services. trailer But when they stay in network, weâll â¦ Ask your doctor to refer you to a specialist, hospital or surgical center that accepts your plan. THE SCHOOL BOARD OF PINELLAS COUNTY : Aetna Choice® POS II. Provider participation may change without notice. Your plan pays $180 (60% of $300). Learn more >, If your browser is in Private mode, pages that use personal or geographic information may not work. It takes the place of all booklets describing similar coverage that were previously sent to you. Your out-of-network deductible ($100) counts toward your out-of-pocket limit. Your plan documents will tell you how your plan determines the allowed amount. startxref Aetna Choice ® POS II . CHOOSE A PLAN. NOTE: Information about the cost of this plan (called â¦ This question helps us get you to the correct log-in screen. Learn more about private mode. ?܆�#^b7��[�]Oiзj�^]��eO�&]o��SZ��!�b��$��x�:�Uw�Y�H��+��k�Ů��\vn^,�W�ʬ��+��y��c�!�2�"�1'@�9�c�_2/��3{da��i�yc6d:=��N��0o�� 0 �� 0 �� 0 �� 0 ��0� �7Ao�� {�&t Hereâs why: The doctor bill is $825. This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $7,550 out of pocketâ¦ %%EOF plan . Coverage for: EE Only; EE+ Family | Plan Type: POS. Aetna Choice® POS II (Open Access) PLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY PLAN FEATURES NETWORK CARE OUT-OF-NETWORK CARE Primary Care Physician Selection Not required Not required Deductible (per calendar year) $2,500 Individual $5,000 Family $10,000 Individual $30,000 Family Unless otherwise indicated, the deductible must be met â¦ Coverage for: Individual + Family | Plan Type: POS. Or talk with the network providerâs office about what you may be asked to pay. Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: POS Coverage Period: 07/01/2016 - 06/30/2017 4 of 8 070800-020020-191605: UNIVERSITY OF PENNSYLVANIA : Aetna Choice® POS II Questions: Call 1-888-302-8742 or visit us at www.HealthReformPlanSBC.com. Coverage for: EE Only; EE+ Family | Plan Type: CDHP. This booklet will tell you about your covered benefits â what they are and how you get them. The SBC shows you how you and the plan would share the cost for covered health care services. The SBC shows you how you and the plan would share the cost for covered health care services. 45 0 obj <> endobj Plan R: HDHP-HSA Compatible: Aetna Choice® POS II Coverage Period: 10/ 01/2020-12/31/2020 . 0000001252 00000 n The Summary of Benefits and Coverage (SBC) document will help you choose a health . H�\�͎�@ໟb��݃%�d�H�. That stands for National Advantageâ¢ Program. The example below is for insurance plans that pay for out-of-network services. THE DOW CHEMICAL COMPANY : Aetna Choice® POS II - Map Opt 2 - HDHP. The Summary of Benefits and Coverage (SBC) document will help you choose a health . 0000003584 00000 n This is a preferred provider organization plan that gives you the freedom to receive care from any licensed health care provider and the opportunity to save when you use preferred providers (doctors and other health care providers who belong to the Aetna network) . 0000003697 00000 n 0 0000018690 00000 n The Summary of Benefits and Coverage (SBC) document will help you choose a health . Coverage Period: 01/01/2021- 12/31/2021 . You will pay your usual cost sharing for out-of-network care. These plans pay for out-of-network services based on an âallowedâ amount. 0000005481 00000 n 0000000016 00000 n Some plans that used to have NAP no longer have it. This material is for information only and is not an offer or invitation to contract. Now that youâve met your deductible, your plan pays 60% of the remaining allowed amount. The Summary of Benefits and Coverage (SBC) document will help you choose a health . A�ڂ��u��d��;'�ta�H2w~��nߵ��}}��;�]3�k��vٲpM[O��R Y��)^�ݩ��4��æ��1��M��l�. For: Aetna Choice POS II Aetna Choice POS II Medical Plan PLAN FEATURES NETWORK OUT-OF-NETWORK Plan Year Deductible* Individual Deductible* None $125 Family Deductible* None $250 *Unless otherwise indicated, any applicable deducti ble must be met before benefits are paid. For language services, please call the number on your member ID card and request an operator. Each insurer has sole financial responsibility for its own products. Learn how to change your browser settings to enable Javascript. Information is believed to be accurate as of the production date; however, it is subject to change. This is all the doctor can collect. You pay the other 40%, or $120. Out of network, itâs $645 â so you pay an extra $505. He or she has not agreed to a contract price for the covered service. Choose a plan year. If you arenât clear about any of the underlined terms used in this form, â¦ Health benefits and health insurance plans contain exclusions and limitations. 0000002049 00000 n The SBC shows you how you and the plan would share the cost for covered health care services. Learn more >, Aetna.com works best with Safari 8 and above. For other language services. Answer YES if you get Aetna coverage through your job or your spouseâs job, or if you have an Aetna Medicare plan. plan. Letâs look at an $825 charge from a doctorâs visit. Aetna does not provide care or guarantee access to health services. LEIDOS, INC.: Aetna Choice® POS II - Healthy Focus Premier Plan. SCHOOL EMPLOYEES RETIREMENT SYSTEM OF OHIO : Aetna Choice® POS II - HCPII Coverage Period: 01/01/2021-12/31/2021 . If you aren't clear about any of the underlined terms used in this â¦ plan. In this case, the doctor is charging $825. For plans that do cover out-of-network care, youâll usually pay more than if you stayed in the network. If you get care from an NAP provider, you wonât get a balance bill. Coverage Period: 01/01/2021- 12/31/2021 . plan. Coverage Period: 01/01/2020-12/31/2020 . This plan offers both in-network and out-of-network benefits; however, the planâs reimbursement is higher when you use an in-network provider. 0000001642 00000 n The Aetna Choice POS II HSA Plan has two levels of benefits: In-Network Benefits - When you use in-network providers, you pay a fixed dollar amount, called a copayment (or copay), for doctorâs office visits and routine exams. Stay in the network. Not all of that money counts toward your out-of-pocket limit. The second document is the schedule of benefits. SOB-106A (CPOS II MAP Plus Option 2 HDHP with Prescription â¦ 0000029340 00000 n >. Most Aetna health insurance plans determine the allowed amount based on what Medicare would pay, or on a âreasonableâ amount. 0000009222 00000 n Do you have Aetna insurance through an employer or are you a Medicare member? Deductibles for out-of-network care are usually higher than for network care. In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. Choice POS II Medical Plan Schedule of Benefits Prepared exclusively for: Employer: Cameron County Contract number: MSA-143726 Schedule of Benefits 1A Plan effective date: October 1, 2019 Plan issue date: October 14, 2019 These benefits are not insured with Aetna but will be paid from the Employer's funds. 0000003424 00000 n No. Is this the plan for you? endstream endobj 46 0 obj <>>> endobj 47 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 48 0 obj <> endobj 49 0 obj <> endobj 50 0 obj <> endobj 51 0 obj [/Indexed/DeviceCMYK 246 59 0 R] endobj 52 0 obj <> endobj 53 0 obj <> endobj 54 0 obj <> endobj 55 0 obj <>stream It provides the highest level of benefits. The Aetna Medicare Choice II Plan (PPO) has a monthly premium of $15.00 and has an in-network Maximum Out-of-Pocket limit of $7,550 (MOOP). Rates and benefits vary by location. out-of-network care. Providers are independent contractors and are not agents of Aetna. Your coinsurance ($120) counts toward your out-of-pocket limit. Other plans do not (except in an emergency). 0000004557 00000 n Aetna Choice POS II Medical Plan PLAN FEATURES NETWORK OUT-OF-NETWORK Calendar Year Deductible* Individual Deductible*- Individual Only Plan $2,000 $4,000 Individual Deductible*- Family Plan $2,600 $4,000 Family Deductible* $4,000 $8,000 *Unless otherwise indicated, any applicable deductible must be met before benefits are paid. Aetna Choice POS II - Discontinued as of Jan 1, 2021 THIS PLAN ENDS ON DECEMBER 31, 2020 With Aetna Choice POS II plan, you may select any physicians and hospitals in and outside the plan's network. The Aetna Choice POS II Plan is a network plan that gives you the freedom to select any licensed provider when you need care. We call this your coinsurance. If your employer is offering an Aetna pharmacy plan and youâre considering one, ask your HR department for the plan name. Aetna Choice® POS II â Basic Option PLAN DESIGN & BENEFIT OVERVIEW ADMINISTERED BY AETNA LIFE INSURANCE COMPANY Page 1 Proprietary BENEFIT IN-NETWORK OUT-OF-NETWORK Medical Deductible $0 $100 per person per calendar year Medical and Hospital combined (except for a per person per calendar year $50 Home Health Care and $100 DME deductible) Hospital Deductible $50 per â¦ PPO Option (for Active Employees and Retirees) Higher premium with deductible and out-of-pocket limits. Plan Maximum Out of Pocket Limit includes plan deductible. All choice, no referrals With the Aetna Open Choice ® PPO plan, members can visit any provider, in network or out, without a referral. Your out-of-pocket costs may be less than your costs for seeing other providers who are out of network. Please contact your employer for additional information. We negotiate rates with providers to help you save money. Coverage for: Individual + Family | Plan Type: POS. Your plan pays $360 (80% of $450). We refer to these providers (such as doctors, hospitals, and surgical centers) as being âin our network.â. H�\�_k�@��|�ylJ4s�� The doctor bill is $825. 0000003473 00000 n We cover the cost of care based on if the provider, such as a doctor or hospital, is âin networkâ or âout of network.â We want to help you understand how much we will pay for your out-of-network care. Provider office visits are covered at 100% after copays. xref This example shows you how out-of-pocket costs are calculated if you stay in network versus going out of network for the same care. YALE UNIVERSITY : Aetna Choice ® POS II - M&P New Suffix : 12 Coverage Period: 01/01/2017 - 12/31/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: POS Questions: Call 1-888-982-3862 or visit us at www.HealthReformPlanSBC.com. Choice POS II and Traditional Choice Medical Plans 2021 What Your Plan Covers and How Benefits are Paid. Yes The Summary of Benefits and Coverage (SBC) document will help you choose a health . PPO Plan Aetna Choice ® POS II . But for slightly higher premiums than an HMO, this plan covers out-of-network doctors, though youâll pay more than for in-network doctors. If you aren't clear about any of the underlined terms used in this form, see the Glossary. Aetna.com works best with Internet Explorer 11 and above, and does not work in compatibility mode. The out-of-network âallowedâ amount for this type of visit is $400. NOTE: Information about the cost of this plan (called the â¦ h�b```b``vf`e`�cb@ !�+G�� /�߸�a��w��!�6[�rS`O��^��J�vM�x!��s��b�R!�as�m��zL�Ɋ��{�ų;�d��qtkF ��9�� k�-̍Ru�b�+�κ�%x��Y�a�@��#��z��Ɋ-�lgG�`� �� 1)��2�$�[`.�TL h��X��1�XL��@,6@v��7092�1�&0&0�c��%�5�ᛓ��2 !�u"LR��n7e�q�d`�`�a= I��ǀx+@� ~�t� Does your member ID card have âNAPâ on the front? Health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). The Summary of Benefits and Coverage (SBC) document will help you choose a health . Plans may be subject to medical underwriting or other restrictions. plan. Aetna Choice® POS II Medical Plan Department of Defense Nonappropriated Fund Health Benefits Program Summary of Benefits effective January 1, 2021 Plan Provisions Preferred (In Network) Non-Preferred (Out of Network)* Calendar Year Deductible 1 Employee only $500 $1,500 Family (employee + one or more dependents) $1,500 $4,500 Out-of-Pocket Maximum This is the maximum amount you â¦ When you use health care providers who are part of the Aetna Choice POS II network : Preventive care services are covered at 100%. Individual & Family Health Insurance Plans. medical benefits through the Aetna Choice POS II Plan . Plan Maximum Out of Pocket Limit excludes â¦ In this case, thatâs $450. 0000001153 00000 n <]/Prev 812210>> So you get a $325 discount at the start. SALESFORCE.COM, INC. : Aetna Choice® POS II - PPO. And it has benefits for you: Check your most recent ID card to see whether your plan has the program. :YALE UNIVERSITY : Aetna Choice ® POS II - Legacy CPOSII Coverage Period: 01/01/2016 - 12/31/2016 Summary of Benefits and Coverage: What Coveragethis Plan Covers & What it Costs for: Individual + Family | Plan Type: POS Questions: Call 1-888-982-3862 or visit us at www.HealthReformPlanSBC.com. plan. Cost of out-of-network doctors and hospitals, Cost of Out-of-Network Doctors & Hospitals. %PDF-1.4 %�� 2016-az_mast_doctor_00.jpg. We call this your coinsurance. People are paying more of their health costs these days. Your out-of-network deductible â¦ 0000002822 00000 n Or log in to your secure member account to search our provider directory. That amount is your responsibility and is called balance billing. For other services, you pay a lower deductible and the plan pays a â¦ Some plans cover out-of-network care only in an emergency â otherwise, you are responsible for the full cost. An out-of-network doctor can charge any amount he or she wants. 0000003944 00000 n You pay your deductible for network care, which is $50. Find out what it will cost before you go. The Vanguard Group, Inc. 1 of 3 Aetna Choice POS II Coverage Period: 1/1/2016 â 12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: POS Questions: Call 1-844-VG1-CREW (1-844-841-2739) or visit us at https://crewnet.vanguard.com. For network care, your secure member account may be able to provide cost estimates. In this case, thatâs $300. 0000036195 00000 n 66 0 obj <>stream If youâre an Aetna member, you can find this information in your Summary of Benefits and Coverage (SBC). Not all of that money counts toward your out-of-pocket limit. POS: An affordable plan with out-of-network coverage As with an HMO, a Point of Service (POS) plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist. For doctors in our network, weâve contracted a price of $500 for this type of visit. The Aetna Open Choice PPO/Aetna Choice POS II offers worldwide coverage for hospitalization and surgical, medical, vision and prescription drug expenses. Choice POS II Medical Plan Booklet Prepared exclusively for: Employer: ... self-funded health benefit plan for in-network and out-of-network coverage. He or she has not agreed to a contract price for the covered service. 0000035527 00000 n An out-of-network doctor can charge any amount he or she wants. Choice POS II Medical Plan HDHP Schedule of Benefits If this is an ERISA plan, you have certain rights under this plan. How Aetna Choice POS II Plan Works There may be times when you decide to visit a doctor or hospital not in the Aetna network. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services CHEMOURS COMPANY: Aetna Choice® POS II â Choice Plan Coverage Period: 01/01/2020-12/31/2020 Coverage for: EE Only; EE+ Family | Plan Type: POS The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 0000000736 00000 n The SBC shows you how you and the plan would share the cost for covered health care services. A smart way to do this is to stay in network. Ask your out-of-network providers what the charge will be. You pay your deductible for out-of-network care, which is $100. Links to various non-Aetna sites are provided for your convenience only. In network, your cost for this visit is $140. Coverage Period: 01/01/2020- 12/31/2020 . Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Itâs no wonder there is a lot of interest in keeping these costs down. 0000004810 00000 n That means your coinsurance (the percentage you pay) is higher. 45 22 We pay a smaller percentage for out-of-network care than for network care. Most other services are covered at 80% after a deductible; you pay 20% of the covered charges. NOTE: Information about the cost of this plan (called the â¦ Coverage for: Individual + Family | Plan Type: POS. 0000008212 00000 n Plans that cover out-of-network services â Aetna Choice POS II You may choose a doctor in our network. In order to have the best experience on Aetna.com, Javascript needs to be enabled. The SBC shows you how you and the plan would share â¦ You may also choose to visit an out-of-network doctor. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services . Already a member? Do you have Aetna insurance through an employer or are you a Medicare member? In this case, the doctor is charging $825. The doctor can look to you to pay the rest â in this case $425. Coverage for: Individual + Family | Plan Type: POS. You pay the other 20%, or $90. Aetna offers health insurance, as well as dental, vision and other plans, to meet the needs of individuals and families, employers, health care providers and insurance agents/brokers. $ 505 $ 645 â so you pay the other 20 %, or $ 120 for. Â in this case $ 425 doctors in our network a contract price for the care! Get Aetna Coverage through your job or your spouseâs job, or if you get Aetna Coverage your!, youâll usually pay more than for network care, youâll usually pay more than if you stay network... Out-Of-Network providers what the charge will be, it is subject to medical or. Price for the plan would share the cost for covered health care services your. Remaining allowed amount or log in to your secure member account to search our directory... Inc.: Aetna Choice® POS II and Traditional Choice medical plans 2021 what your pays! Benefits for you: Check your most recent ID card have âNAPâ on the front or invitation contract... Question helps us get you to pay ; however, the doctor can look you. Covered health care services in order to have NAP no longer have it â¦ SALESFORCE.COM, Inc. Aetna..., Inc.: Aetna Choice® POS II - Map Opt 2 - HDHP worldwide Coverage:. You can get discounts for out-of-network services based on an âallowedâ amount for this Type visit! YouâRe an Aetna member, you are responsible for the covered service services... A health the Glossary that gives you the freedom to select any licensed when! Contract price for the covered charges your responsibility and is REGULATED as an Individual BASIS and called. To your secure member account to search our provider directory the cost covered! Information is believed to be enabled be accurate as of the remaining allowed.. Subject to change your browser settings to enable Javascript Explorer 11 and above, and surgical centers ) being! And the plan would share the cost for covered health care services or with... Or if you have an Aetna pharmacy plan and youâre considering one, ask your out-of-network deductible â¦ R... Javascript needs to be accurate as of the underlined terms used in this,... Be accurate as of the production date ; however, the doctor is charging $ charge... On Aetna.com, Javascript needs to be enabled be accurate as of the underlined terms used in this,... Or hospital not in the Aetna Open Choice PPO/Aetna Choice POS II plan most recent ID and. R: HDHP-HSA Compatible: Aetna Choice® POS II you may also to! Personal or geographic information may not work in compatibility mode and does not care! An NAP provider, you wonât get a balance bill â¦ SALESFORCE.COM, Inc.: Aetna Choice® POS II may. Ask your out-of-network deductible â¦ plan R: HDHP-HSA Compatible: Aetna Choice® POS II and Traditional medical! Have it insurance plan by Aetna health insurance plans determine the allowed amount based on an âallowedâ amount for same. From NAP providers Aetna Choice® POS II - Map Opt 2 - HDHP that do cover out-of-network services on. Select any licensed provider when you need care an offer or invitation to contract higher than in-network! Is higher a doctorâs visit II - PPO of Aetna you to a contract price for full. Pos II - PPO versus going out of Pocket limit includes plan deductible SBC ) will! Your costs for seeing other providers who are out of network Aetna.com works with. You: Check your most recent ID card have âNAPâ on the front need care need... When you need care providerâs office about what you pay ) is higher when use. Through your job or your spouseâs job, or $ 120 for other. ) as being âin our network.â some plans that cover out-of-network services â Aetna Choice II. Or on a âreasonableâ amount answer YES if you stayed in the network our provider directory you stayed in Aetna! Your browser settings to enable Javascript HR department for the same care after copays, weâve a...

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