benefits
Medical
Unlock the secret to staying ahead of health hiccups – early detection is key! Embrace the power of an annual wellness exam, fostering a robust bond with your doctor. Plus, revel in the fact that our plans not only cover preventive services but does it at a glorious 100% when you choose an in-network doctor.
Your Medical Plans
HMO Plan
With an HMO plan you select a primary care provider to coordinate your care and specialty referral needs.
All well-care child visits, routine adult physical exams and telehealth visits are covered by the plan at 100% – no cost to you!
You are responsible for paying the costs of services out of pocket at 100% until you meet your deductible. Once your deductible is met, you have a 20% co-insurance up to your annual out of pocket maximum.
Highlights
- Low premiums
- Covers routine vision exams
HSA Plans
With an HSA plan, you do not pay for services incurred at the time of service. Your provider works with Aetna to relay the negotiated or plan discount for services incurred and due payable by you. An HSA health plan puts you in control of your healthcare dollars. The money in an HSA is your own cash account that is funded by you and your employer. Since the HSA is employee owned, you decide how you want to use the funds in the account to pay for your healthcare expenses. You have the option to either utilize your Health Savings Account (HSA) to pay for incurred services, or save your HSA money, allowing it to earn interest and pay the expenses out of pocket. Let’s go through a real life example to illustrate how a HSA health plan works:
Sarah contributes $2K of her own pre-tax money into her HSA throughout the year. Additionally, Sarah receives an annual employer contribution of $1K. This brings her total HSA balance to $3K.
Sarah visits a doctor for knee pain, which costs $200. Since she has not yet met her deductible of $1,800, Sarah owes the $200 for the visit. Sarah has the option to pay for the services out of pocket or she may choose to use her HSA funds to cover this expense. Over the next couple of months, Sarah incurs additional medical expenses and has met her $1,800 deductible. With the deductible now being met, Sarah is only responsible for 20% of the cost of in-network services incurred, and the plan pays 80%.
Sarah elected to pay for some of the medical expenses she incurred through out the year out of pocket, and some expenses she paid with her HSA. The unused funds in Sarah’s HSA roll over to the next year and can be saved for future medical expenses or invested for growth.
Preventative Care
Stay healthy by taking advantage of your preventative care benefits. It’s the ultimate self -care with no out-of pocket costs.
- Routine check ups for adults and children
- Cholesterol and diabetes screenings
- Immunizations like flu, COVID, pneumonia
- Routine gynecological exams and mammograms
- Routine prostate-specific antigen exams
- Routine colorectal cancer screenings (age 45+)
A smarter, simpler, more convenient way to take charge of your healthcare benefits.
Did you know...
Your Aetna Health Plan is equipped with more than basic healthcare coverage. With your enrollment in Aetna the following resources are available to you.
24 Hour Nurse Line
Questions about upcoming medical visits and choices? You can talk to a registered nurse for information about tests, procedures and treatment options, 24/7 and the call is free.
1-800-556-1555
Women's Health Support Center & Enhanced Maternity Center
Explore a curated hub tailored to the diverse health needs of women, spanning from adolescence to post-menopause. Dive into a wealth of resources designed to accompany you through various life stages and events, empowering you with knowledge and support along the way.
- Reproductive Health
- Menstrual Health & Menopause
- Maternity Support Center
- and more!
To access, navigate to Health & Wellness in your Aenta.com member account.
The maternity journey is different for everyone. Aetna’s Maternity Support Center and Enhanced Maternity Program supports you throughout the entire experience.
- Personalized support – maternity nurses guide you through each stage of your pregnancy journey
- Fertility services
- Preeclampsia prevention
- Adopting a newborn
- Genetic counseling and screening for pregnancy planning
- Education and resources
Text BABY to 66902 or call 1-800-272-3531 weekdays from 8am – 7pm EST.
Aetna’s National Infertility Unit is staffed by a dedicated team of registered nurses and infertility coordinators. They can help you with determining eligibility for benefits and pre-certification. Call 1-800-575-5999
Transgender & Gender Diverse Support
Personalized support and guidance for your unique health needs – from first steps in exploring gender to accessing gender affirming care and more.
- Dedicated transgender and gender diverse support representatives
- Know and understand your benefits and costs
- Locate a care team that provides gender-affirming care
- Resources for all stages
Informed DNA - Guided Genetic Health Program
Genetic counseling and testing to assess your risk of developing inherited cancer and guide your treatment. With the Guided Genetic Health program, you can:
- Access a free online questionnaire to determine if genetic counseling and testing is right for you
- Participate in convenient, at-home genetic testing and counseling
- Receive personalized and actionable health
recommendations that you can share with your provider
To access, navigate to Health & Wellness in your Aenta.com member account.
Gene, Cellular & Innovative Therapies
You may never need treatment for a rare disease. But you can rest a little easier if you do because you have access to this special program.
- Access to facilities specializing in treating genetic conditions
- Nurse care Managers with specialized experience
- Dedicated claims and member services staff
Contact your Aetna Concierge 1-855-586-6958
Health Decision Support with Emmi & Healthwise
Emmi provides video resources to help you prepare for procedures, manage a health condition, explore treatment options and more.
Healthwise is a knowledgebase for health conditions, treatments, medications and more.
To access, navigate to Health & Wellness in your Aenta.com member account.
Aetna Cancer Support Center
The Aetna Support Center brings resources to your fingertips, serving as your trusted source for information and guidance on what to expect while managing cancer treatment and care.
For more information, visit the Aetna Cancer Support Center
Three ways to login:
- Visit aetna.com and navigate to your member website
- Visit aetna.com/cancersupport
- Text “cancer care” to 66902 and receive a link to log in to the support center
Related Content
Looking for assistance with your healthcare? We're here for you.
From guidance in choosing the best options for you, what resources are available to understanding how the plans work. The information you need is at your fingertips.
Your HR Team
Melissa Lizotte
Meaghan Conway Jurczak
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View your HRA fund balance, monitor your deductible and maximum out of pocket costs, and more on your Aetna member website.
Money Saving Tips
See in-network providers– They’ve agreed to the plan’s negotiated rates. Visit your plan website to search for in -network providers near you.
Ditch the ER – Opt for Urgent Care centers. Your plan covers visits to urgent care facilities at 80% with no deductible.
Stack Your Benefits – Ask your behavioral health provider if they are in the Aetna EAP network. If they are, you could be eligible for up to 22 free behavioral health visits.
Optimize Your HSA – Take advantage of the triple tax advantage offered with HSA accounts and contribute the maximum annually.
Ask your Aetna Concierge
Get personalized support and the answers you need.
- Is this covered under my plan?
- Help me understand my bill.
- I have a family history of cancer, what preventative care resources are available to me through Aetna
- Help me find an in-network provider accepting new patients.