About the plan:
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This high deductible health plan (HDHP) with health savings account (HSA) is an innovative health plan that gives you more control over how you spend your health care dollars. Or it can help save for future health care expenses with a tax-advantaged HSA.
Key plan features include:
- Lower premiums with automatic monthly deposits into your HSA of $66.67 for Self Only enrollments and $133.34 for Self Plus One or Self and Family enrollments
- 100% coverage for in-network preventive care (medical, dental and vision) that is not subject to the deductible
- You can use your PayFlex® Aetna HSA Mastercard® to pay claims
- Your voluntary HSA contributions are tax deductible
- Tax-free withdrawals may be made for qualified expenses
- Unused funds and interest are carried over, without limit, from year to year
- You own the HSA and it is yours to keep — even when you change health plans, jobs or retire
- Nationwide coverage with the freedom to choose your providers
- Traditional medical plan coverage of 85% in network and 60% out of network once the deductible has been met
- A cap that limits the amount you will have to pay out of pocket in a plan year
*Please note: There may be fees associated with an HSA. These are the same types of fees you may pay for checking account transactions. See the HSA fee schedule in your HSA enrollment materials for more information.
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The Aetna HDHP with HSA is a health plan that provides traditional health care coverage and a tax-advantaged way to help you build savings for future medical needs. This plan is designed to give greater flexibility and discretion over how you use your health care benefits. You decide how to spend the dollars in your HSA.
To understand how the plan works, let's review its components.
The HSA:- The plan will automatically deposit $66.67 per month/Self Only or $133.34 per month/Self Plus One or Self and Family into your HSA premium pass through. (That is $800/Self Only or $1,600/Self Plus One or Self and Family annually.)
- You can make voluntary contributions to your HSA. The annual statutory maximum (plan contributions plus voluntary contributions) for 2023 is $3,850/Self Only or $7,750/Self Plus One or Self and Family. So, factoring in the plan's contributions, you may voluntarily deposit up to $3,050/Self Only or $6,150 Self Plus One or Self and Family. If you or your spouse are age 55 or older, you may each make an additional catch-up contribution for 2023.
- When you have a qualified expense (e.g. doctor visit, prescription refill, dental procedures), you may pay for it with your tax-free HSA money. Or you can choose to pay out of pocket and allow your HSA to grow over time and use it for future health-related expenses. Expenses covered by the plan will apply to your deductible. Expenses not covered by the plan will not.
- Any unused HSA dollars roll over year after year.
- You own your HSA, so you keep it even if you change health plans or jobs.
- You may want to make voluntary contributions to your HSA every year. This will lower your taxes and help you build a larger savings for future health care expenses.
- In addition to the HSA, your Aetna HealthFund® plan HDHP provides traditional health benefits after you have met your deductible. You can visit doctors or hospitals in our preferred provider organization (PPO) network. Or go out of network and use any licensed health care professional or hospital for covered services — without a referral. Hospitalization and certain procedures require precertification.
- Preventive care — In-network preventive care (e.g. routine physicals, immunizations, screenings and cleanings at the dentist) is covered at 100%.
- Deductible — A deductible is the amount you pay out of pocket before the plan pays for covered services. The plan's annual deductible is $1,800/Self Only or $3,600/Self Plus One or Self and Family for in-network service and $2,600/Self Only or $5,200/Self Plus One or Self and Family for out-of-network service per year. Remember, you may use money from your HSA to pay for covered health care expenses prior to satisfying your deductible.
- Medical coverage — Once the deductible is met, the plan begins to pay for covered expenses. The plan will cover 85% for in-network services and 60% for out-of-network services. The plan also includes an annual out-of-pocket maximum to limit the amount you pay each year. Once you reach that maximum, the plan pays 100% of your covered medical expenses for the remainder of the plan year. The 2023 in-network out-of-pocket maximum is $6,900 for Self Only and $13,800 for Self Plus One or Self and Family enrollment.
- Prescription drug coverage — When you fill a prescription, you will pay the cost of the prescription until the deductible has been met. Once the deductible has been met, you pay a copay or coinsurance for each covered prescription. Refer to your Federal Plan brochure for more details.
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If you are looking for a plan with 100% coverage for in-network preventive care, nationwide coverage in and out of network, and an HSA that is yours, then the HDHP with HSA could be right for you.
Consider the following:- Review your past year's medical services use and expenses. Be sure to include the cost of your prescription medications in your review.
- Estimate any expected changes in your medical expenses for the coming year.
- Compare the out-of-pocket costs (employee contributions, deductibles, coinsurance, etc.) for the HDHP with HSA and other health insurance plans available to you.
- Compare dental and vision benefits available with the HDHP with HSA and other health benefits plans available to you.
- Think about whether you are ready to participate in an HDHP, knowing that you may save through tax-free payments on health expenses.
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You have several options:
- Review the Federal Plan brochure and other information on this website
- Chat live with a health plan specialist or schedule an appointment for a one-on-one phone consultation at AetnaFedsLive.com
- Call us at 1-855-277-4356 (TTY: 711)
Health savings account (HSA):
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An HSA is a tax-advantaged account that you own. You can contribute to it with pre-tax funds. It’s not taxed when you use your funds for qualified medical care. Plus, it even earns interest tax-free.
- The plan makes contributions to your HSA each month.
- You may also make voluntary contributions to your HSA.
- Your HSA dollars earn interest, tax-free.
- At the end of the year, any money remaining in your HSA rolls over to the next year.
- You own your HSA, so you keep the money even if you change jobs or health plans.
You can pay for qualified expenses with money withdrawn directly from your HSA using your PayFlex® Aetna HSA Mastercard®. Or use the online payment features to pay your provider directly from your account. You can also allow the account to grow over time and use it to help pay for future health-related expenses — like long-term care insurance premiums, TCC/COBRA premiums and certain retiree expenses.
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Yes, the Aetna HDHP with HSA meets all of the requirements to be considered qualified by the IRS.
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To be eligible for an HSA, you must meet certain requirements:
- You must be covered by a High Deductible Health Plan (HDHP).
- You cannot have other health coverage that pays for out-of-pocket health care expenses before you meet your plan deductible.
- You or your spouse cannot have a regular health care flexible spending account (FSA)* or regular health reimbursement arrangement (HRA)* in the same year.
- You cannot have Medicare or TRICARE.
- You cannot have received certain Veterans Administration (VA) health benefits in the previous three months.
- You cannot be claimed as a dependent on another person's tax return.
*You can have a Limited Purpose FSA (LPFSA) or Limited HRA. Generally, you can use an LPFSA or LHRA for eligible dental and vision expenses. This can help you save your HSA funds for other eligible expenses.
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No, you may no longer contribute to your HSA. But you may keep using the funds in your account. If you no longer qualify for an HSA, you are responsible for notifying us. Then, we will enroll you in our HDHP with a health reimbursement arrangement (HRA).
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You can check your HSA balance on your member website, or ask to receive a monthly paper statement. Or you can call Aetna Customer Service as directed on your PayFlex Card®.
You may check the status of your deductible on your member website.
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You can use your HSA to pay for some OTC products. You can find detailed information by visiting IRS.gov. Refer to IRS Publications 969 and 502.
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At the end of the year, any money remaining in your HSA stays in your HSA for the next year.
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Yes, the money in your HSA earns interest. Interest earned on your HSA is not included in your income for federal tax purposes. There is no minimum balance required to earn interest. Interest is earned at a higher level as your balance grows. Interest rates are calculated per account balance ranges and the associated interest rates per tier each day, stored, and credited to your account on the second banking day of the next month. If you close your account mid-month, you won't receive interest for that month.
For HSA balances of $1,000 or more, you'll be able to invest in a variety of mutual funds. Participation in the investment options is entirely optional. You can view these funds in the Financial Center of your online account. See the Federal Plan brochure for more details.
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You have three options.
Option 1: Keep your HSA at PayFlex- You can use your remaining balance to pay for your eligible health care expenses.
- You have until the tax filing deadline to contribute for the months that you were eligible. You'll need to divide the IRS contribution limit by the number of months you were eligible. This will help you know how much you're eligible to contribute.
- You'll use the same PayFlex Card®.
- You'll have to pay a monthly maintenance fee. This fee will be paid from your HSA on the first of each month. You'll need to log in to your PayFlex account to view the HSA Fee Schedule.
- You'll continue to use the PayFlex member website to manage your HSA.
- You may move your HSA funds to your new HSA administrator. Just ask them for a Trustee Transfer form. Then, complete the form and send it to PayFlex.
- You may request to withdraw your balance from PayFlex and have the funds sent directly to you.
- To help avoid taxes and penalties on these funds, you'll need to roll over those funds into a new HSA. You must complete this process within 60 days of receiving the funds.
- You're only allowed one rollover into another HSA per calendar year. This is an IRS rule.
- The funds you roll over don't count toward the IRS annual maximum contribution amount.
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If the named beneficiary is the deceased account holder's surviving spouse, the spouse becomes the account holder of the HSA and the transfer is not taxable. The surviving spouse would be subject to income tax only to the extent that any distributions from the HSA were not used for qualified medical expenses.
If the named beneficiary is someone other than the deceased account holder's surviving spouse, the HSA ceases to be an HSA. An amount equal to the fair market value of the account assets as of the date of the account holder's death is includible in the beneficiary's gross income (or, if the beneficiary is the deceased account holder's estate, includible in the decedent's gross income for the year in which the death occurred).
A named non-spouse beneficiary (other than the deceased account holder's estate) may reduce the includible amount by the amount of any payments made from the HSA for qualified medical expenses incurred by the decedent before death, but only if the payments are made within one year after the death.
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You may be able to make pre-tax contributions to your HSA through the Federal Flexible Benefits Plan (FEDFLEX). The Office of Personnel Management has worked with payroll providers and employee self-service systems to provide this service. Please contact your payroll office to determine whether this feature is available for your agency.
You may also contribute to your HSA outside of payroll deductions (post-tax). These contributions are still tax deductible on your tax return. You can make contributions from your personal checking or savings account by completing an EFT form, which can be found in our HSA resources. You have until April 15 of the following year to make HSA contributions for the current plan year.
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Once you have funds in your HSA, you can use your PayFlex® Aetna HSA Mastercard® to pay for eligible health care expenses. If you paid out of your pocket, you can go online and reimburse yourself.
When you reimburse yourself, you can do so through a linked bank account. This will withdraw funds from your HSA and deposit them into your personal account. It can take up to 48 hours for you to see the funds in your account.
To link a bank account, log in and go to your account settings to get started.
If you prefer to receive a check, use the online tool to request funds and pay yourself back. The online "connected claims" feature is another fast and easy way to pay out-of-pocket health expenses from your HSA, without having to use your PayFlex® Aetna HSA Mastercard®. You can go online, view your claims and choose how to pay them. You can pay the provider, pay yourself back or you can archive the claim for future use.
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You can use your HSA to pay for qualified medical expenses . This includes qualified expenses for you, your spouse and your tax dependents. This is true even if they aren’t covered by your HDHP. You can view a list of common eligible expenses online.
To use your HSA funds, you must have received the care on or after the effective date of your HSA. You can find more information IRS.gov. Refer to IRS Publications 969 and 502.
Remember to keep receipts for your HSA purchases to show that you used your HSA funds for qualified expenses. Under HSA regulations, you are responsible for determining which expenses are considered "qualified expenses." Please consult your tax advisor for guidance.
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You may withdraw money from your HSA for items other than qualified expenses; however, taxes and penalties may apply. Please consult your tax advisor for guidance.
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The administrative fee to maintain your HSA is included in your premium. If you are not enrolled in our HDHP, you’ll have to pay a monthly maintenance fee. This fee will be deducted from your PayFlex HSA on the first of each month.
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No, there are no fees associated with using the PayFlex Card®.
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The plan makes deposits to the HSA monthly. The monthly deposit is $66.67 per month for Self Only coverage and $133.34 per month for Self Plus One or Self and Family coverage. Deposits can total up to $800 per year for Self Only coverage or $1,600 per year for Self Plus One or Self and Family coverage, depending on the date that coverage commences.
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Each year, the Internal Revenue Service (IRS) sets annual contribution limits for HSAs. These limits are based on your HDHP coverage level (Self Only, Self plus One, or Self and Family). For 2023, the limit for Self Only coverage is $3,850 and $7,750 for a Self plus One or Self and Family.
You can contribute in a lump sum or multiple times throughout the year. You can change how much you contribute at any time during the year; you don’t need a life event change. If you’re age 55 or older, you can contribute an additional $1,000 per year. This is a “catch-up” contribution.
This means the amount you can contribute is based on a few things:- Do you have Self Only or Self and Family coverage?
- Did you have coverage under the plan for the entire year? If not, you may have to prorate how much you can contribute. Proration means you only contribute for the number of months you have the HDHP.
- Are you 55 or older?
- You may want to speak with your tax advisor. They can help you understand how much you can contribute to your HSA. You might also find it helpful to review IRS Publication 969 at IRS.gov.
- Do you have Self Only or Self and Family coverage?
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Yes. The annual statutory maximum (plan contributions plus voluntary contributions) for 2023 is $3,850/Self Only or $7,750/Self Plus One or Self and Family per year. You may voluntarily deposit up to $3,050/Self Only or $6,150 Self Plus One or Self and Family.
For example, if you have Self Only coverage and you join during Open Season, the plan will contribute $800 from premium on an annual basis (or $66.67 per month) and you may make up to a $3,050 voluntary contribution for a total of $3,850, if your HSA effective date is January 1, 2023. If you have Self Plus One or Self and Family coverage, the plan will contribute $1,600 from premium on an annual basis (or $133.34 per month) and you may make up to a $6,150 voluntary contribution for a total of $7,750 if your HSA effective date is January 1, 2023.
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If the amount of your eligible medical expense exceeds the amount in your HSA, you would be responsible for paying that expense out of pocket. You can reimburse yourself using online payment options as additional funds become available.
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You may be able to make pre-tax allotments to HSAs through The Federal Flexible Benefits Plan (FEDFLEX). The Office of Personnel Management has worked with payroll providers and employee self-service systems to provide this service. Please contact your payroll office to determine whether this feature is available for your agency.
You may also have funds direct deposited to your HSA on a post-tax basis from your personal checking or savings account by completing an EFT form, which can be found in HSA resources.
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You can use funds from your HSA to pay for LTC insurance premiums. The amount you withdraw from your HSA to pay LTC premiums would NOT count toward your catastrophic limit, nor toward your deductible, because it is not a covered expense under the HDHP plan.
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You can view your account balance through the PayFlex Mobile® app. You can also sign up to receive emails or text messages with your balance.
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Yes. The OPM website has extensive information about HSAs including FAQs, worksheets, comparison charts, etc. Go to OPM.gov.
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Your voluntary contributions to your HSA made with post-tax dollars (money that has already been subject to income tax) are tax deductible.
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PayFlex® will send a Form 5498-SA that will list your contributions to your HSA and a Form 1099-SA that will list the distributions from your HSA. You will need to complete a Form 8889 to report HSA contributions. See the IRS website or your tax advisor for more information.
Doctors and networks:
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No. While you can save money by visiting in-network providers, you have coverage in and out-of-network.
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The Aetna HDHP plan offers you the flexibility to visit any licensed provider (both in and out of network). When you visit an out-of-network provider, you will pay a coinsurance of 40% of our plan allowance. And any difference between our allowance and the billed amount once you meet your deductible. The annual out-of-network deductible is $2,600 for Self Only and $5,200 for Self Plus One or Self and Family.
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Use our provider search. You can access information about our extensive network of providers, as well as individual physicians' board certification status, medical school attended, the year they graduated, languages spoken, etc.
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Yes, you can visit a MinuteClinic location for urgent care with a $0 copay after you meet your deductible.
What will I pay?
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Yes, mail-order pharmacy is available for maintenance medications. Your share of the cost for up to a 90-day prescription will be equal to the cost of two 30-day retail fills. You can also get your 90-day prescription at a CVS Pharmacy® location for the same cost as mail-order. For a complete list of other participating pharmacies, log in to Aetna.com and use our provider search tool.
Go to your member website and select "pharmacy benefits" for details and forms.
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Yes, your calendar year in-network deductible is $1,800 for Self Only coverage, $3,600 Self Plus One or Self and Family.
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Once you pay your deductible, you pay a coinsurance for most services. Coinsurance amounts are listed in the Federal Plan Brochure. They will apply until you meet your out-of-pocket maximum.
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The annual deductible must be met before plan benefits are paid for care other than preventive care services.
The annual deductibles for in-network are:- $1,800 for Self Only
- $3,600 for Self Plus One
- $3,600 for Self and Family
- $2,600 for Self Only
- $5,200 for Self Plus One
- $5,200 for Self and Family
Once any covered individual under the Self Plus One or Self and Family enrollment meets a $3,000 deductible, the Plan will begin to cover that member's eligible medical benefits. The remaining balance of the plan deductible can be satisfied by one or more family members.
In-network and Out-of-network deductibles do not cross apply and will need to be met separately for traditional benefits to begin.
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In most cases, you won’t make a payment at the time you receive services at an in-network provider. Instead, you should wait for the medical claim to be processed through our claim system. We will process the claim and apply the applicable amount toward your deductible. The doctor's office will send you a bill requesting payment. If you decide to use your HSA, you should write your PayFlex Card® debit card number on the doctor's bill and submit for payment. If you have already met your deductible, you will be billed for the coinsurance amount which is based on the negotiated rate with the in-network provider.
While many out-of-network providers will submit claims for covered care to us on your behalf, some may not. In that case, you may have to pay the full cost of the visit up front and then submit a claim.
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Until you meet your deductible, you will pay the entire cost of the negotiated rate for the prescription at an in-network pharmacy. It is important for you to identify yourself as an Aetna member and show your Aetna ID card to get the negotiated rate. If you have funds available in your HSA, you may use your PayFlex® Aetna HSA Mastercard® debit card to purchase the prescription. Once you meet your deductible, you will be subject to a prescription copay or coinsurance for covered drugs. See Aetna HealthFund® plan HDHP federal brochure for more details.
Dental and vision:
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Preventive dental benefits are built in to the HDHP at no added cost. There is 100% coverage for dental cleanings and X-rays received from in-network dentists.
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The HDHP plan covers one routine eye exam (including refraction) every 12-month period at 100% in network. Additionally, a $100 reimbursement for eyeglasses or contact lenses is available every 24 months.
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The plan only covers in-network preventive dental care at 100%. Find participating providers by using our provider search.
There is no coverage for out-of-network dental care. You may choose to use your HSA to pay for non-covered dental care. However, non-covered services would not apply to the deductible. As long as the services are considered IRS-qualified expenses, your HSA withdrawal would not be taxed. For the list of IRS-allowable expenses, you can request a copy of IRS Publication 502 by calling 1-800-829-3676. Or visit IRS.gov/publications/p969.
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One routine eye refraction every 12-month period is covered at 100% when you visit a participating provider. Your provider will submit the claim to Aetna and you won’t pay anything. Members are also eligible for a $100 eyewear reimbursement every 24 months and discounts on frames, lenses, LASIK procedure, etc., through the Aetna VisionSM discount program. If you use a participating location, they will take the $100 eyewear reimbursement off at the point of sale. If you use another eyewear provider, simply mail the receipt along with your member ID number to:
Aetna
PO Box 14089
Lexington, KY
40512-4089You can find participating locations by using our provider search.
If you use a nonparticipating provider, you may have to submit a claim. Claim forms are available on your member website.
Enrollment:
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Enrollment procedures vary by agency. Detailed instructions and information on the Federal Employees Health Benefits (FEHB) Program enrollment process is available at the Enroll Now link on the website. You will need to know the enrollment code for the Aetna HDHP with HSA. Please refer to the rate calculator for the plans available in your area and the federal enrollment codes.
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Coverage and 2023 benefit changes for current members and annuitants begins on January 1, 2023. Coverage for Aetna members joining during Open Season becomes effective on the first day of the first pay period in January 2023.
If you enroll as a newly hired Federal Employee, you have 60 days to enroll in an FEHB plan. Your enrollment will become effective the beginning of the pay period after your enrollment is received.
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If you do not receive your ID card by your effective date, you may use a copy of your SF2809 Form or electronic enrollment (e.g., Employee Express, PostalEase, etc.) confirmation. If you are enrolled in our system, you may register on your member website and print an ID card. After you register, simply select "Get an ID card" and follow the instructions. You may use this printable version of your personal ID card if you need medical or dental care.
Member perks:
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Our member website is packed with health and benefits information. When you register, you can print temporary ID cards, check eligibility or claim status, check fund balances and much more. Here are just a few of the highlights:
- Cost estimator tools — Provides personalized cost information. You can estimate how much you’ll pay out of pocket for medical tests, office visits and procedures ahead of time. If Medicare is your primary coverage, these estimates may not be representative of your actual costs.
- Hospital Comparison Tool — See how hospitals in your area rank by factors important to you.
- Personal Health Record —A private and secure online tool that captures important health information in one place. It can help you stay healthy with personalized alerts and reminders and lets you print and share your health history with your doctors.
- Our provider search tool — Helps you find doctors, dentists, hospitals and other providers that accept your plan. Using in-network providers will help you save money. The provider search tool also includes important provider credentials like education, board certification and languages spoken.
- Aetna HealthSM app — Puts our online features at your fingertips. You can view your member ID card, find a doctor, look up claims and access your personal health record (PHR). The app is available on the App Store® or the Google Play™ store. Just type Aetna.com into your mobile web browser.
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All members have access to Teladoc Health, a convenient, lower-cost alternative to urgent care or the emergency room. It lets you access board-certified doctors by web, phone or mobile app in under 10 minutes. It's perfect for when you're traveling or when your doctor isn't available. Members can simply visit Teladoc.com/Aetna or call 1-855-Teladoc to get started.
Teladoc doctors prescribe medical treatment for a wide range of conditions including cold and flu, pink eye, skin rash and stress/anxiety. They can even call in a prescription to your pharmacy of choice, when necessary. All Teladoc doctors:- Are U.S. board-certified internists, state-licensed family practitioners, and pediatricians licensed to practice medicine in the U.S.
- Are U.S. residents
Consultations are $49 or less for most services, depending on your plan, and do not require a referral.
Please note: Teladoc is not available to all members. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. Visit Teladoc.com/Aetna for a complete description of the limitations of Teladoc services. Teladoc, Teladoc Health and the Teladoc Health logo are registered trademarks of Teladoc Health, Inc. -
You must live or work in our service area to enroll in our plan. Return to the homepage to find plans available in your area. Once you’re enrolled in the plan, covered medical services received overseas would be considered out of network. See Section 7 of our federal brochure for more information on how to submit overseas claims. You will continue to be able to use your HSA for Qualified Medical Expenses where accepted.
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Yes. You get access to great discounts on prescription eyewear, vision services, gyms, weight loss programs, chiropractic, acupuncture, massage, vitamins, electric toothbrushes, gum, mints and more. Visit AetnaFeds.com/Perks for more information.
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You can earn additional $75 for Self Only or $150 for Self Plus One or Self and Family (enrollee and spouse only) by completing the online health risk assessment, one online wellness program and your biometric screening. Log in to your member website to complete the health risk assessment. The money goes directly into your HSA.
DISCLAIMERS
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Pharmacy benefits are administered through an affiliated pharmacy benefit manager, CVS Caremark. Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies. Pharmacy benefits are administered through an affiliated pharmacy benefit manager, CVS Caremark.
There may be fees associated with a health savings account (HSA). These are the same types of fees you may pay for checking account transactions. Please see the HSA fee schedule in your HSA enrollment materials for more information. This material is for informational purposes only and is not an offer of coverage. It does not contain legal or tax advice. You should contact your legal counsel if you have any questions or if you need additional information. Information is believed to be accurate as of the production date; however, it is subject to change. PayFlex cannot and shall not provide any payment or service in violation of any United States (US) economic or trade sanctions. For more information about PayFlex, visit payflex.com.
Teladoc is not available to all members and is not available in all states. Check your plan for details. Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna or plans administered by Aetna. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services.
External websites links are provided for your information and convenience only and do not imply or mean that Aetna endorses the content of such linked websites or third-party services. Aetna has no control over the content or materials contained therein. Aetna therefore makes no warranties or representations, express or implied, about such linked websites, the third parties they are owned and operated by, and the information and/or the suitability or quality of the products contained on them.
Estimated costs are not available in all markets or for all services. We provide an estimate for the amount you would owe for a particular service based on your plan at that very point in time. It is not a guarantee. Actual costs may differ from an estimate for various reasons including claims processing times for other services, providers joining or leaving our network or changes to your plan. Health maintenance organization (HMO) members can only get estimated costs for doctor and outpatient facility services.
Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states and on indemnity plans.
DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge on products and services offered by third party vendors and providers. Aetna makes no payment to the third parties — you are responsible for the full cost. Check any insurance plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts.
Discount vendors and providers are not agents of Aetna and are solely responsible for the products and services they provide. Discount offers are not guaranteed and may be ended at any time. Aetna may get a fee when you buy these discounted products and services.
Vision care providers are contracted through EyeMed Vision Care. LASIK surgery discounts are offered by the U.S. Laser Network and Qualsight.
Natural products and services are offered through ChooseHealthy®, a program provided by ChooseHealthy, Inc. which is a subsidiary of American Specialty Health Incorporated (ASH). ChooseHealthy is a registered trademark of ASH and is used with permission.
Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.
Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor.
Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple, Inc. Google Play and the Google Play logo are trademarks of Google LLC. Trademarks included in this material are the intellectual property of their respective owners.
For a complete list of other participating pharmacies, log in to Aetna.com and use our provider search tool.
©2023 Aetna Inc.