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Aetna Value Plan

National PPO network, wellness credits, low rates and no referrals

2021 Biweekly rates for zip code

These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.

Table of rates.
Aetna Value Plan Code Non-Postal Postal 1 Postal 2
Click to learn more about non-postal, postal 1 and postal 2 rates

Your 2021 benefits

Table of plan details.
Plan Details What you pay
In the network
What you pay
Out of network
Preventive Care $0

(no deductible applies)

Primary care visit $25

(no deductible applies)

Specialist visit $40

(no deductible applies)

Maternity   50%
Prenatal Care $0 50%
Hospital Care 20% 50%
Yearly Deductible $700 Self Only
$1,400 Self Plus One or Family
$1,400 Self Only
$2,800 Self Plus One or Family
Other services

(Like inpatient and outpatient hospital procedures)

20% of plan allowance 50% of plan allowance

Prescription drug benefits

Table of prescription drug benefits.
Prescription drugs

(for a 30-day supply at a retail pharmacy)

What you pay
In the network
What you pay
Out of network
Generic formulary* $10

(no deductible applies)

Brand-name formulary*

(no generic available)


(no deductible applies)


(no generic available)


(no deductible applies)

Specialty drugs** 50%

(no deductible applies)


Note: You don’t need to meet a deductible for prescription drugs. Just pay your copay or coinsurance (as noted below).

30-day supply at a retail pharmacy¹:

$10 for generics, 30% of cost of brand name up to a $600 maximum, 50% of cost of non-formulary up to a $600 maximum†

90-day supply through mail-order service:

You’ll generally pay less for a 3-month supply than for 3 separate 1-month supplies.

Earn Wellness Incentive Credits

  • Step 1: Get preventive care like routine physicals, flu shots and biometric screenings.
  • Step 2: Earn $50 in wellness credits for each activity (up to $250 for Self Only or $500 for Self Plus One or Family coverage).
  • Step 3: Use those credits to pay your deductible or medical coinsurance costs.

The rates provided above do not apply to all enrollees. If you are in a special enrollment category, please refer to your special FEHB Guide or contact the agency which maintains your health benefits enrollment.

Why choose the Aetna Value Plan?

  • Large nationwide Aetna PPO Network
  • Low monthly premium costs
  • Deductible no longer applies to office visits or for prescriptions.
  • Earn up to $250/self or $500/self plus one and family in wellness credits
  • Acupuncture and chiropractic care are covered!
  • 24/7 access to doctors via phone or video with Teladoc®
  • Healthy ways to reduce your out-of-pocket costs — complete wellness activities and earn wellness credits toward your medical deductible or coinsurance
  • Discounts on eyewear, LASIK surgery, gym memberships, massage, acupuncture, weight-loss programs and more

Your plan requires the use of generic medication when a generic equivalent exists. ***
*Formulary is a list of generic and brand-name drugs your health plan prefers.
**Plus the difference between the plan allowance and billed amount.
*** If you choose the brand name drug over the generic equivalent, you will owe the corresponding copay plus the difference between the generic and brand name costs. Please see the plan brochure for details.
****For specialty drug information, see the federal plan brochure.

¹If you use an out-of-network retail pharmacy, you pay 50 percent of the negotiated rate for all types of drugs, plus any difference between our allowance and the billed amount.

Or get a 90-day supply through mail-order service.

†Teladoc® is covered at the member cost share.
] Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. 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.

Health insurance plans are offered, underwritten and/or administered by Aetna Life Insurance Company (Aetna).

This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the Plan's applicable Federal brochure(s). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. Plan features and availability may vary by location and are subject to change. Pharmacy clinical programs such as precertification, step therapy, and quantity limits may apply to your prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Discount programs are neither offered nor guaranteed under our contract with the FEHB Program, but are made available to all enrollees and their families who become members under an Aetna Health Insurance Plan. Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor. Information is believed to be accurate as of the production date; however, it is subject to change.

Postal and Non-Postal rates

  • Non-Postal rates apply to most non-Postal employees.
  • Postal rates apply to United States Postal Service employees.
  • Postal Category 1 rates apply to career bargaining unit employees represented by the APWU, IT/AS, NALC and NPMHU.
  • Postal Category 2 rates apply to career bargaining unit employees represented by the PPOA.
  • Non-Postal rates apply to all career non-bargaining unit Postal Service employees and career employees represented by the NRLCA agreement.

New Hires have 60 days to choose benefits.

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