|
|
|
|
|
|
|
AETNA
HIGH DEDUCTIBLE PPO (HSA Qualified)
HSA-qualified
plans are amongst the most popular plans offered by Aetna
Life Insurance Company. These plans usually
offer the lowest premiums of any HSA plan in many states,
along with many additional benefits not covered by other HSA
plans.
The Aetna
HIGH DEDUCTIBLE PPO plans are designed to provide you
with economic incentives for using designated health care
providers (PPO network). They provide coverage for major
hospital, medical, and surgical expenses incurred as a result
of a covered accident or sickness. Coverage is provided
for daily hospital room and board, miscellaneous hospital
services, surgical services, anesthesia services, in-hospital
medical services and out-of-hospital care, subject to any
deductibles or other limitations which may be set forth in
the policy.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Internet
Explorer required
|
|
|
|
Plans
at a Glance:
Plans
vary by state. Please select your state below to view
your plan brochure 
:
|
|
|
|
|
|
Coverage
Synopsis:
HIGH
DEDUCTIBLE PPO - Aetna offers three versions of
their HSA compatible plans - Managed Choice Open Access
High Deductible 3000 and 5000 and Preventative and Hospital
Care 3000. After you have met your deductible, the Managed
Choice Open Access High Deductible 3000 & 5000 pay 100%
of all covered expenses. The Preventative and Hospital Care
3000 pays 20% of covered expenses after the deductible has
been met ($5,000.00 total out of pocket maximum, including
deductible). All three plans pay up to $5 million per person.
These
plans qualify as HSA-eligible. Combining a Health
Savings Account with any High Deductible PPO plan allows
you to make tax-deductible contributions, pay medical expenses
with pre-tax dollars, and earn tax-deferred interest. This
account works much like an IRA, except you may use your
tax-free savings for qualified medical expenses your health
plan does not cover, such as your deductible, contact lenses,
or most types of alternative medicine (see the qualified
medical expenses). If you do not use these
funds, they simply accumulate, with interest, for distribution
upon your retirement.
The
Managed Choice Open Access High Deductible 3000/5000
plans includes many benefits not commonly offered by other
companies offering HSA plans. These include:
- Preventative
Care covered at 100%, after $20/$25 co-payment (NO DEDUCTIBLE),
up to $200 per year, including annual physicals, lab work,
mammography, pap, and PSA
- Annual
OB/GYN exam covered at 100%, with NO DEDUCTIBLE
- Physical/Occupational
Therapy/Chiropractic care covered at 100% after deductible
($25 Max - 24 visits per calendar year)
- Discounts
at participating chiropractors, massage therapist, and
nutrition counselors, as well as discounts on vitamins
and supplements
- Optional
mail order prescription program (www.AetnaRxHomeDelivery.com),
which allows you to order a month's supply through the
mail at a discount
The
Preventative and Hospital Care 3000 plan include
the following benefits:
- Preventative
Care covered at 100%, after $35 co-payment (NO DEDUCTIBLE),
up to $200 per exam
- Annual
OB/GYN exam covered at 100%, with NO DEDUCTIBLE
- Hospital
admission and outpatient surgery covered at 80% after
deductible has been met
- Emergency
room $100 copay (waived if admitted), 20% co-insurance,
after deductible has been met
Optional
Riders :
Dental
Plan
For
a very minimal cost of $10-20 per insured (less than half
the cost of most other dental plans), you can add the
Aetna Individual Dental PPO Max dental plan. The
quote system shows rates with and without the dental rider.
- $25
annual deductible per member (does not apply to Diagnostic
and Preventive Services)
-
$75 family maximum
- Unlimited
annual maximum
- 100%
coverage for diagnostic services, with no deductible
- 100%
coverage preventive services (cleanings, fluoride w/cleaning)
- Basic
Services (Resin Filling, Oral Surgery)
-
80 percent discount -Major Services- 50 percent discount
- Orthodontic
Services- 50 percent discount
Rate
Information:
All
deductible options have a 6 month rate guarantee.
The
premium can be paid via quarterly, semi-annual, or annual
billing, or a monthly bank draft or credit card. The
bank draft will occur on the premium due date each month.
The initial premium can be paid with a check or credit card.
Network:
Aetna
utilizes varying PPO networks, depending on your state of
residence. You may use Aetna's
DocFind to locate Aetna's participating doctors
and hospitals, dentists, in addition to Primary Care Physician-referred
facilities and vendors where required. You may obtain
covered services from any provider anywhere, but you will
pay a higher percentage of the bill for out-of-network expenses.
It is
important to note that many non-emergency services require
you to obtain pre-authorization before services are rendered.
Receiving this authorization is as easy as making a phone
call. Not doing so can result in your benefits being
reduced from 100% to 0%.
Underwriting:
Underwriting
of your application with Aetna normally takes two to three
weeks, though if medical records are ordered it could take
longer.
It is
standard practice to request a Blood Pressure Inquiry or
medical records for all applicants who are currently being
treated for or who have recently discontinued treatment
for high blood pressure or elevated cholesterol. Certain
conditions may be waivered with a temporary rider (usually
for one to two years), or an indefinite rider.
Effective
dates:
The
earliest your coverage can go into effect is one day after
your signed application has been received by Aetna.
You may request an effective date any time as far out as
60 days after you sign your application.
Please
note, if you are requesting an effective date of less than
21 days from the time you complete the application, you
may not receive notification of your approval until after
your effective date. If you have claims during this
period, they will be eligible for coverage if submitted
after you have been approved. Also note that you will
be billed starting on your requested effective date, even
if you have not yet been notified that you have been approved.
This is very good for someone who does not have any present
coverage and would like for their benefits to begin right
away. For those who are already covered, it is suggested
that you maintain your current coverage in force until you
have received notice from either HSA
for America or directly from Aetna that your
coverage has been approved and is in force.
HSA Administrator:
Your
health savings account is totally separate from your health
insurance, and you may use any approved bank or trustee
as your HSA administrator. We recommend that you choose
one from our HSA administrator
page, where you can compare rates and features.
About
Aetna:
Formed
in 1850, Aetna is one of the nation's leaders in
health care, dental, pharmacy, group life, disability, and
long-term care insurance and employee benefits.
Aetna
is rated "A" (Excellent) by the
A.M.
Best Company, an independent insurance rating organization.
HSA
for America is an independent authorized
Aetna agent.
|
|
|
|
 |
|
|
|
|
|
|
|
|
|
|
"You
are saving me so much money! Thank you!"
You
are saving me so much money! You found the perfect
program suited for my needs. Thank you! I was
looking for a cheaper premium and better service than what
I had, and I found that with you!
I
was paying Mega Health a premium of $133.00 per month and
if I remember correctly, I had certain benefits where they
would cover up to a certain amount for certain things, but
then I had a deductible of $2,000.00....for accidents...I
think... It was very confusing.
With
Mega Health, I didn't really know all that I was or wasn't
covered for. And since I thought I was covered for
doctor visits, etc. I went a few months ago for a check
up. So when I started getting bills which now total
$400.00 so far... I decided it wasn't worth spending $133.00
a month if I was going to have to pay most of the bill anyway!
I
now pay a premium of $58.00 a month and my deductible is
$2,700 which my HSA will be adding up to here in the next
year. I actually understand what I have and what I'm
covered for and everything.
I
didn't know there was anything like an HSA out there.
It is perfect for someone who never goes to the doctor.
Over
all, I didn't have to pay a $120.00 start up fee with you,
I'm saving $75.00 per month from what I was paying, and
I'm able to deduct from my taxes what I deposit into my
HSA, which will save me more money! And for someone
just recently married and starting out in life, $75.00
adds up very quickly. That's $900.00 a year
that I'm saving. Thank you!
I
would definitely recommend you to others! You've been
very helpful when I had questions and prompt with calling
me back. I like the fact that I can call you anytime
with a question, and the fact that you will always look
for a better premium for me if my current one goes up.
You
guys are awesome!
Naomi
Hilleshiem
Administrative
Assistant
Cedar Rapids, IA
Read
More...
|
|
|
