| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Company:
|
|
|
Plan:
|
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.
Aetna
High Deductible PPO Brochure 
|
|
|
|
|
|
|
|
|
|
Internet
Explorer required
|
|
|
|
|
|
|
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
Rates:
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.
PPO
Network:
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 ColoHealth
or directly from Aetna Insurance
that your coverage has been approved and is in force
About
Aetna Insurance:
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.
ColoHealth
is an independent authorized Aetna agent in Colorado.
"I
can't believe what great customer care you have!"
I
can't believe what great customer care you have!
I've had a problem trying to find insurance for my daughter
outside of work at a reasonable price. I'm so happy
to have found you! Your price is good and you
are so responsive.
Thanks
so much for all of your help. A lot of people I
work with are trying to find an individual plan away from
work due to the (increased) cost, just like I was.
I have been spreading the word about you guys.
Thanks
again for everything!
Robin
Bachicha
Pueblo, CO
Read
More...
|
|
|
|
|
|
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
