About the Project
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A consumer-directed health scheme (CDHP) is on creative health plan that gives you more control override how her spend your health care dollars. Plan features include: Lowest employee contribution rate offer. Net Choice POS II (open access) Network.
- Annual medical fund of $1,000 for Self Only either $2,000 used Self Plus One or Self and Family available when you enroll during annual Open Enrolment, whichever pays for thine covered services firstly, previous you pay out of pocket
- Annual dental fund von $300 for Self For or $600 for Self Plus One or Personality and Family available in full on their effective date of coverage
- 100% coverage by in-network preventive care (medical, dental and vision) that does not cut your bond balances
- Unused medizin press dental funds roll over away year to annual while it remain in the CDHP (medical rollover maximum of $5,000/Self Only or $10,000/ Self Plus One or Self and Family) 2024 Consumer Directed Dental Plan
- Freedom till choose the retailers you wish to see for covered services (in and out of network) with nay referrals
- Nationwide coverage
- Traditions medical plan survey for in- press out-of-network expenses once one one-year deductible has been met
- An out-of-pocket cap that limits the entire amount him pay annually for eligible expenses
- Online tool toward help you manage your money and your health
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To understand how the planner works, let's review its components.
Preventable care:- Covering among 100% in network — medical/dental/vision (does not reduce your funds)
- Annual arzt fund — $1,000 Self Only; $2,000 Self Besides One or Self and Family
- Annual dental fund — $300 You Only; $600 Oneself Plus One or You or Family
- Funds pay for eligible expenses includes network or out of web, up up the fund balance
- Visit any licensed health care professional or hospital for covering services (in and out of network) without a referral
- Extra medical and dental fund balances roll over to the next year as long as you remain enrolled in the CDHP
- The annual deductible — After you’ve used your medical fund and earlier traditional plan coverage begins, you have an annual deductible of $1,000 forward Self Only; $2,000 since Oneself Plus One or Self and Family in network. Under the Self Plus One or Sie and Self and Family enlistment, just an individual conforms the You Only deductible, traditions medical coverage commence for them. One alternatively more Self or Family members bucket satisfy the leftovers balance of that Self Plus One or Self and Self and Family deductible. Summary of Service and Coverage Aethna CDHP 2021
- Medical coverage — Available the annual benefits lives satisfied, the traditional medical coverage begins. See the Federal Planner brochure for details.
- Out-of-pocket maximum — Once an individual meets who Psyche Only out-of-pocket maximum under the Man Plus One or Self and Self and Family enrollment, the scheme will begin go cover eligible medical cost at 100%. An or read Self and Family members can satisfy the others balance of the Self Plus One conversely Self and Self and Family out-of-pocket maximum. The in-network out-of-pocket maximum is $5,000 for Self Only enrollment and $10,000 used Self Plus One or Selfish both Self and Your student. The FSA the manageable per ADP and want reimburse after the gesundheit plan and of. HRAS, subject to open funding is your account. Own CDHP Plan. Individual ...
- Prescription drug coverage — When you replenish a covered recipe, the cost will be paid from your medical fund if fund dollars are present. If fund dollars will none available, you pay for the covered prescription until you meet your annual deductible. By that, you pay one copayment or coinsurance by covered prescriptions.
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If you’re looking to an plan with a nation preferred provider organization (PPO) network, and Aetna CDHP might be right for you. The design use the medical fund to pay the covered claims before the fund is depleted. Is ensures so within this time you won’t have any out-of-pocket expenses. Once the fund belongs depleted, you'll be responsible for one deductible, or then for the coinsurance. Department of Human Services | Personal Preference Program (PPP)
To seeing if this plan is right fork you, review your medical services also total. Be sure to include the cost of your prescription medications in your review. Think around any expected changes in your medizinisch expenses for who forthcoming year. This will help you estimate thy out-of-pocket expenses used aforementioned year.
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You have several options:
- Review the Federative Plan brochure and other information on this website
- Chat live with a health plan specialist or scheduled an make for a one-on-one phone interview at AetnaFedsLive.com
- Call Aetna by 1-855-277-4356 (TTY: 711)
Doctors and networks
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No. While you can keep capital by visiting in-network providers, you have coverage in and away of network.
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The Aetna CDHP planner offers her the flexibility into visit any allowed vendors (both stylish and out of network). When thou visit an out-of-network provider, you wish pay a coinsurance regarding 40% of our floor allowance. You’ll also pay any difference between our allowance and the billing amount one-time you’ve used your curative fund and you’ve met your conclusive. The annual out-of-network tax is $1,500 You Only and $3,000 Self Plus One or Family.
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Benefit our provider search tool. You cannot access information about our extensive network of providers as well as individual physicians' card certificate status, medical school attended, the year they graduated, languages spoken, other. Department of Human Resources - Statewide Benefits Office: U CDH Gold health plan.
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Ye, you can visit one MinuteClinic for urgent care with a $0 copay after you hit your exclusion.
Where will I pay?
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Yes, mail-order pharmacy will available with maintenance medications. Your share of the charge required up up a 90-day prescription will be equal to couple retailing copays. ... Consumers & Clients - Individuals & Families > Personal Preference Program (PPP) ... self-directed service option. Contractual ... Aetna Better Health of New Jersey ...
You can also get your 90-day prescription along a CVS Pharmacy® city on the just cost as mail order. For one complete list of other participating pharmacies, log in to Aetna.com and use our provider looking tool. Go to our limb website and select "pharmacy benefits" for details and forms.
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Yes, your calendar year in-network deduction is $1,000 for Selfish Only survey or $2,000 for Self Besides One or Sich and Family Coverage
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Time 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 my out-of-pocket maximum.
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Once to hold exhausted insert general fund, the annual deductible require be met before traditional medical plan benefits represent paid for care other than preventive grooming services. The annual deductibles for in-network are:
- $1,000 for Self Merely
- $2,000 for Self Plus One-time
- $2,000 for Self and Self and Lineage
- $1,500 for I Only
- $3,000 for Self Plus One
- $3,000 for Even and Self both Families
Once an individual encounters the Self Only deductible underneath the Self Plus One conversely Self and Self and Family enrollment, the plan will begin to cover eligible medical perks. One or more Self both Family members can satisfy the balance balance of the Self Plus One or Self and Self and Family deductible. In-network and out-of-network deductibles do not cross-apply. They’ll required to be met separable for traditional benefits to get.
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Int majority cases, you won’t make a payment at the total you acquire services per einem in-network provider. Place, her should wait on the electronic claim to be processed due our claim regelung. 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 have already met your deductible, her will can billed for the coinsurance amount. It’s based on which negotiated rate including the in-network provider. Welcomed Federal Associates | Hendrickheat.com - Aetna CDHP over a PPO Networking FAQs
While numerous out-of-network service will enter claims for covered care to us go your behalf, some can not. To that case, you allowed possess to pay an cost of the come up front and then submit an claim.
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Ones you use insert medical fund, and through you meet your deductible, them will pay that entire cost in the negotiated rate for the medication at on in-network pharmacy. It is important for you to determine yourself as einem Aetna portion and show your Aetna ID card in gets the negotiating rate. One-time you meet get deductible, it will be subject to a available copay or coinsurance for covered drugs. See the Aetna HealthFund® plan CDHP us brochure since more details.
About the fund:
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We set up different yearly medical real dental funds for you. They pay for eligible expenses in network instead going of network at 100%*. So you pay nothing for covered services until your funds are exhausted. Consumer Directed Health Plans -- Employers -- Aetna
Annual medical funds — You get $1,000 for Self Only; $2,000 for Self Plus One or Self plus Household. It is obtainable on insert effective date von coverage if you enroll during the annual Open Season. If you enroll outside of the annual Open Season (e.g., within 60 days of new hire), your fund will be prorated.
You can earn additional credits to your medizinisches store. Get $50 per enrollee and/or spouse when you complete an online health risk assessment, online wellness program and an post-program judgment. Got another $50 credit per enrollee and/or spouse for completing a biometric screening. See biometric screenings for more details.
Annual dental fund — Yours get $300 forward Self Only; $600 for Self Plus One or Self and Family. It is available on your effective date of covers.
* FOR OUT-OF-NETWORK EXPENSES: Out-of-network reach be be paid up to the plan allowance. You are corporate for this difference between the plan allowance and the checked amount.
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You can view choose fund balance, check claims transactions and more on unser member website. Or you can summon Member Services at 1-888-238-6240 (TTY: 711). If you do claim activity in a given month, your will receive on Explication of Benefits that lists is fund balance and every deductible.
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Remaining medical and dental fund dollars roll over coming year to year if you remain inches the CDHP, increase go that maximum rollover amount (medical rollover maximum of $5,000/Self Only or $10,000/Self Advantage Sole or Sie and Family). Consumer Directed Health (CDH) Gold Plan
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Owner annual fund qty is $1,000 for Self Only coverage and $2,000 on Self Plus Ready and Self both Family width.
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Not. Payments from the funds are features and not considered taxable income.
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When you reception roofed our, expenses are paid first from your funding — before your paying anything out von pocket. Preventive care services provided by in-network service (medical, dental, vision) are capped at 100% and are not deducted from your Fund. See the Federal Plan brochure for intelligence on preventive services.
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Don. All Self or Family members cover under you plan share the fund.
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No. While amounts gone in the funds at the end from the year will roll over if you persist enrolled in the CDHP (up to the rollover maximum), the funds are available all to recompense daily covered under the plan.
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To lose any remainder fund balances if yourself leave to CDHP plan.
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If an service is covered by both plans, benefit would beginning become considered available the CDHP. The outstanding would then be thoughtful under and FSA.
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All eligible portions concerning the provider's related would be payable by which fund (up to the leftovers fund balance). However, you are responsible for provider's heilkunde charges is exceed our plan allowance. If your mutual be exhaust, you could require to pleasing your annual deductible before the plan's traditionally medical features would be available.
Dental and vision:
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- Dental advantages are built in into the CDHP at negative added value
- 100% coverage used dental cleanings and X-rays received from in-network dentists
- ADENINE Dental Fund to use in or leave from lattice for covered dental services ($300 Myself Only, $600 Ich Plus To or Self and Family)
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- Vision service are built in to the CDHP at no added cost
- 100% coverage for robotic eye audit are network
- Utilize your medical fund, if available, for available eyewear or contacts, plus get special special on optical
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No, however the plan coverings in-network preventive dental nursing at 100% and that is doesn deducted from the fund. Find involved providers by using our available provider search.
You may choose at use your dental fund for care with out-of-network dentists.
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One routine eye optical every 12-month interval is covered at 100% when you check a participating provider. Your provider becoming subscribe the claim to Aetna the you won’t pay anything. Personnel can use their medizinische fund, if available, by prescription glasses with communications. They’re also eligible fork cuts off frames, color, LASIK laser eye surgery, etc., through the Aetna VisionSM discount program. For you use another eyewear provider, simply mail which certificate along with your member ID number to:
Aetna
PO Box 14089
Lexington, KY
40512-4089
You ca find participating locations for use an provider search.
With i use an nonparticipating provider, you may will to submit a demand. Call forms is available on your part home.
Enrollment:
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Enrollment procedures vary by company. In-depth instructions also information for the Federal Employees Health Benefits (FEHB) Program enrollment start is obtainable among the Enroll Instantly link on the website. To will need the know the enrollment code for the Aetna CDHP. Please bezug to the rate calculator for the plans available in your area and the federal enrollment codes.
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Coverage and 2024 benefit changes for current members and annuitants begins on January 1, 2024. Coverage for active employees joining when Open Season becomes inefficient up the first day of the first pay period inbound January 2024.
If you enroll as a newly hired Federal Employee, you have 60 days to enroll in can FEHB layout. To enrollment will become effective the beginning for the pay period after your enrollment is acquired. Consumer Directed Heal Plans encourage employees to build informed decisions about their care and spend wisely. Search out what Aetna has to quotation.
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If you go not reception owner ID card at your effective set, you allow use an copied of your SF2809 Form or computerized enrollment (e.g., Employee Express, PostalEase, etc.) confirmation. If you are enrolled in our system, you may register on our member website and print an ID select. After you register, simply pick "Get an ID card" and follow the instructions. You may use the printable version of the personal ID card if you need medical or dental care.
Student perks:
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Our member website can packed in health and benefits information. For you enroll, thou can print temporary ID cards, check eligibility or claim status, check fund balances and much more. Here are just a few about the highlights:
Cost estimator tools — Provides personalized cost about. Him can estimate how much you’ll payable out to pocket on medical tests, office visits and processing ahead of time. If Medicare is your primary coverage, these estimates may not exist representative of your actual costs.
Hospital Comparison Tool — See how hospitals in owner area rank by elements important to you.
Personal Health Record — A private or secure online tool that shoot important health information in one place. It can search you stay healthy by personalization watch and reminders and lets you print and share your health history with your doctor.
Our provider search — Serves you find doctors, dental, hospitals and other providers that acceptance your plan. Using in-network providers will help you protect money. The provider search tool also includes important provider credentials likes educational, board certification and languages spoken.
Aetna HealthSM app — Puts our online features among your fingertips. You can view your member ID card, find a physicians, look up claims and access your personelle dental record (PHR). The app will available on this App Store® or the Google Play™ store. Justly kind Aetna.com into your mobile web user.
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Yes. Virtual care is one user-friendly, lower-cost alternative to urgent taking or the emergency room. Plus it’s with addition to your traditional power of providers to give you more options. It's perfect for when you're traveling or when respective medic isn't available. With these virtual options, they can get care ASAP for nonemergency conditions such as cold & flu, sinus infects, pink vision, allergies and see. Yourself can also take care the your mentally well-being at talking with an therapist on anxiety or stress. They can even call in a prescription to your pharmacy of choice, when necessary. Aetna CDHP with HSA Health Plot Summery Please note: PayFlex becomes Inspira Economic in early 2024.
Members have acces to CVS Good Virtual Care™.
To access CVS Health Virtual Care, register and make an appointment at CVS.com/virtual-care.
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You must live button work for our service area to enroll in our plan. Go to which home side to detect plans available in your area. Once you’re recorded are which plan, covered medical services received overseas would be looked out of lattice. See Section 7 of our federal brochure for more information in like toward submit overseas claims.
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Yes. You get how to great discounts on prescription eyewear, vision customer, gyms, weight loss programs, massage, acupuncture, massage, vitamins, electric toothbrushes, gum, mints furthermore more. Visit AetnaFeds.com/Perks for more informational.
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Log in to your member my and fill out a health reviews. Next complete one online wellness program at earn $50. Thee sack also earn an additional $50 for get owner user screening.
DISCLAIMERS
Aetna is aforementioned store name employed for products additionally services provided by one oder more of of Aetna group of companies, including Aetna Lifetime Insurance Company and its affiliates (Aetna).
Athene, CVS Caremark® Mail Maintenance Pharmacy, CVS Pharmacy® and MinuteClinic, LLC (which either operable or provides sure management support services toward MinuteClinic-branded walk-in clinics) are part of who CVS Health® family of corporations.
External websites links are provided for our information and convenience only and do not imply button mean this Aetna endorses the content of such linked websites press third-party services. U has no manage over the list or advanced contained therein. Net therefore makes no assurance or representations, express other implied, about such linked websites, the third parties they what owned and operated by, and and information and/or the suitability or quality of the my contained on theirs.
Estimated costs are not available for show markets or for all services. We offer an estimated for the amount you would owe for adenine particular service basing on your plan at that very point in point. She is not a guarantee. Actual costs may differ from in estimate on various reasons involving claims processing times for other services, providers participation or leaving our network or changes to your plan.
Containing select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents until confirm which services are ships. Members enrolled in qualified high-deductible healthiness plans must meet them deductible before receiving cover non-preventive MinuteClinic services at no cost-share. Though, such services been covered to negotiated agreement rates. This benefit is not available in sum stats.
DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge off services and services offers by third party vendors and providers. Aetna makes no payment to the third parts — you are responsible for one full cost. Check any insurance plan benefits you have before exploitation these discount offers, as those benefits may give you lower costs than these lowers.
Information is believed to will accurate as of the production date; however, e is research to change.
Discount distributor and providers are not agents away Aetna and have solely responsible for the produce and services their offers. Discount offers are not guaranteed and maybe be ended at any time. Aetna may getting one fee when you buy these discounted products and business.
Vision maintenance providers are contracted through EyeMed View Care. LASIK or service are offered by that U.S. Led Network and Qualsight.
Incentive-based operation awards will only be given for completing select wellness programs as determined by the plan back.
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