altius federal plans - aetna feds mktg_brochure_altiusbrochure.pdf · this is a brief description...
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Altius Federal Plans 2018 health plan highlights for federal employees
19.02.324.1-FED B (9/17)aetnafeds.com/altius
www.aetna.com/index.html
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Your health journey starts here Altius is an Aetna company. So on top of some familiar plan features, you’ll also be able to take advantage of some great plan perks. We invite you to browse this overview and choose the plan that best fits your needs.
High Option HMO plan
Standard Option HMO plan
High-deductible health plan (HDHP)
• No deductibles, plus predictable costs with thehealth maintenance organization (HMO) plans
• Built -in dental on the High Option HMO plan
• Extras to make the most of your plan
Choosing your care team You can feel good that you get access to the same doctor and hospital networks you’ve been using. Chances are your doctor is in our network.
To make sure, check our directory before signing up.
Just go to aetnafeds.com/altius and click on “Find your doctor now.”
Visit doctors by phone, video or app, too For added convenience, you can take advantage of the Teladoc® network of providers. For $40 or less, depending on your plan, you can consult with doctors over the phone, via online video or Teladoc mobile app. Teladoc physicians are board certified and available 24 hours a day.
They can also write a prescription if medically necessary. Once you become a member, just setup an account at teladoc.com/aetna.
It all starts on your member website All your plan information and extras are in one place — your member website. It’s easy to sign up. Simply register at aetnafeds.com/altius. Then log in anytime. When you do, you can find ways to save on:
• Gym memberships and weight-loss programs
• Chiropractic care, acupuncture, massage therapyand more
Plus, your member website has tools that help you:
• Find a doctor, hospital or walk-in clinic, close tohome or out of state
• Create your own personal health record andreview claims
• Save money by comparing costs, using the MemberPayment Estimator and Price-A-DrugSM tools
Want to test drive the tools now?
Log in at aetnafeds.com/altius. Use “federal3” as your user name and password.
Connect live with our team Chat with us online, watch webinars, schedule a one-on-one appointment and more. Just visit AetnaFedsLive.com.
Health benefits and insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc. and/or Aetna Life Insurance Company (Aetna).
http://aetnafeds.com/altiushttp://teladoc.com/aetnahttp://aetnafeds.com/altiushttp://aetnafeds.com/altiuswww.AetnaFedsLive.com
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High Option HMO Predictible out-of-pocket costs and built-in dental and vision
Key benefits What you pay
Physician services Preventive care Routine physical In office for diagnostic and treatment Teladoc phone or video consult
$0 $0 (one per calendar year) $20 primary care; $35 specialist $30
Hospital services Inpatient Outpatient
$200 a day; up to $600 per admission $450 copay
Maternity Physician care Hospital care
$0 for prenatal care $200 a day; up to $600 per admission
Emergency benefits In and out of area $200 for emergency room services
Mental health/substance misuse treatment Office visits Inpatient services
$20 copay $200 a day; up to $600 per admission
Prescription drugs 30-day supply at retail pharmacy
90-day supply through mail-order service
Specialty drugs
$7 preferred generic; $25 preferred brand name; 40% up to $240 max nonpreferred generic or brand name
$7 preferred generic; $50 preferred brand name; 40% up to $720 max nonpreferred generic or brand name
30% preferred; 50% nonpreferred
Vision care Annual routine eye exam $0 (Plus, you’ll get $100 every 24 months for eyewear
reimbursement.)
Built-in dental
Preventive (like cleanings and X-rays) Minor services (like fillings) Major services (like crowns)
When you visit network dentists:
$0 40% 60% See plan brochure for out-of-network coverage details.
2018 High Option HMO rates (what you pay every other week) Code Non-postal Postal 1 Postal 2
Self only 9K1 $162.17 $155.80 $149.44
Self + one 9K3 $366.03 $352.39 $338.75
Self + family 9K2 $344.02 $329.53 $315.04
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Standard Option HMO Lower biweekly rates and built-in vision
Key benefits What you pay
Physician services Preventive care Routine physical In office for diagnostic and treatment Teladoc phone or video consult
$0 $0 (one per calendar year) $20 primary care; $40 specialist $40
Hospital services Inpatient Outpatient
15% coinsurance $650 copay
Maternity Physician care Hospital care
$0 for prenatal care Nothing after $200 per admission copay
Emergency benefits In and out of area $250 for emergency room services
Mental health/substance misuse treatment Office visits Inpatient services
$20 copay 15% coinsurance
Prescription drugs 30-day supply at retail pharmacy
90-day supply through mail-order service
Injectable and intravenous therapy drugs
$7 preferred generic; $35 preferred brand name; 50% up to $240 max nonpreferred generic or brand name
$7 preferred generic; $70 preferred brand name; 50% up to $720 max nonpreferred generic or brand name
30% preferred; 50% nonpreferred
Vision care Annual routine eye exam $0 (Plus, you'll get $100 every 24 months for eyewear reimbursement.)
2018 Standard Option HMO rates (what you pay every other week) Code Non-postal Postal 1 Postal 2
Self only DK4 $68.49 $62.33 $56.85
Self + one DK6 $149.75 $136.27 $124.29
Self + family DK5 $151.25 $137.64 $125.54
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HDHP Our lowest cost plan with a tax-free health savings account (HSA)
Key benefits What you pay in the network
Deductible $1,300 for self only $2,600 for self + one or self + family
HSA deposits — We’ll contribute $54.16 per month for self only ($108.33 per month for self + one or self + family). You can use your HSA to help pay for your health care. Or save it — even if you leave the plan — and use it for future health expenses.
Physician services Preventive care Routine physical In office for diagnostic and treatment In hospital, surgical center or other facility Teladoc phone or video consult
$0 $0 (one per calendar year) $20 primary care after deductible; $30 specialist after deductible 10% after deductible $30 after deductible
Hospital services Inpatient Outpatient
10% after deductible $500 copay after deductible
Maternity Physician care Hospital care
10% after deductible for prenatal care 10% after deductible
Emergency benefits In and out of area $200 after deductible
Mental health/substance misuse treatment Office visits Inpatient services
$20 copay after deductible 10% after deductible
Prescription drugs 30-day supply at retail pharmacy
90-day supply through mail-order service
Specialty drugs
After deductible: $7 preferred generic; $25 preferred brand name; $50 nonpreferred
$21 preferred generic; $75 preferred brand name; $150 nonpreferred
20% preferred; 35% nonpreferred
Vision care Annual routine eye exam $0 (Plus, you’ll get $100 every 24 months for eyewear reimbursement.)
2018 HDHP rates (what you pay every other week) Code Non-postal Postal 1 Postal 2
Self only 9K4 $48.54 $44.17 $40.29
Self + one 9K6 $99.46 $90.51 $82.55
Self + family 9K5 $101.45 $92.32 $84.20
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Need help choosing a plan? We’re here to help. Just call us at 1-800-837-0977.
It’s easy to enroll
Step 1: Choose a plan Review the brochure or visit AetnaFedsLive.com to find a plan that fits your needs.
Step 2: Find your plan’s enrollment code
They’re listed in the rate charts in this brochure. You can also find them at aetnafeds.com.
Step 3: Fill out the form
Check with your human resources department to see if you can enroll online, using an agency system like MyPay, Employee Express or PostalEASE. Or you may need to submit a paper 2809 form.
Need a form? Go to aetnafeds.com/enroll.
Connect live with our team Chat with us online, watch webinars, schedule a one-on-one appointment and more. Just visit AetnaFedsLive.com.
Health benefits and insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc. and/or Aetna Life Insurance Company (Aetna). This is a brief description of the features of these Aetna health benefits plans. 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 offers may be available but are not guaranteed under our contract with the FEHB program. Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor. HealthEquity Inc. is an IRS-approved nonbank custodian of health savings accounts. There are fees associated with a Health Savings Account ("HSA"). 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, medical, legal, financial 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. HealthEquity cannot and shall not provide any payment or service in violation of any United States (U.S.) economic or trade sanctions. For more information about HealthEquity, visit healthequity.com. Teladoc is not available to all members and operates subject to state regulation. Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna or plans administered by Aetna. For complete description of the limitations of Teladoc services, visit teladoc.com/aetna. External website links are provided for your information and convenience only and does 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. Information is believed to be accurate as of the production date; however, it is subject to change. Alex® is a registered trademark of The Jellyvision Lab, Inc. Quest Diagnostics marks are the registered trademarks of Quest Diagnostics. Teladoc and the Teladoc logo are trademarks of Teladoc, Inc. and may not be used without written permission. For more information about Aetna plans, visit aetnafeds.com.
©2017 Aetna Inc. 19.02.324.1-FED B (9/17)
aetnafeds.com/altius
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tA-14612_Altius_final_hiresAltius Federal PlansCover2018 health plan highlights for federal employees
Your health journey starts hereChoosing your care team Visit doctors by phone, video or app, too It all starts on your member website Connect live with our team
High Option HMOStandard Option HMOHDHPBack CoverIt’s easy to enroll Connect live with our team