Medical


 

All of the available options give you access to high-quality, comprehensive care. They differ largely in the way the cost of care is structured and in the strategies you can use to control your expenses:

  • OAMC Plans: Visit any doctor, no referrals needed. May have to choose a primary care physician (PCP) who can help get the most value from the plan. The PCP will build a relationship with the member to stay healthy. The plan has access to Aetna tools, tip, programs and servic
  • Open Choice PPO Plans: PPOs have the most freedom. They allow members to go to any doctor, anytime—whether they are in-network or out-of-network. This gives members control over how they access medical care. Note: in general, members will want to see in-network doctors, as out-of-network doctors will cost more.
  • EPO (OPEN ACCESS ELECT CHOICE: EPOs are like PPOs, but they don't cover out-of-network doctors. So, members can go to any doctor, anytime, if they are in-network. This gives the member control over how medical care is accessed, if the doctor is in-network.
  • HMO Plans: HMOs are very different from PPOs and EPOs. With an HMO, members must designate a primary care physician, commonly called a PCP. This doctor will serve as the first point of contact when non-emergency medical care is needed. If a member wants to see a specialist, the PCP needs to be seen first so they can send a referral. In the case of a life-or-death emergency, members go to the nearest hospital immediately. If life is in danger, services will be covered.
  • HDHP HSA Plans: these plans are high deductible insurance plans that help protect against large claims as well as to cover preventive care at 100% (deductible is waived for preventive services). If you enroll in this plan, you are eligible to open a Health Savings Account (HSA) which can be used to help pay for qualified medical expenses. (Available to all employees)

Aetna



Aetna Resources for Living℠ Program
Don’t let daily distractions affect your well-being

We’re here for you and your household members, 24/7/365. From phone support  to free short-term counseling (in person or by televideo), we’ll connect you to resources, products and services. So you can stress less and live more.
Find help for personal and family counseling, child/elder care assistance, legal, financial, identity theft and more.
Log in at ResourcesForLiving.com for more resources. You can get help on the go with the Resources For Living® mobile app.
Phone: 833-721-2315
Website: ResourcesForLiving.com
Username: AspenHR
Password: eap

Aetna Behavioral Health AbleTo Support
Focusing on health conditions and life changes

We teamed with AbleTo, a leading behavioral health provider. They’re available for when emotional issues arise and make things worse. This eight-week program offers you emotional support after a medical diagnosis or life transition — for example, becoming a caregiver or giving birth. It combines counseling and coaching to help you:

    • Work through the normal emotions you’re having
    • Understand and stick with a treatment plan
    • Know the types of changes you need to make

To get started, an Aetna® or AbleTo representative will call you. They’ll explain more about the program and how it can help.

Participating retail walk-in clinics
Easy access, with no appointments needed

When you’re a “little bit” sick and it’s after office hours, try a retail clinic. Visit one for minor illnesses like a sore throat, injuries like sprains, and even vaccines. You’ll enjoy:

    • Convenient hours, with some open seven days a week with night and weekend hours
    • Lower prices, such as an average of $81 per clinic visit compared to the $750 to $1,000 average emergency room (ER) price*1

We have many stand-alone and store-based clinics nationwide. Find them in our online directory at Aetna.com — just select “Find a doctor.”

1Average retail and ER pricing. Based on Aetna® average claims costs. Data accessed July 2017. For illustrative purposes only.
*Member responsibility may vary based on plan design; for some plans, copays apply. ER copays are typically higher than walk-in clinic copays.

Simple Steps To A Healthier Life® program
An interactive online health and wellness program that can help enhance your health

With its health assessment and online health coaching programs, this program helps reduce health risks. It helps you stay healthy, productive and connected with Aetna® care management support services. The program also includes tailored health reports and easy-to-find health information.

Aetna Vision Discounts
The clearer way to enjoy savings

Your vision may be just fine. Or it may need a little help. Either way, you can save with our vision discounts.

You get discounts on:

    • Eye exams
    • Prescription eyewear
    • LASIK laser eye surgery
    • Nondisposable contact lenses
    • Designer frame options

You can even save on things that don’t need a prescription, like sunglasses, eyeglass chains, lens cases and cleaners.

Not for use in TX, KS, NY

Natural Products and Services
Give your health a natural boost

Enjoy instant discounts on therapeutic massage, acupuncture ... even chiropractic visits.* This perk is included with your Aetna® benefits and insurance plan.

*Discounts do not apply to visits/claims submitted to your health insurance plan.

Not for use in TX, KS, NY

Choose Generics First
The simple way to get your best coverage

When a drug has a generic equivalent but you fill the brand drug, you’ll pay the difference in cost between the generic and brand drug. You’ll also be responsible for your required copay or coinsurance. You can talk to your doctor about generic alternatives for your brand drug and if they might work for you. If your doctor feels the brand drug is medically necessary, they can request approval to cover the prescription drug at the brand cost share. For approved medical necessity, you won’t be required to pay the cost difference between the generic and brand drug.

Aetna® pharmacy solutions 
The perfect balance of savings and choice

As a part of CVS Health®, we’re able to offer you best-in-class pharmacy benefits. These plans can help you balance cost savings with the choices you want. And when you integrate your pharmacy and medical benefits, you provide us with more insights to help you on the path to your best health. Integration keeps your costs in check, too.

Teladoc® general medicine services — by phone or video
24/7 access to quality care

After hours? Can’t get to the doctor’s office? Teladoc connects you with board-certified doctors anytime.

They can treat many nonemergency medical issues by phone or video. You can request visits three ways: online, via the Teladoc app or by phone. You can speak to a doctor “on demand” in minutes.* Or schedule a time that’s more convenient for you. We know urgent care and emergency room visits can be costly and time-consuming. Go to Teladoc.com/Aetna to find out more and set up your Teladoc account.

*Ten minutes is the median wait time for an on-demand visit, but wait times may be longer during peak hours or seasons. On-demand consults are guaranteed within an hour of request or are free of charge. Idaho is video only; Arkansas and Delaware require video for first visit every 24 months.

Teladoc® is not available to all members. Teladoc and Teladoc physicians are independent contractors and arenot agents of Aetna. For a complete description of the limitations of Teladoc services, visit Teladoc.com/Aetna.
Teladoc, Teladoc Health and the Teladoc Health logo are registered trademarks or trademarks of Teladoc Health, Inc.

24-Hour Nurse Line*
A simple call can make all the difference

Have questions about upcoming medical visits and options? You can talk to a registered nurse for information about tests, procedures and treatment options, 24 hours a day, 7 days a week. And the call is free. You can find the phone number by visiting Aetna.com and logging in to your member website.

*While only your doctor can diagnose, prescribe or give medical advice, our 24-Hour Nurse Line nurses can provide information on a variety of health topics. Contact your doctor first with any questions about your health care needs.

No or low cost Minute Clinic
Convenient care close to home

Get access to convenient, local care at a MinuteClinic® location at no cost to you.* MinuteClinic is a walk-in clinic located inside select CVS Pharmacy® and Target stores, treating a variety of illnesses, injuries and conditions, including:

    • Allergies
    • Ear infections
    • Flu-like symptoms
    • Bug bites, stings and more

MinuteClinic providers can also administer vaccines and write prescriptions, when medically appropriate.

For your best health, we encourage you to have a relationship with a primary care physician or other doctor. Tell them about your visit to MinuteClinic, or MinuteClinic can send a summary of your visit directly to them.

Participating urgent care centers
Say goodbye to ER visits and hello to savings

If you have an urgent but not life-threatening medical issue, think about using an urgent care center.* These centers can treat sprains, the flu, minor cuts and more.

There are over 3,000 participating locations. Many are open seven days a week, with no appointments needed. You’ll typically pay less1 — and cut your waiting time, too. Look up the nearest urgent care center on Aetna.com. Select “Find a doctor” to use our directory. Or use the mobile app.**

1Average retail and ER pricing. Based on Aetna average claims costs. Data accessed July 2017. For illustrative purposes only.

*Member responsibility may vary based on plan design; for some plans, copays apply. Emergency room (ER) copays are typically higher than walk-in clinic copays.
**Standard text messaging and other rates from your wireless carrier may apply.

Aetna® Discount Program
Instant savings on your favorite healthy-living products and services

Instant savings on your favorite healthy-living products and services

Save on gym memberships, weight-loss programs, vision services, hearing aids and more — with any health plan. These built-in discounts aren’t insurance. And there are no claims, referrals or limits on use.

Log in to your member website at Aetna.com to start saving.

DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge on products and services offered by third-party vendors and providers. Aetna makes no payment to the third parties — you are responsible for the full cost. Check any insurance plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts.

Discount vendors and providers are not agents of Aetna and are solely responsible for the products and services they provide. Discount offers are not guaranteed and may be ended at any time. Aetna may get a fee when you buy these discounted products and services.

Not for use in TX, KS, NY

Aetna One Choice (formerly known as Aetna In Touch Care℠ Premier)
Helping you navigate current health challenges

This program is an industry-leading care management program. We help you and your family work through the complex and confusing health system. This way, you can focus on your health.
Through data and by monitoring inpatient admissions, we find members with the greatest need. We then provide support based on their needs and preferences.

A single nurse is responsible for you and your family. Aetna One Choice combines digital and nurse support to help you get the best possible outcome. This program:

    • Helps you practice smart utilization and motivating engagement
    • Finds health barriers and prioritizes health goals
    • Gives support and focuses on real-time interventions
    • Manages continuing health issues

Your dedicated team supports everything from clinical precertification and concurrent review to acute and chronic care management.

Use our provider search tool
You can find providers by name, specialty and location

You’ll also find maps, directions and more. You can even look for providers who speak your language. Visit Aetna.com to try it out.

The Aetna Health℠ app and your Aetna® member website
Manage your benefits, connect to care, handle claims — from anywhere

Manage your benefits, connect to care, handle claims — from anywhere

The Aetna Health℠ app and your Aetna® member website are personalized, seamless and easy to use. Once you’re a member, here’s how you can connect:

    • Get the Aetna Health app by texting “GETAPP” to 90156 for a link to download the app and create an account.*
    • Go to Aetna.com to create an account and log in to your member website.

*Message and data rates may apply.

Apple, the Apple logo and iPhone are trademarks of Apple Inc., registered in the U.S. and other countries. AppStore is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC.

Digital Member ID Card
Access your member ID card whenever you need it

Have your digital ID card on hand, whenever you want, wherever you are with our Aetna Health℠ app. Or find it by going to Aetna.com and logging in to your member website where you have the option to print it out at the top of the page.

The Attain by AetnaSM app
A first-of-its-kind health experience designed in collaboration with Apple

This app combines your health history with your Apple Watch® activity to offer personalized goals,* achievable actions and big rewards** — like an Apple Watch or gift cards from popular retailers. It’s already part of your health plan, so why miss out? Download today from the App Store®. You must be an Aetna® commercial member. You need to be at least 18 years old, and you need an iPhone®.***
* Goals and suggested health actions should not replace your doctor’s advice. If you have a medical condition that prevents you from meeting your goals, or if your doctor advises you not to take part in physical activity, there may be an opportunity for you to earn the same reward by different means.
** Eligibility for particular incentives varies by health plan type and location, including availability of Apple Watch as a reward. Download the Attain by Aetna app and sign in to see which categories of incentives are available to you.
*** Other eligibility and participation requirements, including certain state restrictions and exclusions, may apply.

Health benefits and health insurance plans contain exclusions and limitations. This material is for informational purposes only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Not all services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage.

Visit Aetna.com/individuals-families/member-rights-resources/rights/disclosure-information.html to view or print your medical, dental or vision plan disclosures. Here, you can also find state requirements and information on the Women’s Health and Cancer Rights Act.