Aetna Medical
Ursus Inc. offers 3 medical plans through Aetna. All of the available options give you access to high-quality, comprehensive care. They differ in the way the cost of care is structured and in the strategies that you can use to control your expenses. Ursus, Inc. pays 50% of the cost of employee-only coverage.
Aetna PPO
The Aetna PPO plans are traditional plans that give you the greatest flexibility, combined with lower costs when you choose a provider within Aetna's broad national PPO network. Choosing health professionals who participate in the Aetna PPO network keep your costs lower and eliminate paperwork.
- What’s Next After Enrollment
- Your benefits will run from 11/1 – 12/31 following year, you will not be able to make changes unless you have a qualifying event. ID cards will be mailed out 7 to 10 business days after enrollment had been finalized with Carrier(s).
- Carrier Contact
- Aetna 800-872-3862 www.aetna.com
- Lost ID Card? - Request ID Card Replacement
Deductible - The amount you must pay for medical services, before the plan pays a benefit. Preventative care is always covered at 100% with no deductible required.
Coinsurance - This is the percentage of the cost you pay for certain services after the deductible has been met. You can think of this as “cost sharing”. For example, once your deductible has been met you could pay 20% for the cost of certain services and the plan could pay 80%.
Copay - The flat fee paid by the member when a medical service is received, i.e. $20 for a doctor's visit or $20 for a prescription.
In Network Provider - An in-network provider is a hospital, doctor, medical group, and/or other healthcare provider contracted to provide services to insurance company customers for a discounted fee. Using these providers will lessen your medical expenses when using your benefits.
Out of Network Provider - An out of network provider is a hospital, doctor, medical group, or other healthcare provider who are not contracted to provide services to insurance company customers. Because the fees are not negotiated in advance with the insurance company, the provider can charge the member as much as they wish.
Out of Pocket Maximum - The maximum amount a member would have to pay out of their pocket for medical expenses for the year, with the exception of benefit premiums (which come out of your paycheck). Your out-of-pocket maximum includes your deductible, any coinsurance paid and all co-payments (medical and prescription drug).