Take these considerations into account when comparing how the plans work:
1. Covered Services: All three plans provide comprehensive medical and prescription drug benefits, and cover in-network preventive care at 100%. Click here for a list of covered services.
2. In-Network Providers: All three plans provide you with a choice of where to receive care, but you'll pay less when you receive care from an in-network provider. Click here to see if your current providers are in-network.
3. Spending Accounts: If you enroll in the HSA plan, you'll be required to enroll in a Health Savings Account. You have the option to open a medical Flexible Spending Account (FSA) as long as you are not enrolled in the HSA Plan.
Additional details about the plans can be found here:
Here are some common terms you will find in our plan documents and on our web pages.
Aetna also offers a comprehensive glossary on their website (this link will open in a new window).
The amount you pay for covered services before your health plan begins to pay.
This is a person who is covered by another person’s plan. It can be a child, spouse or domestic partner.
Also known as a formulary. This is a list of prescription drugs the health plan covers. It can include drugs that are brand name and generic. Drugs on this list may cost less than drugs not on the list. How much a plan covers may vary from drug to drug. An open formulary provides a greater choice of covered drugs. It is also called a preferred drug list.
This means there is a contract with that doctor or other health care provider. There are negotiated reduced rates with them to help you save money. Your out-of-pocket costs are lower when you stay in network.
This is the total dollar amount of benefits you can receive. It can also be the total number of services you can receive. These totals are limits for a lifetime, not just for a plan year. Plans subject to federal health care reform can only have lifetime dollar maximums on non-essential benefits.
This is a limit on the costs a health plan member must pay for covered services. The limit can be yearly or a dollar amount.
These are events that let members change their health benefits. Examples include death, job loss, divorce and marriage.
A limit on the amount your health plan will pay. Also called usual, customary and reasonable (UCR), customary and reasonable, or prevailing charge. The limit is based on typical charges for health care services for each zip code. Aetna receives data from Fair Health, an independent organization.
To waive any of your existing health and/or dental insurance, you must first complete the enrollment process online in Workday. Please refer to the Workday Enrollment Decision Guide for screen-by-screen instructions of how to change your election to “Waive” for your existing health and/or dental coverage on the health screen.