Aetna
800-445-5299
Group Number: 237642
Employees can access Aetna Health Maintenance Organization (HMO) Plans provide a high-quality network of doctors and hospitals and allows members to enjoy the freedom to choose from a variety of care options. Both Aetna AWH and Aetna HMO require members to select an in-network Primary Care Provider (PCP). These plans are ideal if you prefer a lower payroll deduction and are comfortable with a PCP directing member's care. Both plans may provide coverage in California only.
Medical Plan Comparisons:
|
2024 MEDICAL PLANS |
Aetna AWH |
Aetna HMO |
|---|---|---|
| Annual Deductible | ||
| Individual | None | None |
| Individual within Family | None | None |
| Family | None | None |
| Annual Out of Pocket Maximum | ||
| Individual | $2,000 | $2,000 |
| Family | $4,000 | $4,000 |
|
Medical Services |
||
| Primary Care Visit | $20 copay | $20 copay |
| Specialist Office Visit | $20 copay with PCP Referral | $20 copay with PCP referral |
| Basic X-ray and Laboratory | No charge | No charge |
| Inpatient Hospital | $250 copay per admission | $250 copay per admission |
| Emergency Room | $100 copay | $100 copay |
| Urgent Care | $20 copay | $20 copay |
| Chiropractic | $15 copay per visit to 20 visits per year |
$15 copay per visit to 20 visits per year |
| Hearing Aid | 20% with $4,000 benefit maximum every 2 year | 20% with $4,000 benefit maximum every 2 year |
| Prescription Drugs | ||
| Generic / Tier 1 | $10 copay | $10 copay |
| Formulary / Tier 2 | $25 copay | $25 copay |
| Non-Formulary / Tier 3 | $50 copay | $50 copay |
| Specialty/ Tier 4 | 20% up to $200 Copay | 20% up to $200 Copay |
| Semimonthly Employee Contribution | ||
| Employee Only | $8.50 | $57.54 |
| Employee + 1 | $89.91 | $244.36 |
| Employee + Family | $169.55 | $370.97 |
Plan Documents and Resources