2017 Medical Plan Options-AE
In 2017 you continue to have the same three medical plan options available to you through Aetna.
The Aetna PPO Plan is the most expensive plan, but has enhanced in-network coverage features such as a broader network of participating providers and a flat copay for most services. This plan does not require the selection of a PCP or referrals. Watch a short video (5 minutes) describing the PPO Plan for 2017.
The Aetna Consumer Choice (HSA) Plan is a plan that features the highest annual deductible and initial upfront out-of-pocket expense potential. For this reason, it is offered as the lowest employee contribution. The deductible applies to all services except preventive medical care and certain preventive prescriptions, and must be met before the plan provides coverage. This plan is paired with a health savings account (HSA), which allows you to set aside funds on a pre-tax basis to pay for qualified medical care (including deductibles and coinsurance). With this plan, you are not required to select a primary care physician (PCP) or obtain referrals for specialist services. Watch a short video (10 minutes) describing the HSA Plan for 2017.
The Aetna Whole Health (ACO) Plan is a unique plan that features varying levels of coverage based on three provider networks. Members incur the lowest annual deductible and out-of-pocket expenses when receiving care from providers in the Aetna Whole Health Tier 1 network. When obtaining care from a Tier 2 network provider or a non-participating provider, you will incur a higher deductible and additional out-of-pocket costs. With this plan, you are required to select a PCP from the Tier 1 network, but you do not need referrals for specialist services. Watch a short video (8 minutes) describing the ACO plan for 2017.
Prescription Drug Coverage: All three plans use the same prescription drug formulary. New in 2017 will be two cost management programs for certain drugs (see listings below). View this short video (8 minutes) introducing the step therapy and pre-authorization programs.
Questions for Aetna? Call the concierge services line listed on the back of your card 1-855-586-6963 or the New Health Advocate service at 1-866-695-8622.
A cost comparison tool (excel spreadsheet) has been developed for you to compare your total out-of-pocket costs by plan for based on your estimated use of healthcare services. This tool provides examples only and actual cost will be based on the actual services used.
Annual Enrollment will take place beginning Monday, November 7th and ending at midnight on Tuesday, November 22nd. Between now and when annual enrollment begins we will have several opportunities for you to learn more about the medical options .
Medical Plan Summaries:
- Aetna PPO Plan Summary
- Aetna Whole Health (ACO) Plan Summary
- Aetna Whole Health Member brochure
- Aetna Consumer Choice (HSA) Plan Summary
- Side by side quick plan comparison
- Aetna Preventive Medicine List for the Aetna Consumer Choice (HSA) Plan
(paid at 100% – not subject to the deductible)
Other Aetna Medical Plan Information
- Whole Health Provider Summary
- Whole Health Full Provider Directory (pdf) most current listing is found online
- Instructions on how to find if a doctor is in Aetna’s PPO/HSA or Whole Health (ACO) network
- NEW: Rx Pre-certification and Step Therapy Overview
- NEW: Rx Pre-cert and step therapy transition
- New: RX listing needing Pre-cert or Step Therapy
- Prescription Drug Listing (4-tier)
- Your personalized Aetna Navigator Account
- Aetna Required Information on your Medical Plan
- Aetna Concierge Service
- Aetna’s Mobile App
- Aetna’s Discount Program
A Health Savings Account, or HSA for short, is a tax advantaged account that both Bates and you can contribute to and it is owned by you. You can use funds from your HSA to pay for current medical expenses (including dental and vision) for yourself and your tax dependents or save for future healthcare expenses.
Unlike our current Healthcare Reimbursement Account any contributions remaining in your HSA roll over from year to year and the account is yours when you leave bates. Watch this short video for an introduction to an HSA.
Health Savings Accounts Reference Materials:
- Health Savings Account General FAQ
- Health Savings Account Quick Reference Guide
- Health Savings Accounts Frequently Asked Questions (4 Pages)
- Health Savings Account 2017 Employee Guide (19 pages)
- HSA Account Fee Schedule
- Health Savings Account Payroll Deduction Form
Investing funds in your Health Savings Account
Once you feel you have enough funds in your Health Savings Account to cover your medical needs you can begin investing in Mutual Funds for longer term growth (minimum balance of $1,000 in your Health Savings Account is required before you can invest in Mutual funds). There is a $2.00 a month Investment Account Maintenance fee.
With an investment account you have:
- Access to a diversified group of mutual funds, each professionally managed by an investment adviser
- HSA Investment Fund Performance as of 06-30-16
- integration with Morningstar research data
- 403(b)-like investment capabilities with no transaction fees for trading
- Tax-free growth
Tour the “Financial Center” section of your Health Savings Account with PayFlex for more information.