Copay: $2 for exam and $1 for eyeglasses (individuals older than age 21 not residing in a nursing facility or an intermediate care facility for people with mental retardation). The information provided on this page is for informational purposes only, and ODM disclaims any obligation or liability based upon its use. ¤If you choose a brand-name medication when a generic is available, you will be charged the generic copay plus the difference in cost between the brand-name and the generic.Retail fills eligible for a greater than a 30-day supply will be subject to the 50% coinsurance up to the maximum of $500 for preferred or $600 for non-preferred.
2021 Biweekly rates for zip code
These rates do not apply to all Enrollees. Ni multisim for mac free download. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
| Aetna Open Access® HMO Plan | Code | Non-Postal | Postal 1 | Postal 2 |
|---|
Your 2021 benefits - DC, MD, Northern VA
| Plan Details | Basic Option |
|---|---|
| Preventive care copay | $0 |
| Primary care visit copay | $25 |
| Specialist visit copay | $55 |
| Maternity | You pay 20% |
| Prenatal Care | $0 |
| Hospital Care | You pay 20% |
| Inpatient hospital copay | You pay 20% |
| Outpatient surgery copay | $350 |
| Emergency room copay | $200 |
| Urgent care center copay | $50 |
| Lab/X-ray/diagnostic services | $25 PCP / $55 specialist ($100 for certain tests) |
| Prescription drug copays (for a 30-day supply at a retail pharmacy) | |
| Generic formulary* | $10 |
| Brand-name formulary* | 50% up to $200 maximum |
| Non-formulary* | 50% up to $300 |
For specialty drug information, see the federal plan brochure. | |
| Built-in Vision | |
| Routine eye exam copay | $55 |
| Money toward prescription eyewear | You get $100 every 24 months |
| Discounts on eyeglasses, contacts, eye exams and more | Included |
Built-in dental, too
Use our Basic Dental Network. Call 1-800-537-9384 to select a dentist OR to switch to our larger PPO network at no additional cost. It's your choice!
Basic - Pay a $5 copay for cleanings, fillings and X-rays when you visit your primary care dentist (PCD). Download appcleaner app for mac.
PPO - After a $20 deductible per member, cleanings, fillings, and X-rays are covered at 100% with network dentists.**
- Large nationwide Aetna Network
- 24/7 access to doctors via phone or video with Teladoc®†
- Built-in dental and vision coverage
- Predictable costs
- No referrals to network specialists*
- Discounts on eyewear, LASIK surgery, gym memberships, massage, acupuncture, weight-loss programs and more
*A formulary is a list of generic and brand-name drugs your health plan prefers.
** Out of Network for cleanings, composite fillings and X-rays – you pay 50% of negotiated rate plus any difference between our allowance and the billed amount.
*** If you choose the brand name drug over the generic equivalent, you will owe the corresponding copay plus the difference between the generic and brand name costs. Please see the plan brochure for details.
†Teladoc® is covered at the member cost share.
] Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna. Download microsoft word 2013 for mac. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services.
Health insurance plans are offered, underwritten and/or administered by Aetna Life Insurance Company (Aetna).
This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the Plan's applicable Federal brochure(s). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. Plan features and availability may vary by location and are subject to change. Pharmacy clinical programs such as precertification, step therapy, and quantity limits may apply to your prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Discount programs are neither offered nor guaranteed under our contract with the FEHB Program, but are made available to all enrollees and their families who become members under an Aetna Health Insurance Plan. Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor. Information is believed to be accurate as of the production date; however, it is subject to change.
Aetna Colonoscopy Policy
Postal and Non-Postal rates
- Non-Postal rates apply to most non-Postal employees.
- Postal rates apply to United States Postal Service employees.
- Postal Category 1 rates apply to career bargaining unit employees represented by the APWU, IT/AS, NALC and NPMHU.
- Postal Category 2 rates apply to career bargaining unit employees represented by the PPOA.
- Non-Postal rates apply to all career non-bargaining unit Postal Service employees and career employees represented by the NRLCA agreement.
- Immunizations;
- Allergies;
- Blood pressure, weight, blood sugar and cholesterol numbers; and
- Share it with your doctor. The 'home page' of your Personal Health Record is the Health Summary. It's your health information at a glance. You can decide what to share with your doctor. You can print out your Health Summary, take it with you to your doctor, or share it securely online before your visit.
- Keep track of when you are due for important checkups. It can help remind you when to get preventive screenings, like a mammogram or colonoscopy.
- Track important health numbers. See how your blood pressure, blood sugar, weight and other health markers change over time in clear, easy-to-understand graphs and charts.
- Manage your family's health information. The Personal Health Record is available to employees who enroll in an Aetna health benefits or health insurance plan. Covered family members have their own Personal Health Records. As the plan subscriber, you can access and add information to their Personal Health Records — as long as they are under age 18. You can give your covered spouse this access, too.
- Preterm labor symptoms;
- Newborn care and more.
- A screening for depression; and
- Finding providers;
- Overseeing Utilization Management (authorization) for applied behavior analysis (ABA);
- Assuring that treatment is effective;
- Connecting parents to all available resources; and
- Coordinating with integrated autism care providers and supports.
Aetna Colonoscopy Cost
- There must be a diagnosis of Autism Spectrum Disorder;
- The maladaptive target behavior must be severe (risk to personal safety, or the safety of others in the child's environment, or very significantly/completely interferes with ability to function);
- Parent/caregiver(s) must be involved in training of behavioral techniques;
- There is a time-limited, individualized treatment plan with objective measures that describes behavioral interventions;
- There is involvement of community resources (such as the school district); and
- Services must be provided by individuals licensed by the state or certified by the Behavior Analyst Certifying Board.