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High Deductible PPO Medical Plan

Contact

Aetna
P.O. Box 14079
Lexington, KY 40512-4079
Group Number: 805400

Tel: (877) 204-9186
www.aetna.com

Information

A High Deductible PPO medical plan is available to employees, Research Associates and dependents. The plan is administered through Aetna and the provider network for the plan is Aetna Choice POS II. To search for a provider under the High Deductible plans, visit on www.aetna.com/docfind or call Aetna at (877) 204-9186.

The High Deductible PPO Health Plan may be paired with a Health Savings Account (HSA) to help pay for qualified health care expenses.

The chart below outlines the main provisions of the High Deductible medical plans.

Service High Deductible PPO
 
In-Network
Non-Network
Outpatient Services
Deductible
$2000 for employee
$6000 for employee + dependent(s)
Out-of-Pocket Max
$4,500 for employee;
$6,750 for employee + dependent(s)
$6,750 for employee;
$10,125 for employee + dependent(s)
Office Visits
80%
60%
Surgery
80%
60%
Lab/X-ray
80%
60%
Inpatient Services
Hospital Charges
80%
60% + $200 co-pay
Other Services
Well Baby Care 100% (deductible waived) Excluded
One Annual Routine Exam
100% (deductible waived)
Excluded
Cancer Screening 100% (deductible waived) Excluded
Immunizations 100% (deductible waived) Excluded
Chiropractic Care*
80%
60%
Acupuncture*
80%
60%
Emergency Room 80% 80%
*20 visits per year