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Aetna HealthFund® CDHP - PPO Network - Benefit Highlights

  • PPO Network
  • Low plan premiums
  • Dental and vision benefits included
  • See any licensed doctor for covered services
  • Pay nothing out of pocket until funds are exhausted

Available to Federal Employees in AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MO, MS, NC, NH, NJ, NV, NY, OH, OK, PA, SC, TN, TX, VA, VT, WA, WI and WV.

Benefit Features
In-Network Preventive Care
(does not reduce your Fund)
Medical — 100%
Dental — 100%
Vision — 100%
Medical Fund Medical Fund
$1,250 — Single
$2,500 — Family
Member Responsibility After Annual Medical Fund is spent
$750 — Single
$1,500 — Family
Rollover Unused Medical Fund balance rolls over to next year’s Fund and reduces your member responsibility!
Traditional Medical Plan Benefits Coinsurance After you pay member responsibility
90% — In network
60% — Out of network
Dental Benefits
  • Cleanings and X-rays covered at 100% in network
  • Dental Fund - 100% coverage in or out of network
    up to $300 — Single
              $600 — Family
  • Aetna Dental network discounts apply even after the Fund is gone.
  • Unused Dental Fund balance rolls over to next year’s Fund
Pharmacy Benefits
(Mail order available for maintenance prescriptions)
Rx copayment program of $10/$25/$40 for up to a 30-day supply after you pay member responsibility.
Vision Benefits
  • Routine eye exams covered at 100% in-network
  • Discounts on eyewear
Special feature for Retirees If you are participating in Medicare Part B you can use your Medical Fund dollars to pay Part B premiums.



 


CDHP Features:

  • NEW – Increased medical fund ($1,250 (single)/$2,500 (family)
  • NEW – Reduced member responsibility.
  • NEW – In-network coinsurance (Aetna’s share) increased to 90%
  • Entire Medical and Dental funds available immediately – nothing is paid out of your pocket until Funds are gone
  • Unused fund amounts roll over to the next year
  • Dental and vision included
  • Nationwide coverage both in and out of network
  • 100% preventive care coverage when you use participating providers





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