Aetna HealthFund® CDHP - PPO Network How the Aetna HealthFund® Consumer-Driven Health Plan (CDHP) Plan Works:
See any licensed doctor!
1.
Preventive care covered at 100% when you use participating providers (does not reduce your Funds)
Medical | Dental | Vision
2.
The Funds
Your Fund pays for eligible expenses in or out of network at 100% up to the fund amount
Annual Medical Fund $1,250 (single)/$2,500 (family)
Annual Dental Fund $300 (single)/$600 (family)
Unused Fund balances roll over to next year and reduce your member responsibility so long as you remain enrolled in the plan
3.
The Member Responsibility
After your Medical Fund is used, you pay an annual member responsibility before traditional medical plan coverage begins. The great news is that when you roll over unused medical funds from the previous year, your annual member responsibility is reduced!
After your Dental Fund is used, you will be responsible for additional dental expenses for the year; however, you can continue to take advantage of significant discounts by using Aetna network dentists. Unused dental funds from the prior year will rollover as long as you remain enrolled in the plan.
4.
Medical and Pharmacy Plan Benefits (after member responsibility)
Pay your coinsurance share or Rx copayments for covered expenses.
Out-of-your pocket maximum limits the amount you pay.
No referrals required.
CDHP Features:
NEW Increased medical fund ($1,250 (single)/$2,500 (family)
NEW Reduced member responsibility.
NEW In-network coinsurance (Aetnas 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
