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Aetna Choice® Point-of-Service (POS) II
How the plan works: If you enroll in the Aetna Choice POS II plan, you may receive care from any provider, but you benefit from lower, negotiated fees when you stay in network. You are not required to select a primary care physician (PCP), however, you may do so if you wish in order to help you better manage your care. Referrals are not required for specialty care. Each year, you must meet a deductible as follows:
After you have met the deductible, the plan starts to pay benefits. Some services, such as provider office visits, emergency room care and urgent care facility visits, require copays. Other eligible expenses are paid as follows:
Every year there is a limit to the amount you have to pay out of your pocket in coinsurance:
If you reach this amount, the plan will pay 100% of covered medical expenses after you pay any applicable medical and prescription drug copays. Note: If you live outside an Aetna network, you may enroll in Aetna Choice POS II and use the plan's out-of-network coverage. Aetna Choice POS II benefit summary Hawaii has a slightly different Aetna Choice Pos II plan design due to territorial requirements. Click here for the benefit summary. |
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