medical plan
Three options (with prescription drug coverage) through Aetna.
Your Choice Overview
Our medical plan administrator is Aetna. One of the biggest differences among the three plans is how you pay for services. With the Aetna Select and Aetna PPO plans, you pay more out of your paycheck and less when you need care. If you don’t go to the doctor often, or prefer to pay later, the Aetna PPO + HSA takes less out of your paycheck, but you pay the full cost of services until you meet the deductible. Consider this as you compare the plans.
| Aetna Select | Aetna PPO | Aetna PPO + HSA |
|---|---|---|
National narrow network plan with in-network benefits only |
PPO plan with a broader provider network than Aetna Select |
Consumer-driven health plan (CDHP) uses the same provider network as Aetna PPO HSA helps you pay for your eligible medical expenses, including deductible, tax free |
No deductible when you choose in-network providers |
Moderate deductible |
Higher deductible, but lowest contributions from your pay |
In-network preventive care 100% covered |
||
No benefits out network |
Reduced benefits out of network |
Reduced benefits out of network |
Lowest overall out-of-pocket cost when you need care and choose in-network providers |
Moderate overall out-of-pocket cost when you need care |
Highest overall out-of-pocket cost when you need care, but HSA helps cover it |
Your Choice Overview
Our medical plan administrator is Aetna. One of the biggest differences among the three plans is how you pay for services. With the Aetna Select and Aetna PPO plans, you pay more out of your paycheck and less when you need care. If you don’t go to the doctor often, or prefer to pay later, the Aetna PPO + HSA takes less out of your paycheck, but you pay the full cost of services until you meet the deductible. Consider this as you compare the plans.
Select the tab for each plan to review the details.
|
National narrow network plan with in-network benefits only |
|
No deductible when you choose in-network providers |
|
In-network preventive care 100% covered |
|
No benefits out network |
|
Lowest overall out-of-pocket cost when you need care and choose in-network providers |
|
PPO Plan with a broader provider network than Aetna Select |
|
Moderate deductible |
|
In-network preventive care 100% covered |
|
Reduced benefits out of network |
|
Moderate overall out-of-pocket cost when you need care |
|
Consumer-driven health plan (CDHP) uses the same provider network as Aetna PPO |
|
Higher deductible, but lowest contributions from your pay |
|
In-network preventive care 100% covered |
|
Reduced benefits out of network |
|
Highest overall out-of-pocket cost when you need care, but HSA helps cover it |
Medical and Prescription Drug Plans at a Glance
Medical Comparison
The plans differ in the providers available to you and how much you pay for your plan, services, and medications.
| In-Network Medical Coverage Details | ||||||||
|---|---|---|---|---|---|---|---|---|
Per Pay Period Cost |
AIC HSA Contribution |
Preventive Care |
Annual Deductible |
Coinsurance |
Office Visit (including CVS Health Virtual Care) |
Urgent Care/ Emergency Room |
Out-of-Pocket Maximum |
|
| Aetna Select1 |
|
NA | ||||||
| 100% covered | NA |
NA |
$25 copay for primary doctor $40 copay for specialist $0 copay for CVS Health Virtual Care |
$75 copay for urgent care $250 copay for emergency room (waived if admitted) |
$2,500 per person $5,000 per family |
|||
| Aetna PPO |
|
NA |
100% covered |
$600 per person $1,200 per family |
You pay 15% after deductible |
$25 copay for primary doctor $40 copay for specialist $0 copay with no deductible for CVS Health Virtual Care |
You pay 15% after deductible |
$3,000 per person $6,000 per family |
| Aetna PPO + HSA |
|
$500 for Employee Only coverage $1,000 for Employee + 1 or Family coverage |
100% covered |
$2,000 per person $3,500 per family |
You pay 15% after deductible |
You pay 15% after deductible 100% covered with no deductible for CVS Health Virtual Care |
You pay 15% after deductible |
$3,500 per person $7,000 per family2 |
Prescription Drug Comparison
| Up to 30-Day Supply Prescriptions (In-Network Retail) | 90-Day Supply Prescriptions (Mail Order or In-Network Retail) |
Preventive Drugs Coverages | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
Generic |
Preferred Brand |
Non-Preferred Brand |
Specialty (Accredo) |
Generic |
Preferred Brand |
Non-Preferred Brand |
ACA Standard Prescription Drugs3 |
Enhanced Preventive Drugs4 |
||
| Aetna Select | $10 copay |
$40 copay |
$70 copay |
$100 copay |
$20 copay |
$80 copay |
$140 copay |
100% covered |
NA |
|
| Aetna PPO | $10 copay |
$40 copay |
$70 copay |
$100 copay |
$20 copay |
$80 copay |
$140 copay |
100% covered |
NA |
|
| Aetna PPO + HSA | You pay 15% after deductible |
You pay 15% after deductible |
You pay 15% after deductible |
You pay 15% after deductible |
You pay 15% after deductible |
You pay 15% after deductible |
You pay 15% after deductible |
100% covered |
You pay 15% with no deductible; coinsurance counts toward out-of-pocket maximum |
|
- This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care.
- With family coverage, any individual family member will meet their out-of-pocket maximum when they have paid the individual out-of-pocket maximum of $3,500. The remaining family members will continue to pay until either they reach their individual maximum of $3,500, or the family out-of-pocket maximum of $7,000 is met.
- Includes aspirin, fluoride, folic acid, smoking cessation products, contraceptives, drugs used for the prevention and treatment of cancer. Limitations based on age and health conditions apply.
- Includes certain drugs for asthma, bone disease, diabetes, heart disease, high blood pressure, and to lower cholesterol.
Medical and Prescription Drug Plans at a Glance
Medical Comparison
The plans differ in the providers available to you and how much you pay for your plan, services, and medications.
Per Pay Period Cost |
|
|
AIC HSA Contribution |
NA |
|
| In-Network Medical Coverage Details | ||
Preventive Care |
100% covered |
|
Annual Deductible |
NA |
|
Coinsurance |
NA |
|
Office Visit (including CVS Health Virtual Care) |
$25 copay for primary doctor |
|
Urgent Care/Emergency Room |
$75 copay for urgent care |
|
Out-of-Pocket Maximum |
$2,500 per person |
|
Up to 30-Day Supply Prescriptions (In-Network Retail) |
||
Generic |
$10 copay |
|
Brand Formulary |
$40 copay |
|
Brand Non-formulary |
$70 copay |
|
Specialty (Accredo) |
$100 copay |
|
90-Day Supply Prescriptions (Mail Order or In-Network Retail) |
||
Generic |
$20 copay |
|
Brand Formulary |
$80 copay |
|
Brand Non-formulary |
$140 copay |
|
Preventive Drugs Coverages |
||
ACA Standard Prescription Drugs3 |
100% covered |
|
Enhanced Preventive Drugs4 |
NA |
|
Per Pay Period Cost |
|
|
AIC HSA Contribution |
NA |
|
| In-Network Medical Coverage Details | ||
Preventive Care |
100% covered |
|
Annual Deductible |
$600 per person |
|
Coinsurance |
You pay 15% after deductible |
|
Office Visit (including CVS Health Virtual Care) |
$25 copay for primary doctor |
|
Urgent Care/Emergency Room |
You pay 15% after deductible |
|
Medical and Prescription Drug Out-of-Pocket Maximum |
$3,000 per person |
|
Up to 30-Day Supply Prescriptions (In-Network Retail) |
||
Generic |
$10 copay |
|
Brand Formulary |
$40 copay |
|
Brand Non-formulary |
$70 copay |
|
Specialty (Accredo) |
$100 copay |
|
90-Day Supply Prescriptions (Mail Order or In-Network Retail) |
||
Generic |
$20 copay |
|
Brand Formulary |
$80 copay |
|
Brand Non-formulary |
$140 copay |
|
Preventive Drugs Coverages |
||
ACA Standard Prescription Drugs3 |
100% covered |
|
Enhanced Preventive Drugs4 |
NA |
|
Per Pay Period Cost |
|
|
AIC HSA Contribution |
$500 for Employee Only coverage |
|
| In-Network Medical Coverage Details | ||
Preventive Care |
100% covered |
|
Annual Deductible |
$2,000 per person |
|
Coinsurance |
You pay 15% after deductible |
|
Office Visit (including CVS Health Virtual Care) |
You pay 15% after deductible |
|
Urgent Care/Emergency Room |
You pay 15% after deductible |
|
Medical and Prescription Drug Out-of-Pocket Maximum |
$3,500 per person |
|
Up to 30-Day Supply Prescriptions (In-Network Retail) |
||
Generic |
You pay 15% after deductible |
|
Prefered Brand |
You pay 15% after deductible |
|
Non-Preferred Brand |
You pay 15% after deductible |
|
Specialty (Accredo) |
You pay 15% after deductible |
|
90-Day Supply Prescriptions (Mail Order or In-Network Retail) |
||
Generic |
You pay 15% after deductible |
|
Preferred Brand |
You pay 15% after deductible |
|
Non-Preferred Brand |
You pay 15% after deductible |
|
Preventive Drugs Coverages |
||
ACA Standard Prescription Drugs4 |
100% covered |
|
Enhanced Preventive Drugs5 |
You pay 15% with no deductible; coinsurance counts toward out-of-pocket maximum |
|
- This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care.
- With family coverage, any individual family member will meet their out-of-pocket maximum when they have paid the individual out-of-pocket maximum of $3,500. The remaining family members will continue to pay until either they reach their individual maximum of $3,500, or the family out-of-pocket maximum of $7,000 is met.
- Includes aspirin, fluoride, folic acid, smoking cessation products, contraceptives, drugs used for the prevention and treatment of cancer. Limitations based on age and health conditions apply.
How to Get the Most from Your Medical Benefits
Choose in-network providers (e.g., doctors, hospitals, facilities)
Call an Aetna One Advocate (A1A) at (877) 700-0069 or find an Aetna provider. Select Find a doctor > Choose a plan > Continue as a Guest > Enter zip code > Search
- Enrolled in Aetna Select?
Warning! This plan does not cover out-of-network care, so you must use in-network providers (Aetna Select Open Access). - Enrolled in Aetna PPO or Aetna PPO + HSA?
While these plans do cover out-of-network care, your benefits are greater—and cost for services is lower—when you use in-network providers (Aetna Choice POS II).
Pick a primary doctor
- They’ll know your overall health status and can treat a wide range of health issues.
- If you can’t see your primary doctor as soon as you need, you have other options. See the Save time and money tip below.
Save time and money—avoid the ER when not a true emergency
Emergency rooms are designed to treat the most serious, time-sensitive medical problems. It is the most expensive place to go for care. For non-emergencies, consider:
- CVS Health Virtual Care visits—Virtual visits are convenient for minor illnesses and injuries, and mental health services. See a qualified health care provider from the comfort and privacy of home, via video or phone call.
- Urgent care facilities—Just walk into one of these facilities when you need to see a doctor right away; for example, for sore throats, migraines, urinary tract infections, cuts that require stitches, and animal bites.
- Retail convenience clinics—The nurse practitioners and physician assistants that staff these clinics (such as MinuteClinic at CVS) are well-qualified to handle minor illnesses and injuries at a lower cost than a visit to the emergency room or urgent care. The Aetna PPO and Aetna PPO + HSA plans cover eligible walk-in care at MinuteClinics 100% after the deductible. With Aetna Select, this care is 100% covered.
Don’t skimp on preventive care—in-network care is free!
See if your medications are on this list
Express Scripts National Preferred Formulary for all three medical plans (Search the Preferred Drug List.)
If they’re not, talk to your doctor about switching to similar medications that are on the list. Some medications have special requirements like prior authorization, step therapy, or quantity limits. If any of these apply to you, RxBenefits will work with you and your doctor to help manage this transition.
Call RxBenefits at (800) 334-8134 if you have questions.
Opt for generics
Generics are FDA-approved to be just as safe and effective as their brand-name counterparts, yet they usually cost a lot less. If your doctor prescribes a brand-name drug and specifies “dispense as written,” you won’t be responsible for paying the difference between the cost of the brand-name drug and the generic equivalent (if available).
If your doctor does not specify “dispense as written” and you choose the brand-name drug instead of an available generic, you will be responsible for paying the cost difference.
Use mail order or an in-network pharmacy for long-term meds
For prescription drugs you take on an ongoing basis (maintenance medications), you have two convenient options for obtaining a 90-day supply:
- Express Scripts mail order service for home delivery, or
- Pick up at an in-network retail pharmacy.
If you have questions about mail-order prescriptions, contact Express Scripts at (800) 334-8134.
Consult with an Aetna One Advocate
Via phone at (877) 700-0069, mobile app, or online chat, this dedicated team can help you connect with the right clinician, navigate the health care system, schedule appointments, get cost estimates, and much more.
Use in-network pharmacies
Check if your pharmacy is in-network with Express Scripts.
If you enroll in the Aetna PPO + HSA, the Art Institute contributes to your HSA once you open your account and elect at least a $1 HSA contribution.
With all three health plans, you have access to on-demand care through CVS Health Virtual Care. Get care for minor illnesses and injuries and mental health services from the comfort and privacy of home, via video or phone call.
The Aetna PPO and Aetna PPO + HSA plans cover CVS Health Virtual Care at 100% with no deductible. With Aetna Select, this care is 100% covered.