2024 benefit highlights
| Aetna Choice POS II – Bronze | In-network | Out-of-network**** |
|---|---|---|
| Deductible | In-Network: EE Only $3,900; EE+ Family: Individual $3,900/ Family $7,800. | Out-of-Network: EE Only $7,800; EE+ Family: Individual $15,600/ Family $15,600. |
| Annual out-of-pocket maximum | In-Network: EE Only $6,900; EE+ Family: Individual $6,900/ Family $13,800. | Out-of-Network: EE Only $13,800; EE+ Family: Individual $27,600/ Family $27,600. |
| Office Visits | 30% coinsurance – Primary Care Physician 30% coinsurance – Specialist | 50% coinsurance, after deductible – Primary Care Physician and Specialist |
| Preventive Care | 100% covered, deductible waived | 50% coinsurance |
| Inpatient Hospital | 30% coinsurance | 50% coinsurance |
| Urgent Care | 30% coinsurance | 50% coinsurance |
| Emergency Room | 30% coinsurance | 30% coinsurance |
| Ambulance | 30% coinsurance | 30% coinsurance |
| Chiropractor | 30% coinsurance | 50% coinsurance, after deductible |
| Short-Term Rehabilitation | 30% coinsurance | 50% coinsurance |
*Deductible: The amount you pay for covered services before your health plan begins to pay.
**Copay: This is the dollar amount you pay for health care expenses after you meet your deductible limit.
***Coinsurance: This is the percentage of health care expenses you pay after your deductible. Your health plan pays the rest up to any benefit or lifetime maximum.
****Note: The plan pays benefits for out-of-network services based on the allowable charge for a service. If your out-of-network provider charges more than the allowable charge, you will be responsible for any expenses incurred that are above this amount, in addition to your out-of-network deductible and coinsurance/copay. Any amount that you pay above the allowable charge will not apply to your out-of-pocket maximum.
