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Gwinnett County Health Plan

Aetna Choice® POS II – Traditional

High Deductible Health Plan (HDHP)

2025 plan highlights


2025 benefit highlights

Table of plan benefit highlights.
Traditional Aetna Choice POS II In-network Out-of-network****
Deductible In-Network: EE Only $1,600; EE+ Family: Individual $1,600/ Family $3,200. Out-of-Network: EE Only $3,200; EE+ Family: Individual $3,200/ Family $6,400.
Annual out-of-pocket maximum In-Network: EE Only $4,200; EE+ Family: Individual $4,200/ Family $8,400. Out-of-Network: EE Only $8,400; EE+ Family: Individual $8,400/ Family $16,800.
Office Visits 50 copay/visit, deductible doesn't apply PCP
$75 copay/visit, deductible doesn't apply SPC
50% coinsurance
Preventive Care 100% covered, deductible waived 50% coinsurance
Inpatient Hospital 30% coinsurance 50% coinsurance
Urgent Care $75 copay 50% coinsurance
Emergency Room 30% coinsurance 30% coinsurance
Ambulance 30% coinsurance 30% coinsurance
Chiropractor $75 copay 50% coinsurance, after deductible
Short-Term Rehabilitation
(60 visits/calendar year for Physical, Occupational & Speech Therapy combined, including outpatient hospital services. Includes treatment of Autism & habilitation services)
$75 copay 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.

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