Page 6 - Benefits Guide

Employee Benefits Guide
Helpful Terms
Coinsurance: A set percentage you pay for the cost of
the care you receive. See the plan design summary for the applicable coinsurance/copayments that would apply to the plan that you select.
Copay or copayment: A set dollar amount you pay when you get health care (for example, $50 when you see a specialist).
Deductible: A set amount you must pay out of your pocket before your health insurance starts paying part of the cost, unless a copay applies.
Out-of-pocket maximum: The most you will pay in a calendar year for doctor visits, prescriptions, etc. This “safety net” provides peace of mind for those who have a serious condition or illness. Just remember, deductibles and out-of-pocket maximums differ for in-network and out-of-network benefits.
Once a covered family member meets the individual out-of-pocket maximum, your insurance will pay the full cost of covered charges for that family member. Charges for all covered family members will continue to count toward the family out-of-pocket maximum.
Once the family out-of-pocket maximum is met, your insurance will pay the full cost of covered charges for
all covered family members. The annual out-of-pocket maximum includes amounts paid toward your deductible.
Aetna Tools and Resources
Corizon Health cares about your health and well-being. Spend some time understanding how the tools and resources available through Aetna can support you in living your best life. Find details about these and other programs at www.aetna.com.
Informed Health Line
The Informed Health Lines provides you with access to registered nurses who can answer questions on a variety of health topics. Available on a 24/7 basis, the nurses are there any time you need help making an informed health care decision.
Teladoc
Teladoc can help you and your covered family members resolve many of your medical issues over the phone or online. Whether you’re at home, at work or out of town, you can request a consultation with a board-certified, telemedicine-trained doctor any time—and receive a prescription (if necessary) called in to your pharmacy.
Teladoc and Aetna will confirm your eligibility real
time, and will determine how much you will pay for the consultation. If you are enrolled in the SMART Value and SMART Choice HDHP, this service will cost $40 per visit (until the deductible is reached and then the coinsurance rate will apply). If you are enrolled in the SMART Premium Plan, it will be charged as a primary care office visit copay.
You also have access to additional services available through Teladoc, including behavioral health, caregiver, and dermatology services. Additional fees per visit will apply depending on the service being requested.
Aetna Health Concierge
The Aetna Health Concierge Team is available to help you better understand your health benefits, utilize Aetna online tools, and help you get the most out of the resources available to you. You can contact Aetna at 1-800-938-0508 or www.aetna.com.
Women’s Health: Prevention and Education
The Aetna Women’s Health Program offers a wealth of resources and preventive services to help women get
the care they need to stay healthy—and handle whatever health issues they may encounter through every life stage.
ƒ Breast Health Education Center
ƒ Confidential genetic testing for breast and
ovarian cancers
ƒ Infertility case management and education
Personal Phone Support
Personal, confidential conversations with a nurse are built into our plans—you pay nothing extra, and you don’t have to be dealing with an illness. You may just have
an occasional question about a symptom you have or
a treatment you may have heard about, or need some helping determining what questions to ask your doctor.
Discount Programs and Services
Stay healthy and save with products and services available through our plans, including savings on gyms, personal training, natural therapy services, and hearing aids and exams.
6