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BENEFITS

Medical Insurance

Meritain Health (Aetna) | EPO Medical Plan

With the Exclusive Provider Organization (EPO) plan, you may self-refer to any physician within the “Aetna Choice POS II” network.
This plan requires that you only utilize doctors, clinics, and hospitals that belong to the network, except in the case of an
emergency, however, you may self-refer to specialists. If you choose to see a provider who is not part of the network, you will be
required to pay the full cost for your care.

Meritain Health (Aetna) | POS Medical Plan
The Point of Service (POS) plan allows you to direct your own care. You are not limited to the physicians within the network and
you may self-refer to specialists. If you receive care from a physician who is a member of the “Aetna Choice POS II” network, a
greater percentage of the entire cost will be paid by the insurance plan. You may also obtain services using a non‐network
provider; however, you will be responsible for the difference between the covered amount and the actual charges and you may be
responsible for filing claims.

Finding a Medical Provider
Online: Go to www.aetna.com/docfind/custom/mymeritain/
Telephone: Call Meritain at (800) 925-2272

Health Advocate

Health Advocate

Health Advocate is a program that provides you with experienced help when dealing with benefit related issues. Their team
includes highly trained registered nurses, backed by a staff of medical directors and administrative experts. When you call Health
Advocate for assistance you are assigned a Personal Health Advocate who takes responsibility for helping you to resolve problems.
Here are a few of the ways that they help:
• They help you get your claims and/or billing issues resolved.
• They help you get answers to your medical questions about test results, treatment plans, and medications recommended by
your doctor.
• They work with our insurance carriers to help obtain appropriate approval for services when necessary.
• They assist in communications between your doctors and the insurance companies.
• They help you locate and contact the best doctors, dentists, and treatment facilities in your networks.
• They share unbiased health information when you need to make an informed decision about your care.

Their years of experience make it easy. You need to make only one call or send an e-mail and your personal health advocate will:
• Act quickly and effectively on your behalf.
• Protect your privacy and keep information strictly confidential.
• Find the best answers.
• Make any necessary follow-up arrangements.

Contacting Health Advocate

Telephone: If you need assistance dealing with benefit-related issues, you can speak directly with a Personal
Health Advocate (typically a highly trained registered nurse) by calling (866) 695-8622
Email: answers@healthadvocate.com

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