Anne Arundel County Government Open Enrollment Meeting

Transcription

Anne Arundel County GovernmentOpen Enrollment Meeting 2021 Aetna Inc.0October 2021

AgendaWelcomePlan overviewAdditional benefitsResources/Contacts 2021 Aetna Inc.1

Welcome to Aetna!Your new medical plans effective January 1, 2022 Open Access Aetna Select HMO-EPO Aetna Open Choice PPO Prescription drug coverage is remaining the same and will continue to be provided byCVS/CaremarkWhat to expect An expanded national network of providers No referrals In-network coverage at hospitals you utilize today, such as:--Anne Arundel Medical CenterJohns Hopkins HospitalUMMS Baltimore Washington Medical CenterUniversity of Maryland Medical CenterMercy Medical Center2

Plan highlights

Open Access Aetna Select HMO-EPOIn-network only (nationwide network)Deductible 100 Individual 200 FamilyAnnual out-of-pocket maximum 1,100 Individual 3,600 FamilyPreventive Care100% covered, deductible waivedOffice Visits 15 copay – Primary Care Physician 15 copay - SpecialistDiagnostic Labs100% covered, after deductibleDiagnostic X-ray100% covered, after deductibleComplex Imaging100% covered, after deductibleAllergy Testing 15 copayAllergy Injections 15 copayOutpatient Surgery 25 copay – facility charges 15 copay – professional charges4

Open Access Aetna Select HMO-EPOIn-network only (nationwide network)Urgent Care 35 copayCVS Minute Clinic 0 copayEmergency Room 75 copay, waived if admittedAmbulance100% covered, deductible waivedInpatient Hospital100% covered, after deductibleSkilled Nursing Facility(120 days per year)Covered 100%, after deductibleShort-Term Rehabilitation(150 visits per year) 15 copayHearing Aids(Two hearing aids every 36 months,100% covered, deductible waivedmaximum of 1,400 per hearing aid)Acupuncture (50 visits per year) 15 copay5

Aetna Open Choice PPOIn-network(nationwide network)Out-of-network*Deductible 125 Individual 250 Family 500 Individual 1,000 FamilyAnnual out-of-pocketmaximum 500 Individual 1,000 Family 1,500 Individual 3,000 FamilyPreventive Care100% covered, deductible waived30% coinsurance, after deductibleOffice Visits 15 copay – Primary Care Physician 35 copay – Specialist30% coinsurance, after deductibleDiagnostic Lab5% coinsurance, after deductible5% coinsurance, after deductibleDiagnostic Lab atIndependent Lab100% covered, deductible waivedN/ADiagnostic Xray5% coinsurance, after deductible5% coinsurance, after deductibleFreestanding RadiologyCenters100% covered, deductible waivedN/AComplex Imaging5% coinsurance, after deductible5% coinsurance, after deductible*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 theallowable charge, you will be responsible for any expenses incurred that are above this amount, in addition to your out-of-network deductible andcoinsurance/copay. Any amount that you pay above the allowable charge will not apply to your out-of-pocket maximum.6

Aetna Open Choice PPOIn-network(nationwide network)Out-of-network*Allergy Testing5% coinsurance, after deductible30% coinsurance, after deductibleAllergy Injections 15 copay – Primary Care Physician 35 copay - Specialist30% coinsurance, after deductibleOutpatient Surgery5% coinsurance, after deductible –facility charges 15 copay PCP/ 35 copay Specialist –professional charges30% coinsurance, after deductibleUrgent Care 35 copay 35 copayCVS Minute Clinic 0 copayN/AEmergency Room 75 copay, waived if admitted 75 copay, waived if admittedAmbulance100% covered, deductible waived100% covered, deductible waivedInpatient Hospital5% coinsurance, after deductible30% coinsurance, after deductibleSkilled Nursing Facility5% coinsurance, after deductible(unlimited days)30% coinsurance, after deductible(120 days per year)*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 theallowable charge, you will be responsible for any expenses incurred that are above this amount, in addition to your out-of-network deductible andcoinsurance/copay. Any amount that you pay above the allowable charge will not apply to your out-of-pocket maximum.7

Aetna Open Choice PPOIn-network(nationwide network)Out-of-network*Short-Term Rehabilitation(300 visits per year) 35 copay30% coinsurance, after deductibleHearing Aids(Two hearing aids every 36months, maximum of 1,400 per hearing aid)100% covered, deductible waived100% covered, deductible waivedAcupuncture 35 copay30% coinsurance, after deductible*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 theallowable charge, you will be responsible for any expenses incurred that are above this amount, in addition to your out-of-network deductible andcoinsurance/copay. Any amount that you pay above the allowable charge will not apply to your out-of-pocket maximum.8

Provider search toolThe help you need to pick your planYou can check both plans to see if the doctors,hospitals and other health care providers you useare in-network at AAcounty.aetna.com.You can search using a doctor or facility’s name,or by: City, state, ZIP code Specialty Common procedure types Specific conditions 2021 Aetna Inc.9

Member Tools

Your Aetna member website View your health plan summary Manage your claims Search for providers and procedures Get cost estimates Track spending and progress towardsyour deductible and out-of-pocketmaximum Access your ID card Get recommended health actionsIt’s easy to register for your secure member website.Once you get your Aetna ID card:Go to www.aetna.comClick “Register now”11

Aetna Health app With the Aetna Health app, you can:0h0 1lView your health plan summary and get detailedinformation about what's covered.See claims details and pay claims for yourwhole family.Q- Search for providers, procedures and medications. Get cost estimates before you get care.ggg000 . q:- 10 0% ·HomeFAMILY SPENDINGTrack spending and progress toward meetingyour deductibles for you and your fam ily.Talk with a doctor anytime by phone or video chatfrom the comfort and safety of home.Access your ID card whenever you need it. 1,070.92 of 5,200 spentDen al In Neb Of DettJcbble 67.40 of 150 spent::;:: View all spending Receive personalized health reminders.12

Additionalbenefits

Discount ProgramsAvailable to you for just being an Aetna memberNo referrals or claim forms requiredMost are accessible through the Aetna memberwebsiteEligible family members can access programsUnlimited use of programs 2021 Aetna Inc. 201814

Aetna FitnessSM DiscountProgramGlobalFit Preferred rates* at over 10,000 gymsnationwide Flexible membership options available Discounts on home exercise products andequipment Access to other programs supportingmembers’ healthy lifestyles At-home weight loss programs One-on-one health coaching services ***Participation in GlobalFit is for new gym members only.Membership to a gym of which members are now, or wererecently members, may not be available.**Offered by WellCall, Inc. through GlobalFit. 2021 Aetna Inc.15

Aetna Weight ManagementSMDiscount ProgramDiscounts from:Jenny Craig Free 30-Day Trial Program* – then, 25% off when enrolling in a Jenny Craig PremiumProgram* available at participating Jenny Craigcenters or through Jenny Craig-At-HomeNutriSystem 2021 Aetna Inc. 2018 12% off any 28-day weight loss meal plan** Plus, other offers available from NutriSystem atthe time of enrollment* Food and, if applicable, shipping not included. Offer applies to initial membership feeonly and is valid at participating centers in the U.S., Canada and Puerto Rico and throughJenny Craig At Home. Each offer is a separate offer and can be used only once perperson. Restrictions apply.** The Aetna discount offers do not apply to any program in which the member isalready enrolled. To receive the discounted rate, they must wait until their program ends.Store with their membership16

Vision Discount ProgramMembers save on prescription andnonprescription vision services and materials: Savings on eye exams, frames, lenses and LASIKsurgery Savings on contact lens solution,nonprescription sunglasses and moreMembers have access to thousands of visionprovider locations, including: 2021 Aetna Inc. 2018 CVS Optical LensCrafters Target Optical Many Pearle Vision Centers America’s Best Plus, independent optometrists andophthalmologists17

TeladocEveryday care (PCP copay)Talk to a U.S.-licensed doctor 24/7 from anywhere you are fornon-emergency conditions including: Flu Sinus infections Sore throats And moreMental Health Care (PCP copay)Talk to a therapist 7 days a week (7 a.m. to 9 p.m. local time)Dermatology (Specialist copay)Upload images of a skin issue online and get a customtreatment plan within two days for conditions such as: Eczema Acne Rashes And more 2021 Aetna Inc.18

CVS MinuteClinic Get low-cost/no-cost care at MinuteClinic Access convenient, local care at MinuteClinic, atlow cost/no cost to you.Available when you need it, including nights andweekends.Convenient care close to homeMinuteClinics are a clinics located inside selectCVS Pharmacy and Target locations, treating avariety of illnesses, injuries and conditions,including: Allergies Ear infections Flu-like symptoms Bug bites, stings and moreMinuteClinic providers can also administervaccines and write prescriptions, when medicallyappropriate. 2021 Aetna Inc.19

Aetna Joint & Back Care With enhanced caremanagement,dedicatedmusculoskeletal(MSK) care managerseducate, motivateand guide youthrough treatment Education, guidance andreferrals to otherprogramsPartnered with HingeHealth (a marketleader in digital MSKsolutions) to provideyou with digitalexercise therapy tohelp to improve yourhealth and well-beingby: Addressing acute injuriesquickly 2021 Aetna Inc. Seamless experiencewith one point of contact Helping you to manageand reduce your MSKpain, without surgery ordrugs Providing a convenient,on-demand exercisetherapy program that youcan do from any location,like from your own home2020

Resources/Contacts

Resources/ContactsAetna Member Services Mon-Fri, 8am–6pm1-855-222-2774Aetna/Anne Arundel County DedicatedMicrositeAAcounty.aetna.com Frequently asked questions Plan information Summary of Benefits Coverage (SBC) Informational flyersAnne Arundel County Benefits TeamPhone: 410-222-7400Email: Benefits Team@aacounty.orgWebsite: www.aacounty.org 2021 Aetna Inc. 201822

Thank you

- Anne Arundel Medical Center - Johns Hopkins Hospital . Skilled Nursing Facility (120 days per year) Covered 100%, after deductible ; Short-Term Rehabilitation (150 visits per year) . Program* available at participating Jenny Craig centers or through Jenny Craig-At-Home .