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Medical, continued
Here is an overview of our fourth is a HSA compatible high deductible medical plan, offered through
Aetna Group
Aetna Medical HDHP Plan
In-Network
Out-Of-Network
Annual Deductible
$5,000 per individual
$10,000 family limit
$10,000 per individual
$20,000 family limit
Annual Out-of-Pocket Max
$6,550 per individual
$13,100 family limit
$13,100 per individual
$26,200 family limit
Lifetime Max
Unlimited
Unlimited
Office Visit
Primary Provider
Plan pays 80% after deductible
Plan pays 60% after deductible
Specialist
Plan pays 80% after deductible
Plan pays 60% after deductible
Preventive Services
Plan pays 100%
Plan pays 60% after deductible
Chiropractic Care
Plan pays 80% after deductible
(up to 20 visits per year)
Plan pays 60% after deductible
(in-network limitations apply)
Lab and X-ray
Complex imaging: plan pays
70% after deductible; all other:
plan pays 80% after deductible
Complex imaging: plan pays
50% after deductible; all other:
plan pays 60% after deductible
Inpatient Hospitalization
Plan pays 80% after deductible
Plan pays 60% after deductible
Outpatient Surgery
Plan pays 80% after deductible
Plan pays 60% after deductible
Urgent Care
Plan pays 80% after deductible
Plan pays 60% after deductible
Emergency Room
Plan pays 80% after deductible
Plan pays 80% after deductible