Non-Medicare

Retiree Health Access^SM offers you access to competitive medical and pharmacy coverage regardless of your current health status.

You are eligible to enroll in a Retiree Health Access plan if you are at least 55 years of age with 5 years of service with your former employer who must participate in the RHA program. You must also meet the following:

You meet your former employer's age and years' of service requirements.
You are no longer a full-time or part-time employee.
You are otherwise eligible to participate in your former employers retirement benefits program.
You may also be able to enroll your dependents. Your Personalized Enrollment Worksheet lists your eligible dependents.

Plan Overviews

The Open Access Managed Choice plans (A,B,C,D and E) offer you the freedom to visit any provider, plus the opportunity to save when you choose in-network providers. Depending on where you live, you may be able to choose an Open Access Managed Choice plan that features the high-performance specialist network. (Aexcel®).
The Out-of-Area plan is a traditional indemnity plan available to retirees living outside the Open Access Managed Choice plan service area.

The Open Access Managed Choice plan

You meet an annual deductible.
After you meet the deductible, the plan pays part of your covered expenses and you pay part. The part you pay may be a fixed fee (copayment) or a percentage of the covered expenses (coinsurance) or a combination of both, depending on the plan design(s) available to you.
The plan has two levels of benefits.
- A higher benefit level is paid when you receive care from in-network providers.
- The lower benefit level is paid when you go outside the network for care.

Once you login and register, the charts for your plan options illustrate how your in-network and out-of-network costs compare for some major covered services. Remember, you pay more for your care when you use out-of-network providers.

You are protected against catastrophic costs. Once your out-of-pocket expenses (including the deductible) reach the out-of-pocket maximum, the plan pays 100% of covered expenses for the rest of the year.
You pay nothing for preventive care when you use in-network providers. When you use out-of-network providers, you pay part of the expenses. Preventive care includes services such as routine exams and certain cancer screenings.

The Open Access Managed Choice Plan with a High-Performance Network (Aexcel^®)

Depending on where you live, you may be able to choose a Open Access Managed Choice plan that features Aexcel^®, a high-performance specialist network. To find out if this option is available to you, login and register to view the charts for your plan options.

Aexcel^® is a designation for select specialists within Aetna’s network who have shown that they can deliver cost-effective care with fewer complications and repeat procedures. When you choose an Aexcel^® specialist, you get quality care you can trust – plus the plan pays benefits at the highest possible level. For some types of expenses, the Aexcel^® network benefit is higher than the in-network benefit.

To find Aexcel^® specialists, use the online provider directory (DocFind). Follow the prompts to start your search and when the list of providers is displayed, look for the blue stars * that identify Aexcel^® specialists. You may see messages that tell you when the specialist’s Aexcel^® designation begins and ends. You can also call 1-800-248-9236 to find Aexcel^® specialists near you.

High-Deductible Open Access Managed ChoicePlan
The High-Deductible Open Access Managed Choice plan combines comprehensive coverage with affordable premium and the opportunity to open a Health Savings Account (HSA). The HSA is a tax-advantaged fund you can use to pay for qualified medical expenses.

If you enroll in a high-deductible Open Access Managed Choice health plan, you may open a health savings account.

A health savings account is a tax-advantaged fund you can use to set money aside for qualified medical expenses (as defined by the IRS). For a complete list of qualified expenses, visit www.IRS.gov and look up “health savings accounts.”

To open your account, you can visit a bank, credit union or other IRS-approved financial institution. Investment options may be available for accounts with a certain minimum balance.

In 2009, you may contribute up to $3,000 for individual coverage and $5,950 for family coverage to your health savings account. You also may be able to make "catch-up" contributions if you are age 55 or older. Contributions must stop once you become eligible for Medicare.

Health saving accounts were developed to help offset the higher out-of-pocket costs of high-deductible health plans and to provide tax incentives to people who set aside their own money for future health care expenses. If these ideas appeal to you, you may want to consider opening a health savings account. The best way to find out whether a health savings account is right for you is to talk with your tax advisor.

Out-of-Area Plan

An out-of-area plan is a traditional indemnity plan (not Open Access Managed Choice) with one level of benefits. If offered by your employer under this plan:

You meet an annual deductible.
After you meet the deductible, the plan pays part of your covered expenses and you pay part. For most medical services, you pay a percentage of the covered expenses.
You are protected against catastrophic costs. Once your out-of-pocket expenses (including the deductible) reach the out-of-pocket maximum, the plan pays 100% of covered expenses for the rest of the year.
You pay nothing for preventive care. Preventive care includes services such as routine exams and certain cancer screenings.

Prescription Drug Benefits

Your prescription drug benefits help you save on a wide selection of top generic and brand-name medications.

You can visit any of more than 57,000 retail pharmacies in Aetna's network to have prescriptions filled. Use the online provider directory to find one near you.

To fill long-term (up to a 90-day supply) prescriptions, you can use the Aetna Rx Home Delivery® service.

You can use Aetna Specialty Pharmacy® for hard-to-fill prescriptions such as injectables and medications that require refrigeration or special handling.

Remember, you save with generic drugs.

You generally pay the least for generic drugs.
You pay more for brand-name preferred drugs listed on the plan’s formulary (a list of preferred, FDA-approved drugs).
You pay the most for brand-name non-preferred drugs – those not listed on the plan’s formulary.

You can look up your drugs on Aetna formulary. The formulary is a list of preferred medications that are FDA approved.

Special Programs and Services

As an Aetna member, you can take advantage of:

Disease Management Program

If you’ve been diagnosed with one or more chronic conditions, the disease management program can help. When you join the program, you receive personalized information and counseling from specially trained medical professionals who work with your health care provider to help you understand and manage your condition(s).

Health Risk Assessment Tools

Quick and easy health risk assessments determine your potential health care needs and offer helpful tips to manage health conditions.

Health and Wellness Discounts

Through your Retiree Health Access® plan, you can take advantage of discounts on:

Vision care. You can save on eyeglass lenses and frames, contact lenses and LASIK surgery at thousands of eye care centers nationwide.
Alternative health care. Your plan provides discounts on services such as massage, acupuncture and chiropractic services, as well as vitamins and nutritional supplements.
Fitness memberships and equipment. Discounts apply to certain fitness club memberships and home fitness equipment available through a national vendor.

Secure Member Website

Once you’re enrolled in an Aetna plan you’ll be able to use Aetna Navigator, a secure member website that offers self-service convenience, up-to-date health information, consumer tools and much more. You’ll need to register first. Then you can log on to:

Find in-network doctors, dentists, hospitals, pharmacies and other providers near you.
Get information about your plan’s coverages, benefits, programs and special features.
Review claims information, including payments made.
Use cost-of-care tools to check the estimated average costs of medical services and prescription drugs in your area.
Compare local hospitals on the criteria most important to you.
Take care of personal benefits business such as requesting a replacement ID card and printing claim forms.
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