GetHealthHelp

A Patient Advocate's View

Changes to the Indemnity PPO options

 

PLAN

 

Empire MEP HCPPO

Out of Network

 

Emoire MEP HCPPO

In Network

 

HOW DOCTORS & PATIENTS LIKE

 THIS PLAN

 

A+ BEST for Adults

Preventive Exams for children not covered

 

Your Aetna Doctors should be sure they are in the Empire HCPPO

 

Deductibles and co-pays

 

$250/$625

Out Of Pocket max. increased to $700

 

 

same as in network

co-pays are not counted to deductibles

 

Well Child Care

 

80% after deductible

 

100% immunizations & office visits

 

 

PRESCRIPTION PLAN CHANGES

 

no assignment of benefits

reimbursement only

 

 

% raised for co-pays

 out of pocket raised

 

CAN I USE MY

 OUT OF NETWORK DOCTOR & HOSPITAL

 

 

All doctors are covered

for 80% of office fee after deductible

 

$15 co-pay

$5 co-pay with Medicare

 

ADVANTAGE OF USING IN NETWORK DOCTORS

 

 

Most doctors know this plan and accept  it.

 

 

Co-pays instead of %

 

 

PHYSICAL THERAPY/

CHIROPRACTIC

 

Same as Medical Coverage Out-of-Network

In-Network agrees to managed care limits

 

 

80 % of contracted rate

 

OUT PATIENT MENTAL HEALTH

 

80% after deductible

 

80% after deductible

 
 
 

November 9, 2008 - Posted by | Uncategorized

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