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Medical Coverage

Policy Year Maximum: Unlimited

DeductiblePreferred CareNon-Preferred Care

The policy year deductible is waived for all of the following eligible medical services: 

  • In-network care for preventive care and wellness
  • In-network care for pediatric dental care
  • In-network care and out-of-network care for pediatric vision care
  • In-network care and out-of-network care for outpatient prescription drugs
Students: $450 per Policy Year
Family: $1,350 per Policy Year		Students: $900 per Policy Year
Family: $2,700 Per Policy Year

Coinsurance: Coinsurance is both the percentage of covered medical expenses that the plan pays, and the percentage of covered medical expenses that you pay.  The percentage that the plan pays is referred to as “plan coinsurance” or the “payment percentage,” and varies by the type of expense. 

Out of Pocket MaximumsPreferred CareNon-Preferred Care

Once the Individual or Family Out-of-Pocket Limit has been satisfied, Covered Medical Expenses will be payable at 100% for the remainder of the Policy Year.

The following expenses do not apply toward meeting the plan’s out-of-pocket limits:

  • Non-covered medical expenses; and
  • Expenses that are not paid or precertification benefit reductions or penalties because a required precertification for the service(s) or supply was not obtained from Aetna.

Individual Out-of-Pocket: 
$5,000 per Policy Year

Family Out-of-Pocket: 

$10,000 per Policy Year

Individual Out-of-Pocket: 
$15,000 per Policy Year

Family Out-of-Pocket:   

$30,000 per Policy Year