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For businesses with 2-100 eligible employees
www.aetna.com
Aetna Savings Plus
plan guide
The Aetna Savings Plus health benefits plans are helping Florida businesses access health services that fit their needs and their budgets. They give members access to an affordable network of health providers right in their own community.
These lower-priced plans generate savings through a concentric network of high-quality providers. They are ideal for businesses that think affordable health coverage for their employees is out of reach.
Building on a history of innovation
These plans are built around fair value, freedom and flexibility, so that businesses get what matters most to them: solutions that offer personal service at a fair price, in a way that allows them to focus their time and efforts on running their business.
Not only is Aetna Savings Plus the solution, but it includes these benefits:
• Benefits for doctor visits, hospital stays, preventive care and prescription drugs
• Secure member portal, Aetna Navigator®
• Payment Estimator, to help members understand costs before receiving services
• Online health assessment and programs to help members manage their health
• Programs that treat individuals, not conditions, to help members achieve better health
A smarter network strategy designed to...
Reduce health care costs for employers and create savings opportunities for employees through a designated
network of quality, cost-effective doctors and hospitals, plus provide employee access to online tools and
services through a secure member website
Fair Value Everyone wants a good deal. Whether you’re looking to cut costs as much as possible, or seeking long-term value and greater employee productivity.
• Network design = savings • Performance network • 100% preventive care • Unlimited lifetime maximums
Flexibility Choice matters. Every business is different. And the people who make up those businesses have different health needs.
• Range of options • Multiple benefits levels • Use of physician or hospital
Freedom Time spent investing with a health plan, should be time well spent. Whether you’re managing the business, or an employee on the front line, we try to make it easier with intelligent solutions.
• Online enrollment and billing • Easy to navigate
• Personal Health Record • Member Payment Estimator
Same quality local care at a lower cost
The Aetna Savings Plus health benefits plans provide Florida members with the same type of coverage as other Aetna medical plans, but at a lower premium cost. Savings are generated through the use of the Savings Plus network, a quality network of local health care providers.
How do the Savings Plus insurance plans work?
The Aetna Savings Plus insurance plans in Florida give businesses the flexibility and choice to best meet their needs. These plans use the Aetna HMO Savings Plus network. It is a community-based network that is made up of local providers who understand community diversity, preferences and common medical conditions.
When members use the Savings Plus network, they realize maximum savings. Members can select a primary care physician (PCP) from the network of preferred participating providers to coordinate care for covered services.
All Savings Plus plans include coverage for doctor’s office visits, hospital stays, preventive care, pharmacy and more. (Refer to the benefits summaries on pages 3 and 4 for more details.) Each plan offers three levels of benefits to your employees. Premiums and out-of-pocket expense levels vary – select the plan that’s right for you and your employees.
Let Aetna be your guide
With 150 years of experience, we
can deliver the right solution for
your business.
Savings Plus plans
Florida (2-100 Eligible Employees) FL HMO Savings Plus Plan 2 FL HMO Savings Plus Plan 3
Lifetime Maximum Unlimited Unlimited
In-Network Services
Coinsurance 70% 50%
Annual Deductible: Individual/Family $2,000 / $4,000 $3,000 / $6,000
Type of Deductible Embedded Embedded
Annual Out of Pocket (OOP): Individual/Family
(deductible included)
$7,000 / $14,000 $9,000 / $18,000
Wellness On UsTM
Well-Child Care (Age/frequency schedules apply;
includes coverage for immunizations)
$0, ded waived $0, ded waived
Preventive Care, including annual adult physicals,
well-women visits, mammograms, colorectal cancer screening and other preventive care services.
$0, ded waived $0, ded waived
Physician Services
Primary Care Physician Office Visit $30, ded waived $50, ded waived
Specialist Office Visit $60, ded waived $100, ded waived
Walk-In Clinic Visit $30, ded waived $50, ded waived
Outpatient Mental Health
(20 visits per year - Mental Health Parity applies to groups over 50)
$60, ded waived $100, ded waived
Inpatient Services
Hospital Inpatient 70%, ded applies 50%, ded applies
Mental Health Inpatient
(30 days per year – Mental Health Parity applies to groups over 50)
70%, ded applies 50%, ded applies
Outpatient/Other Services
Diagnostic Lab $0, ded waived $0, ded waived
Diagnostic X-Ray $60, ded waived 50%, ded waived
Diagnostic Complex Imaging
(CAT, MRI, MRA/MRS and PET scans)
70%, ded applies 50%, ded applies
Outpatient Surgery 70%, ded applies 50%, ded applies
Emergency Room (copay waived if admitted)
70%, ded waived 70%, ded waived
Urgent Care $75, ded waived $125, ded waived
Ambulance
(emergency transport)
70%, ded applies 50%, ded applies
Durable Medical Equipment
($2,000 maximum per year) 70%, ded applies 50%, ded applies
Outpatient Rehabilitative Therapy
(30 visits per year) $60, ded waived 50%, ded applies
Pharmacy
Retail Pharmacy Copay
Step therapy and precertification apply; mail-order drugs (MODs) available at 2x copay for a 31-90 day supply
$20/ $50/ $75 $20/ $50/ $75
Aetna Specialty PharmacyRM
(after first refill, must use Aetna Specialty Pharmacy)
30%
Min/Max. copay – $30/$120
30%
Savings Plus plans
Florida (2-100 Eligible Employees) FL HMO Savings Plus Plan 10
Lifetime Maximum Unlimited
In-Network Services
Coinsurance 0%
Annual Deductible: Individual/Family $10,000 / $10,000
Type of Deductible Embedded (1x)
Annual Out of Pocket (OOP): Individual/Family
(deductible included)
$10,000 / $10,000
Wellness On Us
Well-Child Care (Age/frequency schedules apply;
includes coverage for immunizations)
$0, ded waived
Preventive Care, including annual adult physicals,
well-women visits, mammograms, colorectal cancer screening and other preventive care services.
$0, ded waived
Physician Services
Primary Care Physician Office Visit $50, ded waived
Specialist Office Visit $100, ded waived
Walk-In Clinic Visit $50, ded waived
Outpatient Mental Health
(20 visits per year - Mental Health Parity applies to groups over 50)
$100, ded waived
Inpatient Services
Hospital Inpatient 100%, ded applies
Mental Health Inpatient
(30 days per year – Mental Health Parity applies to groups over 50)
100%, ded applies
Outpatient/Other Services
Diagnostic Lab 100%, ded applies
Diagnostic X-Ray 100%, ded applies
Diagnostic Complex Imaging
(CAT, MRI, MRA/MRS and PET scans)
100%, ded applies
Outpatient Surgery 100%, ded applies
Emergency Room (copay waived if admitted)
100%, ded applies
Urgent Care 100%, ded applies
Ambulance
(emergency transport)
100%, ded applies
Durable Medical Equipment
($2,000 maximum per year) 100%, ded applies
Outpatient Rehabilitative Therapy
(30 visits per year) 100%, ded applies
Pharmacy
Retail Pharmacy Copay
Step therapy and precertification apply; mail-order drugs (MODs) available at 2x copay for a 31-90 day supply
$20/ $50/ $75
Aetna Specialty Pharmacy
(after first refill, must use Aetna Specialty Pharmacy)
30%
Health benefits plans are offered or underwritten by Aetna Health Inc. (Aetna).
This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Rates and benefits vary by location. Health benefits plans contain exclusions and limitations. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. If you are in a plan that requires the selection of a primary care physician and your primary care physician is part of an integrated delivery system or physician group, your primary care physician will generally refer you to specialists and hospitals that are affiliated with the delivery system or physicians group. Information is believed to be accurate as of the production date; however it is subject to change. For more information about Aetna plans, refer to www.aetna.com.
