Medical

Tools and Resources



MEDICAL PLAN -- POS PLAN

Medical House Staff members have one medical plan option, the POS Plan. Below is an overview of the plan. For more details, read the 2017-18 Benefits Guide. You can also view the full Summary Plan Description.

 


OVERVIEW

The POS Plan is a conventional medical plan where members pay co-pays for some services (co-pays are fixed fee amounts that you pay at the time you receive services). The POS Plan also uses co-insurance for some services (co-insurance is the portion of expense you must pay for care, in most cases, after meeting your deductible). The deductible is a set amount that typically you must pay before co-insurance starts. Refer to the Quick Guide for deductible amounts.

The POS Plan also has an out-of-pocket maximum to protect you in the event you have significant medical expenses during the year.

The POS Plan allows members to receive services from a national network of providers and facilities. It is an open access plan that:

The POS Plan has three Network options:

EHN and In-Network preventive care is covered at 100% and is not subject to the deductible. For all other medical services, the plan pays a portion of your covered expenses: 90% for Emory Healthcare Network (EHN), 80% In-Network (Aetna National) and 60% percent Out-of-Network after you pay the annual deductible. Office visits are covered with a co-payment. Prescription drugs are covered through co-insurance.

To locate an EHN or In-Network physician or facility, go to www.aetna.com/docfind/custom/emory or call Aetna at 800-847-9026.

PREVENTIVE CARE - preventive care is covered at 100% under the POS Plan. Preventive care can help you identify potential health risks before they become real health problems. Services include annual physicals, well-child visits, immunizations, health screenings and more. View preventive care list.
 


PRESCRIPTION DRUGS

For details, see Prescription Drugs.