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Pennsylvania Aetna plans provide comprehensive healthcare coverage to Pa residents. As the leading trusted resource for single and family coverage in the Keystone State, we specialize in finding the policies that pay your claims at a price you can afford. Senior Medigap options are offered to persons that have reached age 65 and are eligible for Medicare. Supplement, Advantage, and Part D prescription drug plans are available.

As one of the nation’s largest providers, they feature an extensive Network of doctors, hospitals and facilities. Their rates are typically very competitive throughout most of the state. In some areas, Coventry plans are offered where coverage is not available. Aetna withdrew from the private individual medical market in the Keystone State three years ago. Although Group, Senior, and ancillary products continue to be offered, Marketplace and off-Exchange plans are no longer available. Group coverage to small and large employers provides many attractive options. National General underwrites a short-term policy that utilizes the Aetna PPO network. However, the plan is no longer approved in the Keystone State.

Aetna Senior Health Insurance In Pennsylvania

Medicare Supplement Plans

Available plans are A, B, F. G (HD), G, and N. Basic benefits include medical costs (Part B coinsurance and hospital outpatient services, hospitalization, hospice, and blood. Listed below are current estimated monthly rates (preferred) for an applicant aged 65, 66, or 67.

Female In Zip Codes 150-154, and 156

Plan A – $96

Plan B – $112

Plan F – $134

Plan G (HD) – $44

Plan G – $116

Plan N – $85

 

Male In Zip Codes 150-154, and 156

Plan A – $111

Plan B – $129

Plan F – $154

Plan G (HD) – $50

Plan G – $133

Plan N – $98

 

Female In Zip Codes 189-194

Plan A – $114

Plan B – $123

Plan F – $151

Plan F (HD) – $63

Plan G – $136

Plan N – $111

 

Male In Zip Codes 189-194

Plan A – $131

Plan B – $141

Plan F – $182

Plan F (HD) – $73

Plan G – $156

Plan N – $128

 

Female In All Other Zip Codes

Plan A – $90

Plan B – $97

Plan F – $126

Plan F (HD) – $50

Plan G – $108

Plan N – $88

 

Male In All Other Zip Codes

Plan A – $104

Plan B – $112

Plan F – $144

Plan F (HD) – $58

Plan G – $124

Plan N – $101

Medicare Advantage Plans

MA plans are issued by private insurers that contract with Medicare to provide Parts A and B coverage. Premiums are often less than the cost of a Supplement contract, and additional benefits, including prescription drugs, are often included. HMO, PPO, Special Needs, and Medical Savings Accounts are offered. Dental, vision, and hearing coverage is often included. Listed below are Pa Medicare Advantage Prescription Drug plans offered in Allegheny County. Rates are monthly. Plan benefits and prices can vary, depending upon your county of residence.

Advantra Eagle (HMO) H3959-041-0 – $0 per month with $0 deductible and $4,000 maximum out-of-pocket expenses. Office visit copays are $0 and $35 with ER copay of $90. The inpatient hospital copay is $275, and the ambulance copay is $235. X-rays are subject to a $15 copay and CT scans and diagnostic radiology is subject to a $0-$275 copay. Lab services receive a $0 copay. Prescription drug benefits are not included. The summary star rating is 4.5.

Advantra Silver (PPO) H55522-004-0 – $0 per month with $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $5 and $40 with ER copay of $90. The inpatient hospital copay is $150 for the first five days, and the ambulance copay is $275. X-rays are subject to a $25 copay and CT scans and diagnostic radiology is subject to a $0-$275 copay. Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $0 (Tier 2), $141 (Tier 3), and $300 (Tier 4). The summary star rating is 4.5.

Advantra Silver Plus (PPO) H55522-013-0 – $19 per month with $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $5 and $35 with ER copay of $90. The inpatient hospital copay is $400, and the ambulance copay is $250. X-rays are subject to a $25 copay and CT scans and diagnostic radiology is subject to a $0-$285 copay. Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $0 (Tier 2), $141 (Tier 3), and $300 (Tier 4). The summary star rating is 4.5.

Advantra Silver (HMO) H3959-010-0 – $0 per month with $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $5 and $40 with ER copay of $90. The inpatient hospital copay is $150 for the first five days, and the ambulance copay is $255. X-rays are subject to a $30 copay and CT scans and diagnostic radiology is subject to a $0-$250 copay. Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), $42 (Tier 3), $99 (Tier 4), and 33% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $0 (Tier 2), $126 (Tier 3), and $297 (Tier 4). The summary star rating is 4.5.

Value (PPO) H5521-261-0 – $0 per month with $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $5 and $35 with ER copay of $90. The inpatient hospital copay is $185 for the first six days, and the ambulance copay is $225. X-rays are subject to a $25 copay and CT scans and diagnostic radiology is subject to a $0-$285 copay.  Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $0 (Tier 2), $141 (Tier 3), and $300 (Tier 4). The summary star rating is 4.0.

Advantra Credit Value (PPO) H5522-017-0 – $0 per month with $250 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $10 and $50 with ER copay of $90. The inpatient hospital copay is $360 for first five days and the ambulance copay is $275. X-rays are subject to a $50 copay and CT scans and diagnostic radiology is subject to a $0- $350 copay. Lab services receive a $0- $10 copay. Prescription drug copays for 30 days are $3 (Tier 1), $7 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 28% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $14 (Tier 2), $141 (Tier 3), and $300 (Tier 4). The summary star rating is 4.5.

Advantra Premier (PPO) H5522-018-0 – $19 per month with $0 deductible and $6,800 maximum out-of-pocket expenses. Office visit copays are $5 and $40 with ER copay of $90. The inpatient hospital copay is $325 and the ambulance copay is $240. X-rays are subject to a $25 copay and CT scans and diagnostic radiology is subject to a $0- $275 copay. Lab services receive a $0-$5 copay. Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $10 (Tier 2), $141 (Tier 3), and $300 (Tier 4). The summary star rating is 4.5.

Advantra Premier (HMO) H3959-039-0 – $25 per month with $0 deductible and $7,550 maximum out-of-pocket expenses. Office visit copays are $5 and $35 with ER copay of $90. The inpatient hospital copay is $375 and the ambulance copay is $260. X-rays are subject to a $25 copay and CT scans and diagnostic radiology is subject to a $0- $275 copay. Lab services receive a $0 copay. Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $0 (Tier 2), $141 (Tier 3), and $300 (Tier 4). The summary star rating is 4.5.

Advantra Cares (HMO D-SNP) H3959-036-0 – $0 per month with $0 deductible and $6,700 maximum out-of-pocket expenses. Office visit copays are $0 with ER copay of $0-20%. The inpatient hospital copay is $0 or $1,200 and the  ambulance copay is $0 or 20%. X-rays are subject to a $ copay and CT scans and diagnostic radiology is subject to a $0 copay. Lab services also receive a $0 copay. Prescription drug copays for 30 days are $0 (Tier 1), $0 (Tier 2), 25% (Tier 3), 35% (Tier 4), and 29% (Tier 5). Prescription drug copays for 90 days (mail order) are $0 (Tier 1), $0 (Tier 2), 25% (Tier 3), and 35% (Tier 4). The summary star rating is 4.5.

Part D Prescription Drug Plans Through CVS Health

SilverScript Choice (PDP S5601-012) – cost is $32.90 per month and Medicare Star Rating is 3.5. Deductible is $345 for Tiers 1 and 2, and $345 for Tiers 3, 4, and 5. Preferred pharmacy 30-day copays are $0 (Tier 1), $5 (Tier 2), $35 (Tier 3), 40% (Tier 4), and 26% (Tier 5). Mail-order pharmacy 90-day copays are $0 (Tier 1), $15 (Tier 2), $105 (Tier 3), and 40% (Tier 4). 3,014 formulary drugs are available and 147,719 members are enrolled in the plan in Pennsylvania.

SilverScript Plus (PDP S5601-013) – cost is $72.80 per month and Medicare Star Rating is 3.5. Deductible is $0. Preferred pharmacy 30-day copays are $0 (Tier 1), $2 (Tier 2), $47 (Tier 3), 50% (Tier 4), and 33% (Tier 5). Mail-order pharmacy 90-day copays are $0 (Tier 1), $0 (Tier 2), $120 (Tier 3), and 50% (Tier 4). 3,060 formulary drugs are available and 6,360 members are enrolled in the plan in Pennsylvania.

SilverScript SmartRx (PDP S5601-181) – cost is $7.30 per month and Medicare Star Rating is 3.5. Deductible is $445. Preferred pharmacy 30-day copays are $0 (Tier 1), $19 (Tier 2), $46 (Tier 3), 49% (Tier 4), and 25% (Tier 5). Mail-order pharmacy 90-day copays are $0 (Tier 1), $57 (Tier 2), $138 (Tier 3), and 49% (Tier 4). 3,564 formulary drugs are available and 35,129 members are enrolled in the plan in Pennsylvania.

How An HMO Works

Individuals who join an Aetna HMO are classified as its members. Your primary care physician (PCP) is selected from a large Network list. Your physician will coordinate and supervise all of your medical care and you can change your choice at any time. There are no claim forms when you visit a network provider and no waiting period for routine physical exams or most preventive services. Internal medicine and pediatric services will also be provided, if needed. It’s essentially a “hassle-free” way to be treated. Most Marketplace and Exchange plans are HMOs.

NOTE: Treatment of prescriptions often changes (what is generic, what is non-generic etc…) and the Aetna Pharmacy Plan Drug List will help you stay updated regarding any changes. You can also contact us for an explanation. All plans are available, including Advance Control, Funding Advantage, Performance, Standard Opt Out, Standard, Premier, Premier Plus, Value, Value Plus, and Commercial.

Typically, you present your ID card and your physician or hospital will handle the paperwork. You then receive quality medical treatment at a reduced cost. This is because of the negotiation that is done on your behalf by the carrier. All Keystone State residents benefit by paying less, and the insurer and doctors are happy since they have more customers. If you travel outside of the area, depending on the policy, you can still be treated and receive the negotiated cost reduction.

Leap Network

Aetna previously utilized the Leap Network in Pennsylvania. Generally, you could easily find a doctor, specialist, medical facility, treatment center, or hospital close to your work or home. Listed below are the seven provider networks and the counties of coverage:

Aetna Savings Plus – Bucks, Chester, Delaware, Montgomery, and Philadelphia.

Commonwealth Health – Columbia, Lackawanna, Luzerne, Wayne, and Wyoming.

Lehigh Valley Health Network – Lehigh and Northampton.

Penn Highlands Healthcare – Clearfield, Elk, and Jefferson.

Pinnacle Health – Cumberland, Dauphin, and Perry.

Uniontown Hospital – Fayette.

Aetna – Adams, Bradford, Cameron, Clinton, Franklin, Lycoming, McKean, Mercer, Monroe, Potter, Sullivan, Susquehanna, Tioga, Vernando, Warren, and York.

Impact Of The Affordable Care Act (Obamacare)

With the creation of the “Marketplace” concept of buying subsidized coverage, many companies (including Aetna) no longer offer plans in all parts of the US. Also, it is possible that availability of policies may be different, depending where you live. And of course, federal subsidies can potentially reduce your premiums, if your household income meets Federal Poverty Level guidelines. NOTE: The Pa Health Insurance Exchange offers single, family and small business coverage. You can view all available options directly through our website and enroll in 10 minutes.

Previous private plans were available and eligible for financial assistance to help reduce premiums. However, Aetna, like many carriers, does not currently offer individual (non-Group) coverage in the Keystone State. It is expected that by 2021, single and family coverage may return if individual states are given more control over offered plans and policy benefits.

We have listed below the previously-offered Pa Aetna HMO plans with a brief description. Dental and vision benefits are typically available as riders or stand-alone policies. These policies were purchased on or “off-Exchange” and federal subsidies applied.

Aetna  Pa HMO Plans

Bronze Tier

$15 Copay Savings Plus – $15 primary care physician copay. Specialist visits subject to the deductible ($5,000). $20 generic drug copay.

Deductible Only HSA Eligible –  $6,300 deductible but can be used as an HSA. The investment account is optional.

$20 Copay –  Similar to previous plan with $20 pcp copay and $15 generic drug copay. Deductible is also higher ($5,750).

 

Silver Tier (Eligible for cost-sharing)

$10 Copay –  $3,750 deductible with $10 and $60 copays on office visits.

$5 Copay $2500 Savings Plus – $2,500 deductible with $5 and $50 copay on office visits. Popular with household with multiple children.

$10 Copay –  $3,750 deductible with $10 and $75 office visit copays.

$5 Copay –  $2,750 deductible with $5 and $75 copays on office visits. This plan is the most expensive HMO in the Silver tier.

 

Gold Tier

$0 Copay Savings Plus –  Low $1,250 deductible with $0 and $40 office visit copays. Both generic and brand drugs not subject to deductible.

$5 Copay – $1,400 deductible with $5 and $40 office visit copays. Brand drugs have a copay and deductible to meet.

Popular Non-HMO Plans

Bronze Deductible Only HSA Eligible OAMC POS – Identical to Deductible Only HMO option.

Bronze Deductible $20 Copay OAMC-POS –  Identical to $20 Copay HMO option.

Silver $10 Copay OAMC-POS – Identical to second $10 Copay (Silver-tier).

Aetna Pa Small Group (1-50 Employees) Plans

Pa Platinum PPO 100/50 200D – $0 deductible with $5,000 maximum out-of-pocket expenses. Office visit copays are $20 and $40 with $20 walk-in clinic copay. Diagnostic lab and x-ray testing are covered at 100%. Inpatient hospital facility copay is $200 per day for the first 5 days. Urgent Care and ER copays are $75 and $200. Outpatient surgeries have a $200 copay. Prescription drug copays are $3 (low-cost generic), $10 (generic), $35 (preferred brand), and $60 (non-preferred).

Pa Gold PPO 100/50 600D – $0 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $45 and $75 with $45 walk-in clinic copay. Diagnostic lab and x-ray testing copays are $45 and $75. Inpatient hospital facility copay is $600 per day for the first 5 days. Urgent Care and ER copays are $80 and $300. Outpatient surgeries are covered at 100%. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $100 (non-preferred).

Pa Gold PPO 1000 100/50 – $1,000 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $25 and $50 with $25 walk-in clinic copay. Diagnostic lab and x-ray testing copays are $10 and $50. Inpatient hospital facility visits are subject to deductible. Urgent Care and ER copays are $75 and $300. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $35 (preferred brand), and $60 (non-preferred).

Pa Gold PPO 2000 100/50 – $2,000 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $25 and $50 with $25 walk-in clinic copay. Diagnostic lab and x-ray testing are covered at 100% after the deductible. Inpatient hospital facility visits are subject to deductible. Urgent Care and ER copays are $75 and $250. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $35 (preferred brand), and $60 (non-preferred).

Pa Silver PPO 3000 100/50 – $3,000 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $25 and $75 with $25 walk-in clinic copay. Diagnostic lab and x-ray testing copays are $25. Inpatient hospital facility visits are subject to deductible. Urgent Care and ER copays are $75 and $250. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa Silver PPO 4000 100/50 – $4,000 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $30 and $60 with $30 walk-in clinic copay. Diagnostic lab and x-ray testing copays are covered at 100% after the deductible. Inpatient hospital facility visits are subject to deductible. Urgent Care and ER copays are $75 and $200. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa Silver PPO 5000 100/50 – $5,000 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $25 and $50 with $25 walk-in clinic copay. Diagnostic lab and x-ray testing copays are covered at 100% after the deductible. Inpatient hospital facility visits are subject to deductible. Urgent Care and ER copays are $75 and $250. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $35 (preferred brand), and $60 (non-preferred).

Pa Bronze PPO 7000 100/50 – $7,000 deductible with $7,150 maximum out-of-pocket expenses. Pcp Office visit and walk-in clinic copay is $75. Diagnostic lab and x-ray testing copays are covered at 100% after the deductible. Inpatient hospital facility visits are subject to deductible. Urgent Care copay is $150. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $15 (low-cost generic) and $35 (generic).

Pa Bronze HMO 5580 80 HSA – $5,550 deductible with $6,550 maximum out-of-pocket expenses. HSA-eligible plan. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa Silver Indemnity Silver 2000 80% – $2,000 deductible with $6,000 maximum out-of-pocket expenses. 20% coinsurance. Prescription drug copays are $3 (low-cost generic), $15 (generic), $50 (preferred brand), and $100 (non-preferred).

Pa Gold QPOS 100/50 600D – $0 deductible with $6,850 maximum out-of-pocket expenses. Office visit copays are $45 and $75 with $45 walk-in clinic copay. Diagnostic lab and x-ray testing copays are $45 and $75. Inpatient hospital facility visits are subject to $600 copay for 5 days. Urgent Care and ER copays are $80 and $300. Outpatient surgeries are covered at 100%. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $100 (non-preferred).

Aetna Pa Small Group (51-100 Employees) Plans

Pa PPO 100/50 500D – $0 deductible with $5,000 maximum out-of-pocket expenses. Office visit copays are $40 and $50 with $40 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $40 and $60 copays. Inpatient hospital facility copay is $500 per day for the first 5 days. Urgent Care and ER copays are $60 and $200. Outpatient surgeries have a $500 copay. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 100/50 750D – $0 deductible with $5,000 maximum out-of-pocket expenses. Office visit copays are $50 and $75 with $50 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $50 and $75 copays. Inpatient hospital facility copay is $750 per day for the first 5 days. Urgent Care and ER copays are $75 and $200. Outpatient surgeries have a $750 copay. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 1000 100/50 $25 – $1,000 deductible with $5,000 maximum out-of-pocket expenses. Office visit copays are $25 and $50 with $25 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $30 and $50 copays. Inpatient hospital facility copay is $750 per day for the first 5 days. Urgent Care and ER copays are $50 and $200. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 2000 100/50 $30 – $2,000 deductible with $6,550 maximum out-of-pocket expenses. Office visit copays are $30 and $50 with $30 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $30 (deductible does not apply) and $50 copays. Inpatient hospital facility copay is $500 after the deductible. Urgent Care and ER copays are $50 and $200 (after the deductible). Outpatient surgeries are covered with a $250 copay after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 2000 100/50 $35 – $2,000 deductible with $5,000 maximum out-of-pocket expenses. Office visit copays are $35 and $60 with $35 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $35 and $60 copays. Inpatient hospital facility covered at 100% after the deductible. Urgent Care and ER copays are $60 and $200. ER is subject to the deductible. Outpatient surgeries are covered at 100% after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 2500 100/50 $30 – $2,500 deductible with $5,000 maximum out-of-pocket expenses. Office visit copays are $30 and $50 with $30 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $30 and $50 copays (x-rays subject to deductible). Inpatient hospital facility covered at 100% after the deductible and $500 copay. Urgent Care and ER copays are $50 and $200 after the deductible. Outpatient surgeries are covered at 100% after a $250 copay and the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 3000 100/50 $30 – $3,000 deductible with $6,000 maximum out-of-pocket expenses. Office visit copays are $30 and $50 with $30 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $30 and $50 copays. Inpatient hospital facility copay is $500 after the deductible. Urgent Care and ER copays are $50 and $200 (after the deductible). Outpatient surgeries are covered with a $250 copay after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 5000 100/50 $25 – $5,000 deductible with $6,550 maximum out-of-pocket expenses. Office visit copays are $25 and $50 with $25 walk-in clinic copay. Diagnostic lab and x-ray testing are covered with $25 and $50 copays. Inpatient hospital facility covered in full after the deductible. Urgent Care and ER copays are $50 and $200 (after the deductible). Outpatient surgeries are covered in full after the deductible. Prescription drug copays are $3 (low-cost generic), $10 (generic), $50 (preferred brand), and $75 (non-preferred).

Pa PPO 5000 100/50 HSA – $5,000 deductible with $6,550 maximum out-of-pocket expenses. HSA-eligible plan. Prescription drugs are subject to deductible.

Pa PPO 3000 100/50 HSA – $3,000 deductible with $6,550 maximum out-of-pocket expenses. HSA-eligible plan. Prescription drugs are subject to deductible.

Small Group Dental Voluntary And Non-Voluntary Plans

Preventative Care

DMO

Freedom-Of-Choice

PPO Max

PPO High-Option Plan

PPO 1500

DMO 100/90/60

PPO Max 100/80/0

Active PPO Max

PPO 1000

Copay 42

DMO 100/80/50

DMO 100/90/60

DMO 100/100/60

Copay 56

PPO Max 100/70/40

PPO 100/80/50

Preferred 100/90/60

Preferred 100/80/50

Preferred 100/100/60

International Travel And Medical Coverage For Company Employees

International business travelers, students, third-country nationals, and expatriates can secure excellent benefits at a fair and affordable price. Coverage for your company employees is professionally administered with a wide variety of doctors, hospitals and medical facilities. Available policy options are listed below:

Indemnity – Treatment is provided by a provider you choose. Services are paid at the time of treatment, and a claim is subsequently submitted for reimbursement. Worldwide benefits are included.

PPO – A preferred provider organization also allows the covered individual or family member to pick their provider. While back in the US, staying within the network will result in lower out-of-pocket expenses. Thus, there is great incentive to choose network providers.

HRA (Health Reimbursement Arrangement) – A deposit is made into the HRA each year to assist paying healthcare expenses. Qualified preventative expenses are 100% covered. When no funds remain, and the deductible is paid, the contract covers remaining medical expenses according to the policy provisions.

Group Trust – Designed for a business with expatriate 2-50 employees. Comprehensive benefits that is typically only offered to larger companies.

International Expatriate Trust – PPO option with emergency evacuation and assistance. Prescription, vision, and mental health counseling also included. Dental, life, and disability options can be added.

World Traveler – Ideal for travelers that need coverage for business trips less than six months.

International World Traveler – More extensive benefits than previous plan. Several extras include political and natural disaster help, lost checked-in baggage protection, trip interruption and evacuation coverage.

International Ascent – For groups of 2-10 employees. Six different plans that include global and wellness benefits.

Two mobile plans (Classic and Exclusive) are also offered. Both policies provide up to $2 million of benefits. The Exclusive plan provides more extensive coverage.

We realize that it’s sometimes not easy to fully understand all of the specifics of medical coverage. We’ll be happy to take the time to review the coverage and determine if a policy is best for you. If it isn’t, we’ll consider hundreds of other options from the top companies and together, we’ll compare your best choices. Remember that it’s very important to review your existing policy before every annual Open Enrollment.

We provide all the tools you need (along with personal service) to easily view benefits and apply for coverage. Call or email us any time for additional information. Purchasing a policy is an easy process.