50 copayment for urgent care visit.
Aetna emergency room copay ppo.
Ppo after a 20 deductible per member cleanings fillings and x rays are covered at 100 with network dentists.
Aetna life insurance company aetna standard ppo plan schedule of benefits plan 2 gr 96257 schedule plan 2 standard ppo ed.
For questions regarding enrollment plan changes premium costs or adding or deleting dependents contact the new jersey department of pension and benefits.
You are responsible for any emergency room copay.
But it pays less of the bill than it would if you got care from a network doctor.
Covered 100 after deductible durable medical.
When seeking emergency care please note that.
Emergency room visit at hospital 250 copayment per visit waived if admitted ambulance 100 copayment per transport urgent care 75 copayment per visit if the use of a participating or non participating hospital emergency room is not due to an emergency medical condition for a condition covered by this group plan the only payment made will.
Also some plans cover out of network care only in an emergency.
200 copayment for emergency room visit waived if the visit leads to an inpatient admission to the hospital out of network differ between the choice ppo and basic ppo.
Any services you receive must be covered under the terms of your aetna plan.
Your aetna health benefits or insurance plan may pay part of the doctor s bill.
Includes radiologists anesthesiologists pathologists and emergency room physicians operating in a network facility covered same as network provider.
An out of network doctor sets the rate to charge you.
Doesn t apply 50 coinsurance in network 90 coinsurance out of network for non emergency use.
Out of network rates are higher.
Basic pay a 5 copay for cleanings fillings and x rays when you visit your primary care dentist pcd.
20 coinsurance in network 90 coinsurance out of network for non emergency tran sport.
Generally you are not responsible for any outstanding balance billed by your doctors in an emergency situation.
711 monday through friday 8 a m.
Emergency room visit at hospital.
1 50 emergency room copayment waived if the visit.
7 03 2 emergency services and care member responsibility coinsurance payment after satisfaction of the calendar contract year deductible.
To 6 p m all time zones.
Active choice ppo aetna member services 1 800 991 9222 pebtf active members 2017.
Call 1 800 537 9384 to select a dentist or to switch to our larger ppo network at no additional cost.
Copayments must be paid at time of service.
20 coinsurance 20 coinsurance.
For more information regarding the aetna medicare advantage ppo esa plan simply call aetna at 1 866 234 3129 tty.
150 copay visit deductible doesn t apply 150 copay visit deductible.
