Outside U.S.

The Aetna Deductible for expenses outside of the U.S. is $0.

Aetna has direct-bill relationships with 168,000 medical providers outside the United States. If Aetna does not already directly bill your current doctor, Aetna will establish a relationship with your current doctor or clinic to set up direct billing.

U.S. In-Network

The Aetna Deductible for expenses incurred in the U.S. In-Network is $2,000 employee/$4,000 family (employee + spouse, child, or family).

In the United States, Aetna has Preferred Provider Network (PPO). After reaching your deductible, Aetna covers most* medical costs at 100% (see the Plan Summary for additional details on the types of medical expenses covered under Aetna's plan).

*Some co-pays pay still apply after the deductible is met. Please see restrictions for non-emergency use of emergency room and urgent care services, as additional out of pocket costs may apply.  

U.S. Out-of-Network

Expenses incurred from a U.S. Out-of-Network provider will count toward a separate additional deductible of $2,000 employee/$4,000 family (employee + spouse, child, or family)

If you incur expenses from a U.S. Out of Network provider after you reach your plan deductible, Aetna covers 20% or 50% of expenses depending on the type of medical expense.

Inside U.S.

• For expenses incurred through U.S. In-Network providers, you will be responsible to pay a co-pay of $10 per month supply of generic drugs, $20 copay per month supply of formulary brand name drugs, and $40 copay per month supply of non formulary brand name drugs. For prescriptions through U.S. Out-of-Network providers, you will be responsible for 20% of the cost of your prescription. 

Outside U.S.

• There is no charge pharmacy expenses outside the U.S.