Aetna U. S. Healthcare, Inc. - Southern Indiana

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General Information

Plan Name:	Aetna U. S. Healthcare, Inc.
Service Area:	Southern Indiana
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	No
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	7L1
Enrollment Code-Self & Family:	7L2
Link to Plan Home Page:	http://www.aetnaushc.com/feds
Telephone:	800/537-9384
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$20
Hospital Inpatient Room and Board Charges:	$200-$600
RX/ Generic/ Retail:	$10
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	50%

Rates

Non-Postal
___Biweekly	Self: $28.78	Self: & Family: $71.09
___Monthly	Self: $62.35	Self: & Family: $154.03
___Twice Biweekly	Self: $57.56	Self: & Family: $142.18
_
Annuitants
___Monthly	Self: $62.35	Self: & Family: $154.03
_
U.S. Postal Service Employees (Type A)
___Monthly	Self: $28.06	Self: & Family: $69.32
___Biweekly	Self: $12.95	Self: & Family: $31.99
_
U.S. Postal Service Employees (Type B)
___Monthly	Self: $28.06	Self: & Family: $106.67
___Biweekly	Self: $12.95	Self: & Family: $49.23
_
Worker's Compensation Recipients
___Twice Biweekly	Self: $57.56	Self: & Family: $142.18
_
Certain Temporary Employees
___Biweekly	Self: $115.11	Self: & Family: $284.37
___Monthly	Self: $249.41	Self: & Family: $616.14
_
Former Spouse Enrollees
___Biweekly	Self: $115.11	Self: & Family: $284.37
___Monthly	Self: $249.41	Self: & Family: $616.14
_
Temporary Continuation of Coverage
___Biweekly	Self: $117.41	Self: & Family: $290.06
___Monthly	Self: $254.40	Self: & Family: $628.46
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FDIC
___Biweekly	Self: $12.95	Self: & Family: $31.99
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Department of Defense Demo Project
___Monthly	Self: $160.72	Self: & Family: $261.43
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Department of Defense Demo Project Temporary Continuation of Coverage
___Monthly	Self: $380.21	Self: & Family: $760.40
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