Aetna U. S. Healthcare, Inc.-High -North/Central/Southern Maryland

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General Information

Plan Name:	Aetna U. S. Healthcare, Inc.-High
Service Area:	North/Central/Southern Maryland
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	JN1
Enrollment Code-Self & Family:	JN2
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:	$15
Hospital Inpatient Room and Board Charges:	$100-$300
RX/ Generic/ Retail:	$10
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	50%

Rates

Non-Postal
___Twice Biweekly	Self: $67.74	Self: & Family: $162.56
___Biweekly	Self: $33.87	Self: & Family: $81.28
___Monthly	Self: $73.39	Self: & Family: $176.10
_
Annuitants
___Monthly	Self: $73.39	Self: & Family: $176.10
_
U.S. Postal Service Employees (Type A)
___Biweekly	Self: $16.21	Self: & Family: $40.94
___Monthly	Self: $35.13	Self: & Family: $88.70
_
U.S. Postal Service Employees (Type B)
___Monthly	Self: $48.75	Self: & Family: $150.69
___Biweekly	Self: $22.50	Self: & Family: $69.55
_
Worker's Compensation Recipients
___Twice Biweekly	Self: $67.74	Self: & Family: $162.56
_
Certain Temporary Employees
___Biweekly	Self: $131.73	Self: & Family: $304.69
___Monthly	Self: $285.42	Self: & Family: $660.16
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Former Spouse Enrollees
___Biweekly	Self: $131.73	Self: & Family: $304.69
___Monthly	Self: $285.42	Self: & Family: $660.16
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Temporary Continuation of Coverage
___Monthly	Self: $291.13	Self: & Family: $673.36
___Biweekly	Self: $134.36	Self: & Family: $310.78
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FDIC
___Biweekly	Self: $16.21	Self: & Family: $40.94
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