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

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General Information

Plan Name:	Aetna U. S. Healthcare, Inc.-Std
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:	JN4
Enrollment Code-Self & Family:	JN5
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
___Monthly	Self: $51.94	Self: & Family: $121.54
___Twice Biweekly	Self: $47.94	Self: & Family: $112.18
___Biweekly	Self: $23.97	Self: & Family: $56.09
_
Annuitants
___Monthly	Self: $51.94	Self: & Family: $121.54
_
U.S. Postal Service Employees (Type A)
___Biweekly	Self: $10.79	Self: & Family: $25.24
___Monthly	Self: $23.37	Self: & Family: $54.69
_
U.S. Postal Service Employees (Type B)
___Biweekly	Self: $10.79	Self: & Family: $25.24
___Monthly	Self: $23.37	Self: & Family: $54.69
_
Worker's Compensation Recipients
___Twice Biweekly	Self: $47.94	Self: & Family: $112.18
_
Certain Temporary Employees
___Monthly	Self: $207.76	Self: & Family: $486.16
___Biweekly	Self: $95.89	Self: & Family: $224.38
_
Former Spouse Enrollees
___Biweekly	Self: $95.89	Self: & Family: $224.38
___Monthly	Self: $207.76	Self: & Family: $486.16
_
Temporary Continuation of Coverage
___Monthly	Self: $211.92	Self: & Family: $495.88
___Biweekly	Self: $97.81	Self: & Family: $228.87
_
FDIC
___Biweekly	Self: $10.79	Self: & Family: $25.24
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