Jan 15, 2021
Aetna Issues Retro Benefit Changes for 2021
Aetna has received guidance from the California Dept. of Insurance on their 2021 portfolio. The following plans have an update of their In-network Habilitation benefit. The benefit will change from 0% Deductible Waived to now match the PT/OT/ST copay.
|
Plan Name |
Deductible |
|---|---|
| CA Platinum MC 90/50 | $0 |
| CA Platinum MC Savings Plus 90/50 | $0 |
| CA Platinum MC AWH SoCA 90/50 | $0 |
| CA Gold MC 80/50 | $350 |
| CA Gold MC Savings Plus 80/50 | $350 |
| CA Gold MC AWH SoCA 80/50 | $350 |
| CA Silver MC 70/50 | $2,250 |
| CA Silver MC Savings Plus 70/50 | $2,250 |
| CA Silver MC AWH SoCA 70/50 | $2,250 |
| CA Bronze MC 60/50 | $6,300 |
| CA Bronze MC Savings Plus 60/50 | $6,300 |
| CA Bronze MC AWH SoCA 60/50 | $6,300 |
On this plan, the specialty plan coinsurance is changing from 50% to 20%.
|
Plan Name |
Deductible |
|---|---|
| CA Gold PPO 80/50 | $1,000 |
The Pediatric Vision Exam benefit now has a deductible waived for In-Network services.
|
Plan Name |
Deductible |
|---|---|
| CA Gold MC 80/50 | $1,500 |
| CA Gold MC Savings Plus 80/50 | $1,500 |
| CA Gold MC AWH SoCA 80/50 | $1,500 |
This plan has no longer combined Rx/Med Deductible. The Rx deductible is now $150 for an individual and $300 for a family.
|
Plan Name |
Deductible |
|---|---|
| CA Silver HMO 50/75 | $2,550 |
Aetna systems will be updated with this change and claims will be reprocessed accordingly. Members will be notified of the change and kept updated throughout the process.
Contact your LISI Regional Sales Representative for more information.
