Employee benefits

DCHR employee benefits Aetna HMO Plan Aetna PPO Plan Open Choice PPO Aetna Consumer Driven Health Plan CDHP with Open Choice PPO

Get to know how
your health plan works:

HMO Plan: Visit any in-network doctor of your choice

You can visit any doctor, provider or facility in network when you choose the Aetna HMO Plan.

You must stay in network in order to receive coverage. There is no coverage for out-of-network providers. To find an in-network doctor, visit www.aetna.com and select “Find a Doctor.”

Your options for getting care when you need it:

Option #1: Visit your primary care physician (PCP)

A PCP is the doctor you go to first. Your PCP helps you learn about your health and how to manage it.

  • See your PCP for routine checkups or when you are sick or injured.
  • You can choose any PCP from our network. You can change your PCP at any time.
  • For most services, you pay a copay (a specific dollar amount) at the time of your care.

Option #2: Go directly to any in-network doctor

Make an appointment with any doctor or specialist in the Aetna network.

  • You never need a referral.
  • You must see network providers to receive benefits through this plan.

2022 HMO SBC.pdf [click to download]

 


 

PPO Plan: Visit any doctor — in network or out of network

The Aetna Open Choice PPO Plan gives you two options for visiting your doctor.

Option #1: Visit any network doctor

You do not need to select a PCP, nor do you need a referral to visit different doctors or specialists in Aetna’s network. Because in-network doctors have agreed to offer discounted rates, you will pay less for their services.

Option #2: Go to any licensed doctor

You may visit any licensed doctor you choose. You can also see out-of-network doctors without a referral. You will pay more for using an out-of-network doctor. Also, you may have to:

  • Get approval from Aetna before receiving certain services.
  • File your own claims.

2022 PPO SBC.pdf [click to download]

 


 

CDHP: Take charge of your healthcare costs

With the Aetna Consumer Driven Health Plan (CDHP) with Open Choice PPO, you’re in control of your health care costs — a consumer-driven health plan puts you, the consumer, in the driver’s seat.

You get the protection of a medical plan plus a tax-free health savings account (HSA) to help you pay for qualified expenses. After you pay the annual deductible, the plan pays a percentage of covered services. You can use the money in your HSA to pay your share of the costs. Or you can choose to pay out of pocket and save your account for future expenses. The HSA is part of your health plan and is separate from a Flexible Spending Account (FSA).

Here’s how to get the most out of your CDHP plan:

Step 1: Build your Health Savings Account (HSA)

PayFlex® administers your account. Log in to www.payflex.com to manage your HSA.

  • The total maximum allowed deposits for 2021 are $3,650 per individual and $7,300 for family and an additional $1,000 for 55 and older.
  • Your HSA earns interest. You have investment options once your balance reaches $1,000.
  • Funds roll over from year to year.

Step 2: Shop smart for health care

Find a doctor and know the cost of care by using the tools located on www.aetna.com.

Step 3: Visit your doctor and pay your share

  • Preventive care is covered at 100 percent.
  • Pay your share of other covered health care services.
  • Pay until you reach the out-of-pocket maximum.
  • After that, the CDHP pays for covered services. You pay nothing.

Help your HSA funds last longer

Getting care in the Aetna network will always cost less than getting out-of-network care. But you could save even more by comparing costs at different in-network facilities before you go.

The Member Cost Estimator tool makes it easy. It factors in your plan details to find out how much you’ll pay. To use this tool, log in or register at www.aetna.com

2022 CDHP SBC.pdf [click to download]

 


 

One Medical – your primary care benefit

One Medical is a membership-based primary care practice designed around you. With fast access to appointments in 100+ locations nationwide and free 24/7 virtual care through the One Medical app, they’ll be there for you whenever you need them. Expect the highest quality care and compassionate providers that take the time to listen and get to know you as a person.

One Medical is the first place for you and your family to turn for their physical and mental health — from annual wellness visits to care for everyday ailments to management of chronic conditions like diabetes and depression. Illnesses and injuries. Big issues and small ones. One Medical can help you through it all.

 Activate your free membership

  • Aetna covers the complete cost of annual membership for you, your spouse, and dependents of all ages.
  • One Medical providers are in-network with Aetna’s medical plan. Scheduled visits are billed to your insurance like any doctor’s office. 24/7 virtual care is no cost.
  • Visit onemedical.com/aetna to sign up using your Aetna ID number.
    • Having issues signing up with your Aetna ID number? Try to sign up here or contact hello@onemedical.com.

D.C. Metro Area (DMV) office locations:

View our DMV offices, located at:

  • Adams Morgan
  • Chevy Chase
  • Union Station
  • Dupont Circle
  • Metro Center
  • Farragut Square
  • Thomas Circle
  • Tyson’s Corner

 

Offices coming soon:

  • Flats at Bethesda
  • Ballston
  • Old Town, Alexandria
  • 14th & University

And if you have any questions, simply email hello@onemedical.com.

For more information about your health plan, download the Benefits Guide: