Altius Health Plan
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Altius Health Plan High and Standard is an HMO plan. Members have the freedom to visit any in-network provider (PCP or specialist) for covered services without a referral. You can find Altius network providers by using the our provider search tool. We suggest that members select a primary care physician, but it is not required. You can find more information in the Federal Plan brochure.
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The Altius Health Plan High and Standard gives you access to an extensive network of providers, and the freedom to see Altius network specialists without a referral.
Plan features include:- No referrals
- 100% coverage in network for preventive medical care
- No requirement to choose a primary care physician (PCP)
- Built-in dental benefits on the High Option
- Vision benefits including an eyewear reimbursement every 24 months
- Lots of perks like discounts on eyewear, gyms, weight loss programs, acupuncture, massage therapy, vitamins, electric toothbrushes, gum, mints, and more!
- Online tools to help you manage your health
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Yes. Altius Health Plan High and Standard each include an annual deductible — the amount you pay out of pocket before the medical coverage begins payment for covered expenses — of $50/Self Only or $100/Self Plus One or Family for High and $100/Self Only or $200 Self Plus One or Family for Standard.
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Once you pay your deductible, you pay a copay for most services. Inpatient hospital benefits on Standard, and Specialty Pharmacy on both High and Standard, are exceptions. These services will require coinsurance. Copay and coinsurance amounts are listed in the Federal Plan Brochure and will apply until you meet your out-of-pocket maximum.
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Yes. You may visit any PCP or specialist in the Altius network service area. You do not need a referral to see a specialist in the network. You can find network providers by using our provider search tool.
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Out-of-network services and supplies are not covered under this Plan. However, eligible expenses for emergency care are covered. See section 5(d) Emergency Services/Accidents in the Federal Plan brochure.
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No. While you do not have to select a PCP, we encourage you to establish a relationship with one as it can help you better manage your health. Your PCP can provide routine care, treat you for illnesses and injuries, or recommend that you see participating providers or specialists, if required.
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Yes, you may choose a different PCP for each member of your family. You may also request to change your PCP at any time.
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Use our provider search tool. You can access information about our extensive network of providers, as well as individual physicians' board certification status, medical school attended, the year he or she graduated, languages spoken, etc.
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Dental benefits are included with the High Option. The dental plan is available with our PPO network and allows you to visit any licensed dentist nationwide.*
You'll get preventive care (like cleanings and X-rays) covered at 100 %, minor services (like fillings) covered at 60% and major services (like crowns) covered at 40% when you visit network dentists.*
Plus, there's no deductible or waiting period.
There are no dental benefits under the Altius Health Plan Standard.
* If you use an out-of-network dentist, you are responsible for the difference between our plan allowance and the dentist's charges. -
Routine eye exams are covered under the medical plan. Members are also eligible for an eyewear reimbursement every 24 months. See your Federal Plan brochure for details.
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When you enroll in the Altius Health Plan, you have access to valuable online resources.
Your secure member website is packed with health and benefits information. When you register, you can print temporary ID cards, check eligibility or claim status, e-mail customer service and much more. Here are just a few of the highlights:- Cost of Care tool and cost estimator - Provides insight into out-of-pocket costs for various medical services. If Medicare is your primary coverage, these estimates may not be representative of your actual costs.
- Hospital Comparison Tool – see how hospitals in your area rank by factors important to you.
- Personal Health Record - is a private and secure online tool where you can access your important health information in one place, helping you stay healthy with personalized alerts and reminders and allowing you to print and share your health history with your doctors.
- Your provider search tool lists participating physicians, hospitals and other health care providers. The provider search tool also includes important provider credentials like education, board certification and languages spoken.
- Aetna Mobile - puts Aetna's online features at your fingertips. It allows you to view your member ID card, find a doctor, look up claims, and access your Personal Health Record (PHR). It's available for Android™ and iPhone® mobile devices. If you have a smart phone, we have apps you can use. Just type Aetna.com into your mobile web browser.
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Enrollment procedures vary by agency. Detailed instructions and information on the Federal Employees Health Benefits Program enrollment process is available on our website at Enroll Now. You will need to know the enrollment code for the Altius Health Plan. Please refer to the rate calculator for the plans available in your area and the federal enrollment codes.
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If you do not receive your ID card by your effective date, you may use a copy of your SF2809 Form or electronic enrollment (e.g., Employee Express, PostalEase, etc.) confirmation. If you are enrolled in our system, you may register on our member website and print an ID card. After you register, simply click on "Get an ID card" and follow the instructions. You may use this printable version of your personal ID card if you need medical or dental care.
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Members usually do not need to file claim forms except in some out-of-network emergency care situations.
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All members have access to Teladoc, a convenient, lower-cost alternative to urgent care or the emergency room. Teladoc lets you access board-certified doctors by web, phone or mobile app 24/7/365 in under 10 minutes. It's perfect for when you're traveling or when your doctor isn't available. Members simply visit Teladoc.com/aetna or call 855-Teladoc to get started.
Teladoc doctors prescribe medical treatment for a wide range of conditions including cold & flu, pink eye, skin rash, stress/anxiety, and recommend treatment. They can even call in a prescription to your pharmacy of choice, when necessary. All Teladoc doctors:- Are U.S. board certified internists, state-licensed family practitioners, or pediatricians licensed to practice medicine in the U.S.
- Are U.S. residents
Please note: Teladoc is not available to all members and operates subject to state regulations. Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna or plans administered by Aetna. For complete descriptions of the limitations of Teladoc services, visit Teladoc.com/Aetna -
You must live or work in our service area to enroll in our plans. Once enrolled in the plan, medical services received overseas would be covered for emergency or urgently needed care only. If you receive covered services overseas, you will need to submit your claims to Aetna for reimbursement.
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Please see the Federal Plan brochure for information on the Altius HDHP.
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