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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 DocFind® online provider directory. We suggest that members select a primary care physician, but it is not required. You can find more information in the Federal Plan brochure.
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
- No deductible
- 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
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 the DocFind® online provider directory.
Out-of-network services and supplies are not covered under this Plan. However, eligible expenses for emergency care and urgent care services are covered. See section 5(d) Emergency Services/Accidents in the Federal Plan brochure.
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.
Yes, you may choose a different PCP for each member of your family. You may also request to change your PCP at any time.
Use the DocFind® online provider directory. 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.
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 periods.
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. See your Federal Plan brochure for details. Members are also eligible for an eyewear reimbursement every 24 months.
When you enroll in the Altius Health Plan, you have access to valuable online resources.
Aetna Navigator® the secure member website that 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:
- Estimate the Cost of Care - compare the cost of brand-name drugs versus their generic equivalents.
- 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.
- DocFind® - an online provider directory that lists participating physicians, hospitals and other health care providers. DocFind® 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.
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. Enrollment procedures vary by agency. 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.
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 Aetna Navigator® 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.
Members usually do not need to file claim forms except in some out-of-network emergency care situations.
All members have access to Teladoc, a convenient, lower cost alternative to urgent care or the emergency room. Teladoc® lets you speak to a licensed doctor by web, phone or mobile app 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 diagnose non-emergency medical problems, like 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 in internal medicine, family practice, emergency medicine or pediatrics.
- Are U.S. residents and licensed in your state.
- Average 15 years of practice experience.
Consultations are $40 or less, depending on your plan, and do not require a referral.
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 of those services.
Please see the Federal Plan Brochure for information on the Altius HDHP.
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