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Aetna CDHP with a national PPO network

This plan provides a fund that pays for care before you do – plus, no referrals


2025 Biweekly rates for zip code

These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.

Table of rates.
Aetna HealthFund® CDHP Code Biweekly Premium

How your CDHP works

STEP 1: You get a medical fund
This is the amount you get at the start of the plan year to pay for your health care. You pay nothing for covered services until the medical fund is gone. Any unused amounts roll over from year to year, unless you switch health plans or leave the plan.*

STEP 1: You get a medical fund
How much do you get in your medical fund? Medical Fund Dental Fund
Self Only: $1,000 $300
Self Plus One or Self and Family: $2,000 $600

The full fund amount is available on day 1 for you to use!**


STEP 2: You may have a deductible
A deductible is the amount you need to pay out of your pocket for covered services after you've used up all the medical fund for the year.

STEP 2: You may have a deductible
What is your deductible amount? In-network Out-of-network
Self Only: $1,000 $1,500
Self Plus One or Family: $2,000 $3,000

STEP 3: You may have coinsurance
Coinsurance is how much the Plan and you pay for health care expenses. It is a shared amount. We pay the larger part. You pay the smaller part.

Coinsurance starts after you have used up the medical fund and met your deductible.

What is your coinsurance amount?
What is your coinsurance amount? We pay You pay
In network: 85% 15%
Out of network: 60% 40%

To pay the least out of pocket, use network providers. (Doctors, hospitals and labs are examples of providers.)

MinuteClinic® or Walk in clinic - $0 after deductible (In network)

CVS Virtual Care - $0 after deductible


You get in-network preventive care at no additional cost to you!
Examples include wellness screenings and exams, dental cleanings and routine eye exams.

If you see network providers for services like these, nothing comes out of your pocket (or the Fund).

Grow the medical fund by up to $100!
Log in to your member website and fill out a health assessment. Then complete one online wellness program to earn $50. You can also earn an additional $50 for completing your biometric screening.

Built-in pharmacy, dental and vision benefits, too

Coverage Details Table.
Type of coverage What you get
Pharmacy
  • Copays after you use up the medical fund and meet your deductible. For a 30-day supply in-network, pay $10 (Preferred generic), 50% up to $200 (Preferred brand name), 50% up to $300 (Non-Preferred – generic or brand name).*** Specialty drugs are covered at 50%.†****
  • Your plan requires the use of generic medication when a generic equivalent exists. ††*****
  • Mail-order delivery. For maintenance prescriptions (medicine you need for 90+ days), mail-order service is available or you can get up to 90 days at CVS retail Pharmacy®. See Aetna.com for participating pharmacies. .
Dental
  • Cleanings and X-rays covered 100% when you see network dentists
  • Dental Fund ($300 – Self; $600 – Self Plus One or Self and Family) to pay for other covered services in or out of the network.
Vision
  • Routine eye exams covered 100% when you visit network doctors.
  • Medical Fund. Use it to pay for prescription eyewear. (You must submit a claim.)
  • Discounts on eyeglasses, contact lenses and more.

Why choose Aetna CDHP?

  • Large nationwide Aetna PPO Network
  • Coverage in network or out — and no referrals needed for covered services
  • A medical fund to help you pay for care; any unused dollars roll over to the next plan year
  • 24 hour / 7 days a week access to doctors via video with CVS Virtual Care
  • Discounts on eyewear, LASIK laser eye surgery, gym memberships, massage, acupuncture, weight-loss programs and more.

*The most you can roll over is $5,000 (Self Only) or $10,000 (Self Plus One or Self and Family).
**If you join after open enrollment season, the amount of the Fund will be prorated.
***A formulary is a list of generic and brand-name drugs your health plan prefers.
†**** For specialty drug information, see the federal plan brochure
††*****If you choose the brand name drug over the generic equivalent, you will owe the corresponding copay plus the difference between the generic and brand name costs. Please see the plan brochure for details.

Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies. CVS Virtual CareTM services are only available in the USA. Limitations may apply based on services and location.

This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the Plan's applicable Federal brochure(s). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included.

For a complete list of other participating pharmacies log in to your member website to use our provider search tool. Includes select MinuteClinic services. For your best health, we encourage you to have a relationship with a primary care physician or other doctor. Tell them about your visit to MinuteClinic, or MinuteClinic can send a summary of your visit directly to them. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services.

DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge on products and services offered by third-party vendors and providers. Aetna makes no payment to the third parties — you are responsible for the full cost. Check any insurance plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts.

Pharmacy clinical programs such as precertification, step therapy, and quantity limits may apply to your prescription drug coverage. Aetna's Drug Guide is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change.

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