IQVIA Benefits Handbook
AT A GLANCE
Questions?
If you have questions about your medical benefits, call Aetna at 800-726-4366 or Kaiser at 800-464-4000, or log on to their websites at www.aetna.com or https://healthy.kaiserpermanente.org.
The Aetna Medical Plan options are network-based, meaning the benefits will be richer if you use a preferred network physician or hospital. However, you are welcome to see out-of-network providers if you choose, and benefits will be paid at the out-of-network rate.
If you choose Kaiser, coverage is in-network only. There is no coverage out of the network (except emergency care).
Here is a quick look at what each of the plan options cover.
Medical Options
$400 Deductible
PPO Plan
$900 Deductible PPO Plan
$1,850 Deductible
Plan with HSA
$2,850 Deductible
Plan with HSA
 
In-Network
Out-of-Network
In-Network
Out-of-Network
In-Network
Out-of-Network
In-Network
Out-of-Network
Annual Deductible
               
  • Individual
  • $400
  • $2,500
  • $900
  • $3,000
  • $1,850
  • $3,700
  • $2,850
  • $5,700
  • Family
  • $800
  • $5,000
  • $1,800
  • $6,000
  • $3,700
  • $7,400
  • $5,700
  • $11,400
Coinsurance for most covered services
80%
60%
80%
60%
80%
60%
70%
50%
Annual Medical Out-of-Pocket Maximum
               
  • Individual
  • $2,200
  • $4,400
  • $3,000
  • $6,000
  • $3,500
  • $7,000
  • $5,500
  • $11,000
  • Family
  • $4,400
  • $8,800
  • $6,000
  • $12,000
  • $6,500
  • $13,000
  • $11,000
  • $22,000
Lifetime Maximum
               
Preventive Care
100%
60%, after deductible
100%
60%, after deductible
100%
60%, after deductible
100%
50%, after deductible
Physician Office Visits
Primary Care Physician: $20 copay
Specialists:$40 copay
Deductible doesn't apply
60%, after deductible
Primary Care Physician: $40 copay
Specialists:$80 copay
Deductible doesn't apply
60%, after deductible
80%, after deductible
40%, after deductible
70%, after
deductible
50%, after deductible
Telehealth* (Teladoc)
(online video or phone appointments for treatment of non-emergency medical issues)
$20 copay; deductible doesn't apply
$20 copay; deductible doesn't apply
$49 copay until deductible is met; then 80% coinsurance
$49 copay until deductible is met; then 40% coinsurance
Inpatient Hospital Services
80% after deductible
60%, after deductible
80% after deductible
60% after deductible
80% after deductible
60% after deductible
70%, after
deductible
50%, after deductible
*Available with the Aetna plans only.