Aetna is available to City of New York
employees and non-Medicare retirees in the following regions:
- The five boroughs in New York City
- Dutchess county
- Nassau county
- Orange county
- Putnam county
- Rockland county
- Suffolk county
- Sullivan county
- Ulster county
- Westchester county
- The entire states of New Jersey, Connecticut, and
Delaware
- A number of counties in Georgia, Maryland,
Massachusetts, North Carolina, Pennsylvania, and Washington, DC
Each Aetna member selects a
participating primary care physician to coordinate his/her care and issue
specialist and hospital referrals. Preventative care exams such as routine Adult
Physical Exams and Immunizations, Well-Child Exams and Immunizations are covered
at 100%.
There are no deductibles to pay.
Additionally, members have access to:
Aetna NavigatorTM, Aetna’s member website that provides
a single source for online health and benefits information 24 hours a day, 7
days a week at www.aetna.com. Through Aetna Navigator, members can change their
primary care physician, replace an ID card, research Aetna’s products and
programs, contact Aetna directly and access a vast amount of health and wellness
information. Aetna Navigator also includes secure, personalized features for
members who register on the site including access to claim and benefit status.
Additionally, members can contact their designated member services team and
customize their home page to meet their individual health needs.
DocFind®, an online provider list located at www.aetna.com; InteliHealth®, an online consumer health information network located at www.intelihealth.com; and Informed Health® Line, a telephonic nurse line
available 24 hours a day, 7 days a week.
Aetna Special Medical
Programs
Disease
Management -- Specific
programs are aimed at slowing or avoiding complications of certain diseases
through early detection and treatment to help improve outcomes and quality of
life. The programs include: Low Back Pain, Asthma, Heart Failure and
Diabetes.
The
Moms-to-Babiesâ„¢ Maternity Management Program-- A management program to help
identify at-risk pregnancies, which are given special attention from nurse case
managers.
Natural
Alternatives-- A program that offers contracted discounted rates for
alternative types of health care (e.g., chiropractors [for chiropractic care not
covered under the medical plan], acupuncturists, massage therapists and
nutritional counselors), all available without a referral or
precertification.
Vision One®
Discount Program -- A
program that offers significant discounts on eye care needs, such as
prescription eyeglasses, contact lenses, non-prescription sunglasses, contact
lens solutions and eye care accessories. Members can call 1-800-793-8618 to find
the Vision One®locations nearest to them. This benefit is in addition to, not in
place of, members’ union welfare fund vision benefits.
Prescription Drugs
An Optional Rider benefit is available for
prescription drug coverage with a three-tier copay structure: $10 for
generic drugs/30% for formulary drugs/50% for non-formulary drugs, for a 30-day supply, mandatory
generic, available at retail pharmacy. Mail Order
Delivery for prescription drugs is $20/30%/50% for a 31-90 day
supply. Once maximum is met there are no copays or
coinsurance.
Cost
Please see rate chart for payroll and pension deductions.
See the rate page
For More
Information
For more details, refer to the City
of New York/Aetna Commercial packet. To speak to a customer service
representative, call (800) 445-8742, 8:00 am - 6:00 pm, Monday through Friday.
You can send your questions in writing to:
Aetna
99 Park Avenue
New York, NY 10016
Attn: City of New York Department
Visit the Plan Web site
Updated to reflect health
plan changes effective January 1, 2008.