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Federal Employees Benefits Q &A

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cfrost  
#1 Posted : Monday, November 11, 2019 9:55:58 AM(UTC)
cfrost

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Ed, confused over the language in the deductible requirements. Here's what it says n Aetna Direct "The annual deductible of $1,800 for Self Only, $3,600 for Self Plus One or $3,600 for Self and Family in-network and $2,600 for Self Only, $5,200 for Self Plus One or $5,200 for Self and Family out-of-network, must be met before Plan
benefits are paid for care other than preventive care services. Is this a change? Since we have both medicare and this plan we've never worried about a deductible before?
Ed Zurndorfer  
#2 Posted : Monday, November 11, 2019 10:23:57 AM(UTC)
Ed Zurndorfer

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Do not know whether or not this is a change for Aetna Direct. But what is happening is that there are separate deductibles - one for in-network care and another set of deductibles for out-of-network care. Preventive care including annual well visits are covered “first dollar” with no requirement to meet deductible first. If you and your spouse are enrolled in Medicare and your doctors accept Medicare patients you should contact Aetna to see if Aetna Direct is the appropriate insurance for annuitants enrolled in Medicare.
holeinoneguy  
#3 Posted : Tuesday, November 12, 2019 10:48:32 AM(UTC)

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cfrost, I believe you are reading page 33 of the 2020 brochure. This brochure contains information for two Aetna plans. What you quote is for the Health Fund HDHP plan from Aetna and not Aetna Direct. If you read the deductible paragraph related to Aetna Direct on page 33 you will see the following at the end: (Note: If you are enrolled in Medicare Part A and
B and Medicare is primary, we will waive the deductible)

Ed Zurndorfer  
#4 Posted : Tuesday, November 12, 2019 4:34:35 PM(UTC)
Ed Zurndorfer

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