Pick Your Healing Potion
Our medical plans, provided through Aetna, are designed to help you and your family get quality care at an affordable price. Employee only coverage under the HDHP plan is free to employees who enroll in the employee-only tier. In-network providers can be found for any plan using the PPO and HMO quick links in the sidebar.
If you need help selecting the plan that will best meet your needs, visit ALEX and see what he has to say.
The Women’s Health Support Center is a collection of educational information and resources to guide members on health topics over different life stages and events.
The support center is accessible via health.aetna.com (under Member Resources)
Educational information and resources include:
On July 1, 2025 Midi Health, a virtual-only menopause and midlife care provider, was expanded to become part of Aetna’s national in-network providers. Midi Health has a national network of licensed clinicians specializing in women’s midlife hormonal changes. They provide expert virtual care for perimenopause and menopause. Clinicians are licensed nurse practitioners, doctors, nurse midwives and naturopathic doctors who specialize in midlife health. Each patient receives a personalized care plan to help them manage symptoms and overall health.
Details
Ages 35-45: perimenopause
Ages 45-55: menopause
Ages 55+: post-menopause
The following sections provide an overview of each plan available to you.
The HMO (EPO) plan provides coverage through in-network doctors. You must select a primary care physician (PCP) who will oversee your care and refer you to specialists, if needed. There are no deductibles, but you will have copays at the time of service. There is no out-of-network coverage with this plan. If you seek out-of-network treatment, you are responsible for the full cost of treatment. The only exception in which you would be covered is in the event of an emergency.
There are two Preferred Provider Organization (PPO) plans: the PPO Base and PPO Buy Up. Both offer the flexibility to choose an in-network or out-of-network provider each time you need care. However, you will save money when you visit in-network providers. You will likely have copays for office visits and the pharmacy. Other services like testing and hospitalization will likely fall under deductible or coinsurance.
The High Deductible Health Plan (HDHP) offers health coverage with the ability to choose to visit in-network or out-of-network providers. The premium cost is lower when compared to other plans—and is 100% covered by Aristocrat at the employee-only tier—but you must satisfy a higher deductible before Aetna, the medical carrier, will begin paying for your medical services. However, you may be eligible to enroll in a Health Savings Account (HSA) which allows you to pay for certain expenses, including medical, dental, vision, and prescriptions with tax-free money.
Pharmacy benefits are managed through Express Scripts, Inc. You will receive a separate ID card for prescription benefits that should be provided to your pharmacy. Prescription benefits are not provided through the Aetna medical plan. For additional information on your pharmacy benefits, please review the documents in the sidebar.
| Aetna Plan Features | HDHP | HMO (EPO) | PPO Base |
PPO Buy Up |
|---|---|---|---|---|
| In-Network* | In-Network Only | In-Network* | In-Network* | |
| Annual Deductible Individual/Family |
$2,000 / $4,000 | None | $2,000 / $4,000 | $1,000 / $2,000 |
| Annual Out-of-Pocket Maximum Individual/Family |
$5,000 / $10,000 | $3,000 / $6,000 | $5,000 / $10,000 | $4,000 / $8,000 |
| Aristocrat Annual HSA Contribution Individual/Family |
$1,000 / $2,000 | N/A | N/A | N/A |
| In-Network* you pay: | ||||
| Preventive Care Visit | Covered in full | Covered in full | Covered in full | Covered in full |
| Virtual Visit | 20% after deductible | $20/$40 copay | $25/$50 copay | $15/$30 copay |
| Primary Care Visit | 20% after deductible | $20 copay | $25 copay | $15 copay |
| Specialist Visit | 20% after deductible | $40 copay | $50 copay | $30 copay |
| Diagnostic Services Labs X-rays Advanced Radiology |
20% after deductible | No charge $25 $50 |
20% after deductible | 20% after deductible |
| Urgent Care | 20% after deductible | $25 copay | $75 copay | $50 copay |
| Emergency Room (copay waived if admitted) |
20% after deductible | $200; waived if admitted | $250; waived if admitted | $150 |
| Hospital Services | 20% after deductible | $300/day, up to 3 days $250 |
20% after deductible | 20% after deductible |
| Mental Health Services Inpatient Outpatient |
20% after deductible $0 |
$300/day, up to 3 days $0 |
20% after deductible $0 |
20% after deductible $0 |
| Prescription Drugs: Retail (up to a 30-day supply) | ||||
| Generic | $10 after deductible | $10 copay | $15 | $10 copay |
| Preferred Brand | $35 after deductible | $35 copay | $35 | $30 copay |
| Non-Preferred Brand | $60 after deductible | $60 copay | $60 | $50 copay |
| Prescription Drugs: Mail Order (up to a 90-day supply) | ||||
| Generic | $25 after deductible | $25 copay | $30 | $20 copay |
| Preferred Brand | $87.50 after deductible | $87.50 copay | $87.50 | $75 copay |
| Non-Preferred Brand | $150 after deductible | $150 copay | $150 | $125 copay |
*For Out-of-Network benefits on the PPO plans, please refer to the plan documents in the Documents section
| Coverage Level | HDHP | HMO (EPO) | PPO Base | PPO Buy Up |
|---|---|---|---|---|
| Employee Only | $10.65 | $15.35 | $39.06 | $96.17 |
| Employee + Spouse/DP | $77.21 | $108.94 | $177.74 | $343.34 |
| Employee + Child(ren) | $60.71 | $68.41 | $113.49 | $221.98 |
| Employee + Family | $105.57 | $141.37 | $213.73 | $387.89 |
Annual checkups help you stay healthy. Take care of yourself and your family by using your FREE in-network preventive care benefits each year! Preventive care visits allow you to take action early and keep treatable health issues from becoming chronic conditions.
Call your doctor to schedule your FREE annual checkup today. Need to find a doctor? Visit aetna.com.
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