Aetna Choice POS II (Open Access) Preferred Provider Network
Claims Administrator: Meritain
Your Care Coordinator: AptaHealth
www.ubt.myaptahealth.com | 866.274.9478 | 7:30 a.m. – 9 p.m. CST Monday to Friday
Two medical plan options are available for you and your family. The plans are qualified high-deductible health plans that can be combined with a health savings account (HSA). The plans have differing premiums and deductibles, allowing you to choose the one that best meets your needs. The medical insurance plans utilize the Aetna provider network. To review the Aetna provider network, choose “Aetna Choice POS II (Open Access)” when asked to select a plan.
AptaHealth is your Care Coordination team and is looking forward to meeting you! Call to introduce yourself, pre-certify a service, and ask questions about how you can potentially save money on your out-of-pocket healthcare expenses. You have one number to call with ANY medical insurance or healthcare questions. The best part is that they are not the insurance company! They’re completely separate and work for you as the member by researching questions and partnering with you to navigate the healthcare system. Check out these Care Coordinator FAQs. Download the Quantum Health mobile app for services on the go. You can find in-network providers, access your ID card, check claims information, schedule a call with a Care Coordinator, and more.
Details
- The Basic Plan has a higher deductible with lower monthly premiums, while the Classic Plan has a lower deductible with higher monthly premiums. Both medical plans are eligible to be paired with a health savings account.
- The Classic and Basic AETNA Network medical insurance plans include a provider network option from Aetna. To review the Aetna provider network, choose “Aetna Choice POS II (Open Access)” when asked to select a plan. A provider directory can be found here.
- By enrolling in medical insurance, participants are eligible for enhanced preventive care, which means services coded as “routine” or “preventive” are FREE (not applied to deductible). Insurance will cover 100% of qualified preventive care, including well-child exams and immunizations, annual checkups, annual eye exams, and diagnostic testing appropriate for your age and gender (per American Medical Association guidelines). Click here for a list of FREE preventive care services covered at 100%.
- With Doctor On Demand, you and your family (children and adults) will receive easy, stress-free access to board-certified medical doctors through video visits on your smartphone, tablet, or computer. Get prescriptions refilled, keep your family in tip-top shape, and be prepared for the unexpected, all from the comfort of your own home or office! Download the Doctor On Demand app in Google Play™ or the Apple App Store®. When setting up your account, Insurance = Meritain; Employer = Union Bank & Trust.
- Prime Therapeutics is our pharmacy benefit manager. If you need help filling a prescription, call the pharmacy help desk at 800.424.6817. Save money on your prescription medications by visiting https://web.primetherapeutics.com/member/login/ or by using the PrimeCentral App. Once you register your account, you can price prescriptions as your doctor writes them and choose the most cost-effective pharmacy. Click here for instructions on how to download the app.
- Participants prescribed select medications may be eligible for financial assistance administered by our partner, PaydHealth. There are a variety of public and private assistance programs in the marketplace. Some are needs-based and some are not. If you are prescribed a medication that qualifies, you will be contacted via text, email, or mail with instructions on how to enroll in the program with this message: “To avoid a financial penalty, Union Bank & Trust Company requires enrollment in their Select Drug program before your prescription can be processed. For assistance, call PaydHealth at 877-869-7772.” This is a win-win for both the participant and the health plan! This program increases affordable access to your medications while saving money for you and the health plan, which in turn impacts future monthly premiums. If PaydHealth is able to connect you with a program, you could see little to no out-of-pocket cost for medications that qualify. If alternate funding is secured, participation in the program is required for the UBT health plan to cover the medication.
- Some prescription medications are FREE! Find out if your medication is eligible to be shipped to you from participating international pharmacies. Check out this brochure and call Elect Rx at 855.353.2879.
- Traveling out of the country? Contact your Care Coordinator to find out what services are covered should you have medical needs while traveling. Also, consider a supplemental travel insurance policy.
- OptiMed is a national and accredited healthcare provider of infusion and injectable medications and assists members with coordinating care under the Plan’s benefits. To learn more about this opportunity, you can reach out to OptiMed directly at 877-884-0998 or read more about the program on the Optimed flyer.
- Regenexx provides patients with an alternative to orthopedic surgery by harnessing their body's own healing processes to treat orthopedic injuries. The UBT Health Plan covers Regenexx services at 100% after the applicable federal minimum deductible. Review the program features by clicking here: UBT Regenexx Benefits Portal. You can register for a 45-minute Benefits and Coverage webinar to learn more about the service using the link on the home page and visit with a Regenexx Patient Liaison via chat or by calling 866-624-6422.
- The Samaritan Fund Program is designed to support those who have serious medical conditions or high-cost medications that may be financially crippling even with insurance in place. Participation in Samaritan Fund Program is completely voluntary. Check out the details here. If you are a good fit for the program, they will help identify an individual health plan you and your providers are comfortable with and propose appropriate funding.
Quality healthcare
How can physicians and patients have the important conversations necessary to ensure the right care is delivered at the right time? Choosing Wisely® aims to answer that question.
Choosing Wisely is focused on encouraging physicians, patients, and other healthcare stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances, can cause harm. To spark these conversations, leading specialty societies have created lists of Things Physicians and Patients Should Question — evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation.
Eligibility
You can elect coverage for yourself and your eligible dependents including:
- Spouse
- Dependent children under age 26
- Disabled adult children, if the disability occurred before age 24.
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Plan Features: Classic & Basic |
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| Deductible Individual / Family | Classic $2,600 / $5,200 |
Basic $5,200 / $10,400 |
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Prescription Medications |
Applied to / included in deductible, coinsurance and maximum out-of-pocket |
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| Deductible Type |
Classic Aggregate / Basic Embedded
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Preventive Care |
In-network only |
Covered at 100%. Not subject to deductible or coinsurance. Examples include: Annual exam, PSA, pap, mammogram, etc. (per AMA guidelines) |
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HSA Starter Contribution |
Individual= $1,000* Family= $2,000* *HSA starter contribution pro-rated based on enrollment date. Visit the HSA page for further details. |
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Maximum Lifetime Benefit |
Unlimited |
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Note: Plans are creditable for Medicare Part D prescription drug purposes. The Classic Plan has an Aggregate Deductible, meaning the total family deductible must be reached prior to applying coinsurance if you cover dependents. The Basic Plan has an Embedded Deductible, meaning no individual will have to pay a deductible higher than the individual deductible amount before coinsurance starts applying. |
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| HEALTH | Classic Deductible $2,600/$5,200 |
Basic Deductible $5,200/$10,400 |
| Coverage Level | AETNA Choice POS II (OPEN Access) Network |
AETNA Choice POS II (OPEN Access) Network |
| Individual | $294.44 | $195.78 |
| Individual + Spouse | $670.78 | $570.18 |
| Individual + Child(ren) | $576.36 | $489.90 |
| Family | $828.68 | $704.38 |
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Add or subtract your WellRight Incentive |
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| Calendar Year Maximum Benefits | |
| Refer to your dashboard at ubt.myaptahealth.com for the maximum number of visits allowed for chiropractic care, occupational therapy, speech therapy, and physical therapy. | |
Additional resources:
HIPAA Notice of Privacy Practices
Glossary: Health Coverage & Medical Terms
Medicare Creditable Coverage Notice
Omnify COBRA continuation initial notice
Transparency in Coverage (machine-readable file; not for consumers)
