{"id":34,"date":"2018-04-10T23:42:57","date_gmt":"2018-04-10T23:42:57","guid":{"rendered":"http:\/\/ffbenefits.ffga.com\/pasadenaisd-2\/?page_id=34"},"modified":"2024-10-18T21:30:15","modified_gmt":"2024-10-18T21:30:15","slug":"medical","status":"publish","type":"page","link":"https:\/\/ffbenefits.ffga.com\/pasadenaisd-2\/medical\/","title":{"rendered":"Medical"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-wyiu-9252d288cb7a1ad993aed15c5afffaa9\">\n.flex_column.av-wyiu-9252d288cb7a1ad993aed15c5afffaa9{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-wyiu-9252d288cb7a1ad993aed15c5afffaa9 av_one_full  avia-builder-el-0  el_before_av_two_third  avia-builder-el-first  first flex_column_div av-zero-column-padding '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jv8srw4g-3fd5575921605b29fbabef4426804693\">\n.avia-image-container.av-jv8srw4g-3fd5575921605b29fbabef4426804693 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-jv8srw4g-3fd5575921605b29fbabef4426804693 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-jv8srw4g-3fd5575921605b29fbabef4426804693 av-styling- avia_animated_image av-animated-when-visible-95 left-to-right avia-align-center  avia-builder-el-1  avia-builder-el-no-sibling '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-3060 avia-img-lazy-loading-not-3060 avia_image ' src=\"\/wp-content\/uploads\/sites\/2611\/2019\/10\/Medical-1030x139.png\" alt='' title='Medical'  height=\"139\" width=\"1030\"  itemprop=\"thumbnailUrl\" srcset=\"\/wp-content\/uploads\/sites\/2611\/2019\/10\/Medical-1030x139.png 1030w, \/wp-content\/uploads\/sites\/2611\/2019\/10\/Medical-300x41.png 300w, \/wp-content\/uploads\/sites\/2611\/2019\/10\/Medical-768x104.png 768w, \/wp-content\/uploads\/sites\/2611\/2019\/10\/Medical-1500x203.png 1500w, \/wp-content\/uploads\/sites\/2611\/2019\/10\/Medical-705x95.png 705w\" sizes=\"(max-width: 1030px) 100vw, 1030px\" \/><\/div><\/div><\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-e8ote-e899b39894645e30ecb0a21538019451\">\n.flex_column.av-e8ote-e899b39894645e30ecb0a21538019451{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-e8ote-e899b39894645e30ecb0a21538019451 av_two_third  avia-builder-el-2  el_after_av_one_full  el_before_av_one_third  first flex_column_div av-zero-column-padding column-top-margin'     ><section  class='av_textblock_section av-dd8hi-c603fbe3067319bfa8ababe0773d150b'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3>Plan Options:<\/h3>\n<p>Pasadena ISD offers three medical plans through Aetna. Plan 2 is now a &#8220;Grandfathered&#8221; plan; therefore, &#8220;new&#8221; enrollment will not be allowed.\u00a0 You can choose between ACO-Kelsey, EPO, and HMAC Plan.<\/p>\n<p><em>Expand plans for details.<\/em><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3nsbe-48f9dd623aa71a3ac4e9eac5f79d3373\">\n#top .av-special-heading.av-3nsbe-48f9dd623aa71a3ac4e9eac5f79d3373{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-3nsbe-48f9dd623aa71a3ac4e9eac5f79d3373 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-3nsbe-48f9dd623aa71a3ac4e9eac5f79d3373 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-3nsbe-48f9dd623aa71a3ac4e9eac5f79d3373 av-special-heading-h3  avia-builder-el-4  el_after_av_textblock  el_before_av_toggle_container '><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >Administered by Aetna (medical) <span class='special_amp'>&amp;<\/span> CVS\/Caremark (pharmacy)<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-baq2u-3fe483663ee386f99acef3e651f6e502\">\n#top .togglecontainer.av-baq2u-3fe483663ee386f99acef3e651f6e502 p.toggler{\nborder-color:#2d5c88;\n}\n#top .togglecontainer.av-baq2u-3fe483663ee386f99acef3e651f6e502 p.toggler.activeTitle{\nbackground-color:#d3d3d3;\n}\n#top .togglecontainer.av-baq2u-3fe483663ee386f99acef3e651f6e502 .toggle_wrap .toggle_content{\nborder-color:#2d5c88;\n}\n<\/style>\n<div  class='togglecontainer av-baq2u-3fe483663ee386f99acef3e651f6e502 av-minimal-toggle  avia-builder-el-5  el_after_av_heading  el_before_av_hr  toggle_close_all' >\n<section class='av_toggle_section av-3e4v2-b0436d7e27b54df09ab666ce07cd014a'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-1' class='toggler   av-inherit-border-color'  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-1'>Point of Service (POS) Plan<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-1' class='toggle_wrap  '  ><div class='toggle_content invers-color av-inherit-border-color'  itemprop=\"text\" ><p>POS plans offer a nationwide network of doctors and hospitals and gives you the flexibility to choose any provider, in or out-of-network, to receive benefits. If you choose an in-network provider, your benefits will be greater, and you will generally pay less out-of-pocket than if you choose an out-of-network provider. The plans include a full spectrum of covered services and direct access to specialists without the need to gain approval from a Primary Care Physician (PCP). The POS plans are traditional health plans with coinsurance and deductibles.<\/p>\n<p><strong>Benefits Booklet<\/strong> \u2013 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions.<\/p>\n<p><strong>DocFind\u00ae<\/strong><b> \u2013 <\/b>When you need to find a doctor or facility, start with DocFind\u00ae. It\u2019s quick, easy and online 24\/7. To use DocFind\u00ae you must register for your own secure Aetna Navigator\u00ae website. Once you do, you will get a personalized version of DocFind\u00ae that has your medical plan and zip code preprogrammed. Visit: <i><a href=\"http:\/\/www.aetna.com\/docfind\/custom\/pasadenaisd\">www.aetna.com\/docfind\/custom\/pasadenaisd<\/a>.\u00a0<\/i><\/p>\n<p>If you have not set up your Aetna Navigator\u00ae website and need to find a doctor, use the network as follows.<\/p>\n<ul>\n<li>Medical Plan II (Grandfathered Plan) &#8211; \u201cTX Medical Neighborhood &#8211; Houston Choice POS II\u201d<\/li>\n<li>Medical Plan III &#8211; &#8220;KelseyCare &#8211; ACO&#8221;<\/li>\n<li>Medical Plan IV &#8211; \u201cExclusive Provider Organization EOP\u201d<\/li>\n<li>Medical Plan V &#8211; \u201cMemorial Hermann Accountable Care Network MHAC&#8221;<\/li>\n<\/ul>\n<p><strong>Aetna Navigator <\/strong>&#8211; Access medical ID cards, medical claims payments and Explanations of Benefits.\u00a0Your Aetna Navigator\u00ae account is personalized for you and your family. The information you see will be based on the health plan you are enrolled in. This site will also keep track of any personal health information that you enter. It is a quick and easy place to begin looking for all of your health care answers.<\/p>\n<p><strong>Aetna Mobile App<\/strong> \u2013 Get ID cards and plan information on the go. The Aetna Mobile app puts the most popular online features at your fingertips.\u00a0It\u2019s available for iPhone\u00ae, Android\u2122 and BlackBerry\u00ae mobile devices. Visit <a href=\"http:\/\/www.aetna.com\/mobile\">www.aetna.com\/mobile<\/a>.<\/p>\n<p><strong>Resource Guides<\/strong> \u2013 One for each plan explaining what is offered with website links for more info:<\/p>\n<ul>\n<li>How the plan works \u2013 deductibles, co-pays, co-insurance, out-of-pocket maximums<\/li>\n<li>Choosing network providers and what happens if you go out-of-network<\/li>\n<li>Routine and emergency care options and costs<\/li>\n<li>Teladoc \u2013 doctors available 24\/7 to diagnose, treat and prescribe medications<\/li>\n<li>24-Hour Nurse Information Line \u2013 registered nurses answer questions and advise on care<\/li>\n<li>Aetna member discounts \u2013 save on health-related products and services<\/li>\n<li>Wellness programs and services<\/li>\n<li>Care Advocate Team \u2013 trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care<\/li>\n<li>Beginning Right Maternity Program &#8211; obtain support during your pregnancy and receive a $100 gift card for participation<\/li>\n<li>Finding participating retail pharmacy providers<\/li>\n<li>Maintenance medications and Specialty medications \u2013 options for obtaining them<\/li>\n<li>How to receive savings on glucose meter and supplies<\/li>\n<li>Drug Cost Tool \u2013 see what medications cost under your plan<\/li>\n<\/ul>\n<p><strong>Summary of Benefits &amp; Coverage<\/strong> \u2013 For each plan, a summary of what you pay\/what the plan pays for medical\/pharmacy.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-ln9alnbc-f447388ae30f57cc6602fe13e85229d2'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-2' class='toggler   av-inherit-border-color'  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-2'>Aetna KelseyCare - Accountable Care Organization (ACO)<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-2' class='toggle_wrap  '  ><div class='toggle_content invers-color av-inherit-border-color'  itemprop=\"text\" ><p>The KelseyCare ACO plan provides top rated coverage with member copays at lower premium point.\u00a0 You will be required to stay within the Kelsey Seybold network and designate a PCP but will NOT need a referral to see a specialist within the Kelsey Network and Kelsey will help with anything outside their network.\u00a0 There is no out-of-network coverage, except in the case off an emergency.\u00a0 Kelsey also has their own clinic options.<\/p>\n<p><strong>Benefits Booklet<\/strong> \u2013 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions.<\/p>\n<p><strong>DocFind\u00ae<\/strong><b> \u2013 <\/b>When you need to find a doctor or facility, start with DocFind\u00ae. It\u2019s quick, easy and online 24\/7. To use DocFind\u00ae you must register for your own secure Aetna Navigator\u00ae website. Once you do, you will get a personalized version of DocFind\u00ae that has your medical plan and zip code preprogrammed. Visit: <i><a href=\"http:\/\/www.aetna.com\/docfind\/custom\/pasadenaisd\">www.aetna.com\/docfind\/custom\/pasadenaisd<\/a>.\u00a0<\/i><\/p>\n<p>If you have not set up your Aetna Navigator\u00ae website and need to find a doctor, use the network as follows.<\/p>\n<ul>\n<li>Medical Plan II (Grandfathered Plan) &#8211; \u201cTX Medical Neighborhood &#8211; Houston Choice POS II\u201d<\/li>\n<li>Medical Plan III &#8211; &#8220;KelseyCare &#8211; ACO&#8221;<\/li>\n<li>Medical Plan IV &#8211; \u201cExclusive Provider Organization EOP\u201d<\/li>\n<li>Medical Plan V &#8211; \u201cMemorial Hermann Accountable Care Network MHAC\u201d<\/li>\n<\/ul>\n<p><strong>Aetna Navigator <\/strong>&#8211; Access medical ID cards, medical claims payments and Explanations of Benefits.\u00a0Your Aetna Navigator\u00ae account is personalized for you and your family. The information you see will be based on the health plan you are enrolled in. This site will also keep track of any personal health information that you enter. It is a quick and easy place to begin looking for all of your health care answers.<\/p>\n<p><strong>Aetna Mobile App<\/strong> \u2013 Get ID cards and plan information on the go. The Aetna Mobile app puts the most popular online features at your fingertips.\u00a0It\u2019s available for iPhone\u00ae, Android\u2122 and BlackBerry\u00ae mobile devices. Visit <a href=\"http:\/\/www.aetna.com\/mobile\">www.aetna.com\/mobile<\/a>.<\/p>\n<p><strong>Resource Guides<\/strong> \u2013 One for each plan explaining what is offered with website links for more info:<\/p>\n<ul>\n<li>How the plan works \u2013 deductibles, co-pays, co-insurance, out-of-pocket maximums<\/li>\n<li>Choosing network providers and what happens if you go out-of-network<\/li>\n<li>Routine and emergency care options and costs<\/li>\n<li>Teladoc \u2013 doctors available 24\/7 to diagnose, treat and prescribe medications<\/li>\n<li>24-Hour Nurse Information Line \u2013 registered nurses answer questions and advise on care<\/li>\n<li>Aetna member discounts \u2013 save on health-related products and services<\/li>\n<li>Wellness programs and services<\/li>\n<li>Care Advocate Team \u2013 trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care<\/li>\n<li>Beginning Right Maternity Program &#8211; obtain support during your pregnancy and receive a $100 gift card for participation<\/li>\n<li>Finding participating retail pharmacy providers<\/li>\n<li>Maintenance medications and Specialty medications \u2013 options for obtaining them<\/li>\n<li>How to receive savings on glucose meter and supplies<\/li>\n<li>Drug Cost Tool \u2013 see what medications cost under your plan<\/li>\n<\/ul>\n<p><strong>Summary of Benefits &amp; Coverage<\/strong> \u2013 For each plan, a summary of what you pay\/what the plan pays for medical\/pharmacy.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-2pvem-dd139e30e0d704aacd0e228b09e20f25'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-3' class='toggler   av-inherit-border-color'  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-3'>Exclusive Provider Organization (EPO) Plan<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-3' class='toggle_wrap  '  ><div class='toggle_content invers-color av-inherit-border-color'  itemprop=\"text\" ><p>Aetna\u2019s EPO plans are offered as alternatives to the POS plans with specified network of participating providers and facilities. The EPO provides a wide range of medical services and you will not be required to select a PCP. If your medical condition requires the attention of a specialist, you can schedule an appointment directly without having to go through your PCP.<\/p>\n<p><strong>Benefits Booklet<\/strong> \u2013 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions.<\/p>\n<p><strong>DocFind\u00ae<\/strong><b> \u2013 <\/b>When you need to find a doctor or facility, start with DocFind\u00ae. It\u2019s quick, easy and online 24\/7. To use DocFind\u00ae you must register for your own secure Aetna Navigator\u00ae website. Once you do, you will get a personalized version of DocFind\u00ae that has your medical plan and zip code preprogrammed. Visit: <i><a href=\"http:\/\/www.aetna.com\/docfind\/custom\/pasadenaisd\">www.aetna.com\/docfind\/custom\/pasadenaisd<\/a>.\u00a0<\/i><\/p>\n<p>If you have not set up your Aetna Navigator\u00ae website and need to find a doctor, use the network as follows.<\/p>\n<ul>\n<li>Medical Plan II (Grandfathered Plan) &#8211; \u201cTX Medical Neighborhood &#8211; Houston Choice POSII\u201d<\/li>\n<li>Medical Plan III &#8211; &#8220;KelseyCare &#8211; ACO&#8221;<\/li>\n<li>Medical Plan IV &#8211; \u201cExclusive Provider Organization EOP\u201d<\/li>\n<li>Medical Plan V &#8211; \u201cMemorial Hermann Accountable Care Network MHAC\u201d<\/li>\n<\/ul>\n<p><strong>Aetna Navigator <\/strong>&#8211; Access medical ID cards, medical claims payments and Explanations of Benefits.\u00a0Your Aetna Navigator\u00ae account is personalized for you and your family. The information you see will be based on the health plan you are enrolled in. This site will also keep track of any personal health information that you enter. It is a quick and easy place to begin looking for all of your health care answers.<\/p>\n<p><strong>Aetna Mobile App<\/strong> \u2013 Get ID cards and plan information on the go. The Aetna Mobile app puts the most popular online features at your fingertips.\u00a0It\u2019s available for iPhone\u00ae, Android\u2122 and BlackBerry\u00ae mobile devices. Visit <a href=\"http:\/\/www.aetna.com\/mobile\">www.aetna.com\/mobile<\/a>.<\/p>\n<p><strong>Resource Guides<\/strong> \u2013 One for each plan explaining what is offered with website links for more info:<\/p>\n<ul>\n<li>How the plan works \u2013 deductibles, co-pays, co-insurance, out-of-pocket maximums<\/li>\n<li>Choosing network providers and what happens if you go out-of-network<\/li>\n<li>Routine and emergency care options and costs<\/li>\n<li>Teladoc \u2013 doctors available 24\/7 to diagnose, treat and prescribe medications<\/li>\n<li>24-Hour Nurse Information Line \u2013 registered nurses answer questions and advise on care<\/li>\n<li>Aetna member discounts \u2013 save on health-related products and services<\/li>\n<li>Wellness programs and services<\/li>\n<li>Care Advocate Team \u2013 trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care<\/li>\n<li>Beginning Right Maternity Program &#8211; obtain support during your pregnancy and receive a $100 gift card for participation<\/li>\n<li>Finding participating retail pharmacy providers<\/li>\n<li>Maintenance medications and Specialty medications \u2013 options for obtaining them<\/li>\n<li>How to receive savings on glucose meter and supplies<\/li>\n<li>Drug Cost Tool \u2013 see what medications cost under your plan<\/li>\n<\/ul>\n<p><strong>Summary of Benefits &amp; Coverage<\/strong> \u2013 For each plan, a summary of what you pay\/what the plan pays for medical\/pharmacy.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-20c1e-919ea4162a5b5fba05b1a90d045c2e66'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-4' class='toggler   av-inherit-border-color'  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-4'>Memorial Hermann Accountable Care (MHAC) Network<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-4' class='toggle_wrap  '  ><div class='toggle_content invers-color av-inherit-border-color'  itemprop=\"text\" ><p>It is a small network of Memorial Hermann healthcare providers who are able to share electronic health records such as your medical history, current medications and test results to better provide you with a personalized care plan. Gaps in your current care are easier to spot and address.<\/p>\n<p>During an emergency, call 911 or go to the nearest hospital. Your coverage will be the same as if you were within the Memorial Hermann Accountable Care Network.<\/p>\n<p><strong>Benefits Booklet<\/strong> \u2013 100+ pages of Aetna plan details including a detailed comparison of Aetna plans, list of covered services, limitations and exclusions, important terms and plan provisions.<\/p>\n<p><strong>DocFind\u00ae<\/strong><b> \u2013 <\/b>When you need to find a doctor or facility, start with DocFind\u00ae. It\u2019s quick, easy and online 24\/7. To use DocFind\u00ae you must register for your own secure Aetna Navigator\u00ae website. Once you do, you will get a personalized version of DocFind\u00ae that has your medical plan and zip code preprogrammed. Visit: <i><a href=\"http:\/\/www.aetna.com\/docfind\/custom\/pasadenaisd\">www.aetna.com\/docfind\/custom\/pasadenaisd<\/a>.\u00a0<\/i><\/p>\n<p>If you have not set up your Aetna Navigator\u00ae website and need to find a doctor, use the network as follows.<\/p>\n<ul>\n<li>Medical Plan II (Grandfathered Plan) &#8211; \u201cTX Medical Neighborhood &#8211; Houston Choice POS II\u201d<\/li>\n<li>Medical Plan III &#8211; &#8220;KelseyCare &#8211; ACO&#8221;<\/li>\n<li>Medical Plan IV &#8211; \u201cExclusive Provider Organization EOP\u201d<\/li>\n<li>Medical Plan V &#8211; \u201cMemorial Hermann Accountable Care Network MHAC\u201d<\/li>\n<\/ul>\n<p><strong>Aetna Navigator <\/strong>&#8211; Access medical ID cards, medical claims payments and Explanations of Benefits.\u00a0Your Aetna Navigator\u00ae account is personalized for you and your family. The information you see will be based on the health plan you are enrolled in. This site will also keep track of any personal health information that you enter. It is a quick and easy place to begin looking for all of your health care answers.<\/p>\n<p><strong>Aetna Mobile App<\/strong> \u2013 Get ID cards and plan information on the go. The Aetna Mobile app puts the most popular online features at your fingertips.\u00a0It\u2019s available for iPhone\u00ae, Android\u2122 and BlackBerry\u00ae mobile devices. Visit <a href=\"http:\/\/www.aetna.com\/mobile\">www.aetna.com\/mobile<\/a>.<\/p>\n<p><strong>Resource Guides<\/strong> \u2013 One for each plan explaining what is offered with website links for more info:<\/p>\n<ul>\n<li>How the plan works \u2013 deductibles, co-pays, co-insurance, out-of-pocket maximums<\/li>\n<li>Choosing network providers and what happens if you go out-of-network<\/li>\n<li>Routine and emergency care options and costs<\/li>\n<li>Teladoc \u2013 doctors available 24\/7 to diagnose, treat and prescribe medications<\/li>\n<li>24-Hour Nurse Information Line \u2013 registered nurses answer questions and advise on care<\/li>\n<li>Aetna member discounts \u2013 save on health-related products and services<\/li>\n<li>Wellness programs and services<\/li>\n<li>Care Advocate Team \u2013 trained nurses who can help you understand confusing medical conditions and treatments, and coordinate complex medical care<\/li>\n<li>Beginning Right Maternity Program &#8211; obtain support during your pregnancy and receive a $100 gift card for participation<\/li>\n<li>Finding participating retail pharmacy providers<\/li>\n<li>Maintenance medications and Specialty medications \u2013 options for obtaining them<\/li>\n<li>How to receive savings on glucose meter and supplies<\/li>\n<li>Drug Cost Tool \u2013 see what medications cost under your plan<\/li>\n<\/ul>\n<p><strong>Summary of Benefits &amp; Coverage<\/strong> \u2013 For each plan, a summary of what you pay\/what the plan pays for medical\/pharmacy.<\/p>\n<\/div><\/div><\/div><\/section>\n<section class='av_toggle_section av-1rhoa-9c4ab6c099bf7e553b24b12ad7f66de7'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div role=\"tablist\" class=\"single_toggle\" data-tags=\"{All} \"  ><p data-fake-id='#toggle-id-5' class='toggler   av-inherit-border-color'  itemprop=\"headline\"  role='tab' tabindex='0' aria-controls='toggle-id-5'>CVS Caremark Prescription Benefits<span class=\"toggle_icon\"><span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p><div id='toggle-id-5' class='toggle_wrap  '  ><div class='toggle_content invers-color av-inherit-border-color'  itemprop=\"text\" ><p>When you enroll in one of the three medical plan options, you automatically receive prescription drug coverage\u00a0through CVS Caremark which gives you access to a large, national network of retail pharmacies.<\/p>\n<p><strong>GENERIC OVER BRAND<\/strong><\/p>\n<p>To keep costs low, make sure you explore all options with your doctor when you are being prescribed a medication. Most brand-name drugs have a generic equivalent that is equal in strength and quality.<\/p>\n<p><strong>HOME DELIVERY<\/strong><\/p>\n<p>You could also be saving additional money by having your regular prescriptions delivered to you through Home Delivery.<\/p>\n<p>Effective January 1, 2023, prescriptions for medications you take regularly (such as asthma and high blood pressure) must be filled in 90-day supplies.\u00a0 You will have a choice to receive your prescription via Mail Order or at a pharmacy that is considered 90-day supply network.<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\" width=\"462\"><strong>CVS CAREMARK PHARMACY BENEFIT<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"462\"><strong>RETAIL PHARMACY<\/strong>*<strong>&#8211; UP TO 30-DAY SUPPLY<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"228\"><strong>TIER 1: GENERIC<\/strong><\/td>\n<td width=\"234\">$30 COPAY<\/td>\n<\/tr>\n<tr>\n<td width=\"228\"><strong>TIER 2: PREFERRED BRAND<\/strong><\/td>\n<td width=\"234\">$45 COPAY<\/td>\n<\/tr>\n<tr>\n<td width=\"228\"><strong>TIER 3: NON-PREFERRED BRAND<\/strong><\/td>\n<td width=\"234\">$75 COPAY<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"462\"><strong>DEDUCTIBLE (COMBINED TIER 2 &amp; 3 DRUGS ONLY): $200<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"462\"><strong>HOME DELIVERY &#8211; UP TO 90-DAY SUPPLY<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"228\"><strong>TIER 1: GENERIC<\/strong><\/td>\n<td width=\"234\">$50 COPAY<\/td>\n<\/tr>\n<tr>\n<td width=\"228\"><strong>TIER 2: PREFERRED BRAND<\/strong><\/td>\n<td width=\"234\">$80 COPAY<\/td>\n<\/tr>\n<tr>\n<td width=\"228\"><strong>TIER 3: NON-PREFERRED BRAND<\/strong><\/td>\n<td width=\"234\">$140 COPAY<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div><\/div><\/div><\/section>\n<\/div><br \/>\n<div  class='hr av-6m38u-721e41f525b6f91cfd753baa9a2bf66a hr-default  avia-builder-el-6  el_after_av_toggle_container  avia-builder-el-last '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><\/p><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3ycpu-d59c1670fe39606bd68326dd98528212\">\n.flex_column.av-3ycpu-d59c1670fe39606bd68326dd98528212{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-3ycpu-d59c1670fe39606bd68326dd98528212 av_one_third  avia-builder-el-7  el_after_av_two_third  el_before_av_heading  flex_column_div av-zero-column-padding column-top-margin'     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jv9m4793-99a383823ad31739fb1ad03a98668832\">\n#top .avia-icon-list-container.av-jv9m4793-99a383823ad31739fb1ad03a98668832 .iconlist_icon{\nbackground-color:#c42032;\n}\n<\/style>\n<div  class='avia-icon-list-container av-jv9m4793-99a383823ad31739fb1ad03a98668832  avia-builder-el-8  el_before_av_hr  avia-builder-el-first '><ul class='avia-icon-list avia_animate_when_almost_visible avia-icon-list-left av-iconlist-big av-jv9m4793-99a383823ad31739fb1ad03a98668832 avia-iconlist-animate'><\/ul><\/div><br \/>\n<div  class='hr av-26m4a-3aede459d7efa46b911cbbd70d473512 hr-default  avia-builder-el-9  el_after_av_iconlist  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-11y2q-544b9b6ae305f32ae276c61587ef551b'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h3><span style=\"font-size: 18.72px\"><b>ID Cards<\/b><\/span><\/h3>\n<h5>AETNA (medical)<\/h5>\n<ul>\n<li><a href=\"http:\/\/www.aetna.com\/mobile\" target=\"_blank\" rel=\"noopener\">Aetna Mobile App<\/a><\/li>\n<li><a href=\"http:\/\/www.aetnanavigator.com\/\" target=\"_blank\" rel=\"noopener\">Aetna Navigator<\/a><\/li>\n<li>Call Aetna:<br \/>\n1-866-841-3541<\/li>\n<\/ul>\n<h5>CAREMARK (pharmacy)<\/h5>\n<ul>\n<li><a href=\"https:\/\/fast.caremark.com\/mcontainer\/v0\/info-caremark-mobile\/index.html\" target=\"_blank\" rel=\"noopener\">Caremark Mobile App<\/a><\/li>\n<li><a href=\"https:\/\/www.caremark.com\/portal\/asset\/TRS_tempID.pdf\">Caremark Temporary Card<\/a><\/li>\n<li><a href=\"https:\/\/www.caremark.com\/trsactivecare\" target=\"_blank\" rel=\"noopener\">Caremark Website for ActiveCare<\/a><\/li>\n<li>Call Caremark:<br \/>\n1-888-234-0781<br \/>\n7 days\/week, 24 hours\/day<\/li>\n<\/ul>\n<h5><a href=\"http:\/\/www.aetna.com\/docfind\/custom\/pasadenaisd\">DocFind<\/a><\/h5>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-q85u-ede68bccfd439640158a849724e8ca6b\">\n#top .av-special-heading.av-q85u-ede68bccfd439640158a849724e8ca6b{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-q85u-ede68bccfd439640158a849724e8ca6b .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-q85u-ede68bccfd439640158a849724e8ca6b .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-q85u-ede68bccfd439640158a849724e8ca6b av-special-heading-h3  avia-builder-el-11  el_after_av_one_third  el_before_av_video  av-linked-heading'><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >BUYING HEALTH INSURANCE<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><\/p>\n<div  class='avia-video av-jv8ozkwj-ceb834b4ee1bd2582c9000015f45aba0 avia-video-16-9 av-no-preview-image avia-video-load-always av-lazyload-immediate av-lazyload-video-embed'  itemprop=\"video\" itemtype=\"https:\/\/schema.org\/VideoObject\"  data-original_url='https:\/\/ffga.wistia.com\/medias\/1zaw922gso'><script type='text\/html' class='av-video-tmpl'><div class='avia-iframe-wrap'><iframe loading=\"lazy\" class=\"wp-embedded-content\" sandbox=\"allow-scripts\" security=\"restricted\" title=\"Buying Health Insurance Video\" src=\"https:\/\/fast.wistia.net\/embed\/iframe\/1zaw922gso?dnt=1#?secret=JxUvSWgIxo\" data-secret=\"JxUvSWgIxo\" frameborder=\"0\" scrolling=\"no\" width=\"640\" height=\"360\"><\/iframe><\/div><\/script><div class='av-click-to-play-overlay'><div 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