Penn State Re-signs Aetna For 2015-16 Healthcare Contract
After what the Graduate and Professional Student Association calls a “competitive bidding process,” Aetna was again selected as the Penn State Student Health Insurance provider. The plan is considered a platinum value plan, one which covers the highest proportion of expenses allowed to be covered by an individual plan under the Affordable Care Act. Aetna will cover “nearly all” visits and procedures at University Health Services, the GPSA website says.
Though the complete plan brochure has yet to be released, a summary of the plan is available below, via the GPSA website:
- Annual Deductible: $250 individual/$500 family
- Out of Pocket Limit: $1,300 individual/$2,600 family in-network; $15,000 out-of-network
- Non-UHS Primary Care Physician Office Visit: 100 percent after $10 copay preferred care/30% coinsurance non-preferred care
- Specialist Physician Office Visit: 10 percent coinsurance preferred care/30 percent coinsurance non-preferred care
- Outpatient Mental Health: 100 percent after $10 copay preferred care/30 percent coinsurance non-preferred care
- Inpatient Hospitalization: 10 percent coinsurance preferred care/30 percent coinsurance non-preferred care
- Emergency Room: 10 percent coinsurance after $150 copay (waived if admitted)
- Lab/X-Ray: 100 percent at UHS/10 percent coinsurance preferred care/30 percent coinsurance non-preferred care
- Prescribed medicines: 100 percent at UHS and Hershey Medical Center/$10 (generics); $30 (formulary brand name); $60 (non-formulary brand name) copay in-network/50 percent coinsurance out-of-network
- Treatment at UHS: 100 percent coverage with deductible waived
The plan also includes annual premiums of $3,195 for first-year medical students; $3,054 for undergraduate, graduate, law, and medical students; $3,054 for spouses and dependents of students; and a $254.50 monthly premium for visiting scholars. Graduate students with assistantships or fellowships will have part of this premium subsidized, and while the exact amount remains undecided, last year the university subsidized 80 percent of the premium cost. These premiums reflect a 7.8 percent increase for students, but a 57 percent decrease for spouses. ACA requirements state that premiums for individuals within the same age bracket cannot be different for individual care plans, so spouses and student rates are similar, as are rates for each dependent. The GPSA website notes that the plan premiums are subject to annual adjustment based on overall cost changes, utilization, and total enrollment in the plan.
Just as in the 2014-15 plan, prescriptions at UHS and Hershey Medical Center will still be fully covered, and prescriptions at out-of-network pharmacies will be covered at 50 percent. There is more flexibility built into the new 2015-2016 plan, as well. Prescriptions at pharmacies beyond the Aetna provider network will be available for $10, $30, or $60 copays.
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