Medical Plan Options
2012–2013 Benefits Open Enrollment
As of July 1, 2012, women will have 100% in-network coverage under all medical plans for the following services: contraceptives (such as birth control pills or IUDs), sterilization procedures and patient education and counseling. In addition, coverage for transgender benefits will be extended to include sexual reassignment surgery (SRS) under the Aetna POS II plan.
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PennCare/Personal Choice Preferred Provider Organization (PPO)
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Aetna Choice Point-of-Service (POS) II
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Keystone/AmeriHealth Health Maintenance Organization (HMO)
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Aetna High Deductible Health Plan (HDHP) with a Health Savings Account (HSA)
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Waiving Medical Coverage
Administered by Independence Blue Cross (Enroll Online)
You don’t need a Primary Care Provider (PCP) or referrals for this plan. You can receive care from any provider you choose, but your out-of-pocket costs are based on the type of provider you use.
PennCare Network Providers (PennCare provider directory)
- Use health care providers who are part of or affiliated with the UPHS network.
- Preventive care services are covered at 100%.
- Most other services are covered at 90% after a deductible; you pay only 10% of the covered charges.
Personal Choice Preferred Providers (Personal Choice provider directory)
- Use health care providers who are part of the Personal Choice network.
- Preventive care services are covered at 100%.
- Provider office visits are covered at 100% after copays.
- Most other services are covered at 80% after a deductible; you pay 20% of the covered charges.
Non-Preferred Providers
- Use health care providers who aren’t part of the PennCare or Personal Choice networks.
- Most services are covered at 60% after a deductible; you pay 40% of the covered charges.
Administered by Aetna (Enroll Online)
You don’t need a Primary Care Provider (PCP) or referrals, even when using in-network providers. You can receive care from any provider you choose, but your out-of-pocket costs are based on the type of provider you use.
In-Network Providers (Aetna provider directory)
- Use health care providers who are part of the Aetna Choice POS II network.
- Preventive care services are covered at 100%.
- Provider office visits are covered at 100% after copays.
- Most other services are covered at 80% after a deductible; you pay 20% of the covered charges.
Out-of-Network Providers
- Use health care providers who aren’t part of the Aetna Choice POS II network.
- Most services, including preventive care, are covered at 60% after a deductible; you pay 40% of the covered charges.
Administered by Independence Blue Cross (Enroll Online)
You must choose and coordinate your care through a network Primary Care Physician (PCP). You also must obtain referrals from your PCP if you need to see other network providers for care. This plan doesn’t provide coverage if you self-refer your care or go outside the HMO network of providers (except for emergency care).
In-Network Providers Only (Keystone provider directory) (AmeriHealth provider directory)
- Preventive care services are covered at 100%.
- Most other services are covered at 100% after copays.
Administered by Aetna (Enroll Online)
You don’t need a Primary Care Provider (PCP) or referrals for this plan. You can receive your care from any provider you choose, but your out-of-pocket costs are based on the type of provider you use.
As the name implies, this plan carries a high deductible and you need to meet that deductible before the plan begins paying benefits. This applies to most services, including prescription drugs and office visits. However, the deductible does not apply to in-network preventive care and preventive generic prescription drugs.
This plan has an HSA, a tax savings account that you can contribute to via payroll deduction and use the money to offset the cost of care. What’s more, Penn will also contribute money to the HSA on your behalf—$500 for employee only coverage or $1,000 if you cover any dependents.
In-Network Providers (Aetna provider directory)*
*Note: In the "select a plan" field, you must choose Aetna Choice POS II (Open Access).
- Use health care providers who are part of the Aetna HDHP network.
- Preventive care services are covered at 100%.
- Provider office visits are covered at 100% after copays.
- Most other services are covered at 90% after a deductible; you pay 10% of the covered charges.
Out-of-Network Providers
- Use health care providers who aren’t part of the Aetna HDHP network.
- Most services, including preventive care, are covered at 60% after a deductible; you pay 40% of the covered charges.
More Information
Aetna High Deductible Health Plan
*The Aetna High Deductible Health Plan with Health Savings Account is not available to Visiting Scholars or the members of Locals 54, 115 and 590.
If you have medical coverage through another source, you may elect to waive medical coverage.