Aetna Colonoscopy Coverage 2020
View the 2021 Standard Option planRoutine Screening. Aetna considers any of the following colorectal cancer screening tests medically necessary preventive services for average-risk members aged 45 years and older when these tests are recommended by their physician. Annual immunohistochemical or guaiac-based FOBT; or Colonoscopy (considered medically necessary every 10 years for persons at average. Aetna Open Access ® Elect Choice®. Urgent care $35 copay/visit Not covered No coverage for non-urgent use. If you have a hospital stay Facility fee (e.g., hospital room) $300 copay/stay Not covered Max copay/calendar year: $900. Physician/surgeon fees No charge Not covered None. Colonoscopy, well baby care, tubal ligation and vasectomy no charge. No coverage Nutrition - Up to six visits per calendar year; $20 copayment. Medically necessary Most contraceptive drugs, IUDs and birth control implants are covered at no charge.
Traditional coverage. Affordable premiums.
- Note: If the test results in the biopsy or removal of a growth, it’s no longer a “screening” test, and you will be charged the co-insurance and/or a co-pay (but you don't have to pay the Part B deductible). Colonoscopy: Covered at no cost. at any age (no co-insurance, co-payment, or Part B deductible) when the test is done for screening.
- Aetna Member Services 1-800-367-6276. nafhealthplans.com Plan Provisions Preferred (In-Network) Non-Preferred (Out-of-Network). Physician Services Office visits for treatment of illness or injury 100% after copay: $30 PCP5/ $45 specialist; no deductible 60% after deductible Walk-in clinic visit 100% after $30 copay 60% after deductible.
When you enroll in GEHA’s Standard Option, you:
- Pay nothing for online doctor visits with access to certified doctors, including dermatologists, and licensed therapists through MDLIVE.
- Pay nothing for routine, in-network maternity care.
- Get a complete range of prescription services.
More Standard Option highlights:
- A 30-day supply of generic medication costs just $10.
- You can visit your primary care doctor for only a $15 copay each visit.
- This plan covers 100% of preventive care costs when you see an in-network provider.
2020 Rates
Aetna Colonoscopy Cost
These rates do not apply to all enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer that maintains your health benefits enrollment.
Self Only | Self Plus One | Self and Family | |
---|---|---|---|
Non-Postal biweekly | $60.54 | $130.18 | $155.52 |
Postal biweekly – Category 1 | $58.12 | $124.97 | $149.30 |
Postal biweekly – Category 2 | $50.25 | $108.05 | $129.08 |
Monthly (retirees) | $131.18 | $282.05 | $336.96 |
Pay nothing for online doctor visits with access to certified doctors, including dermatologists, and licensed therapists through MDLIVE.
A 30-day supply of generic medication costs just $10.
You can visit your primary care doctor for only a $15 copay each visit.
Covered benefits for routine in-network maternity care and hospital stays.
PreviousNextCosts for services in 2020
The table below summarizes your in-network cost for medical benefits with GEHA Standard Option. For complete information, refer to the GEHA Plan Brochure.Copays
Copay | What you pay in-network |
---|---|
Primary physician office visit | $15 |
Specialist | $30 |
MinuteClinic (where available) | $10 |
Urgent care | $35 |
Annual eye exam | $5 through EyeMed |
Other services
Service | What you pay in-network |
---|---|
Preventive lab services | Nothing with Lab Card |
Well-child visit; up to age 22 | Nothing |
Adult routine screening | Nothing |
Preventive dental care | 50% of allowance, twice yearly |
Maternity care
Service | What you pay in-network |
---|---|
Routine provider care | Nothing |
Inpatient care | Nothing |
Self Only | Self Plus One | Self and Family | |
---|---|---|---|
Calendar-year deductible (in-network) | $350 | $700 | $700 |
Out-of-pocket-maximum (in-network) | $6,500 | $13,000 | $13,000 |
Prescriptions
The table below summarizes your cost for prescription drugs with GEHA’s Standard Option. For complete benefit information, including details on specialty drugs that are injected or infused, refer to the GEHA Plan Brochure. Free imovie.
To find a drug cost based on your benefit plan and prescription dosage, check your drug costs.
Retail pharmacy – 30-day supply
In-Network | Out of Network | |
---|---|---|
Generic | $10 | $10, plus difference between plan allowance and cost of drug |
Preferred brand-name | 50%, up to $200 max¤ | 50%, up to $200 max, plus difference between plan allowance and cost of drug**¤ |
Non-preferred brand-name | 50%, up to $300 max¤ | 50%, up to $300 max, plus difference between plan allowance and cost of drug**¤ |
Mail service pharmacy – 90-day supply
In-Network | Out of Network | |
---|---|---|
Generic | $20 | n/a |
Preferred brand-name | 50%, up to $500 max¤ | n/a |
Non-preferred brand-name | 50%, up to $600 max¤ | n/a |
¤If you choose a brand-name medication when a generic is available, you will be charged the generic copay plus the difference in cost between the brand-name and the generic.
**Retail fills eligible for a greater than a 30-day supply will be subject to the 50% coinsurance up to the maximum of $500 for preferred or $600 for non-preferred.
HEALTH REWARDS
VISION COVERAGE
GYM DISCOUNTS
^GEHA supplemental benefits are neither offered nor guaranteed under contract with the FEHB, but are made available to all enrollees and family members who become members of a GEHA medical plan. For information on year-round savings for GEHAdental members, visit Savings for GEHA dental members.