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MEDICAL PLANS
AEP offers three consumer-directed health plans (CDHPs). All of AEP’s medical plan options are administered by Anthem Blue Cross Blue Shield, are available in all areas, include behavioral health, fully covered in-network preventive care and coverage for prescription drugs through Express Scripts. The plans are differentiated in their deductibles, out-of-pocket maximums, coinsurance and AEP funds provided for the different plans. The three CDHP options are below.
What’s Included?
All of AEP’s medical plan options include coverage for prescription drugs, behavioral health and fully covered in-network preventive care. This means you pay nothing for immunizations, routine annual exams, adult screenings, routine colonoscopies and other preventive care, as long as you receive this type of care from in-network providers.
Find an in-network medical provider
If you are not currently enrolled in an AEP medical plan you can check to see if your providers are in the Anthem network at anthem.com. Select Find Care at the top of the page and use the Guests option. Select Medical as the type of care, select the state, then select Medical (Employer-Sponsored) and National PPO (BlueCardPPO) for plan/network.
Health Reimbursement Account (HRA) Plan
The HRA Plan provides medical coverage and convenience with an AEP-funded account that covers out-of-pocket costs associated with your medical plan. AEP credits to your HRA annually, and the funds are available for use at the beginning of the calendar year. The amount of AEP’s contribution depends on the coverage level you elect. Your account is automatically set up by AEP when you enroll in the plan. The balance in your HRA is automatically applied to your medical, prescription drug and behavioral health claims until it is gone. You cannot make contributions to this account. Any unused balance can be carried over from year to year only if you remain in the HRA Plan. Remaining balances in your HRA when you convert to a Medicare Plan will rollover to a Retiree Reimbursement Account (RRA), as long as you remain enrolled in an AEP Retiree Medical plan.
Health Savings Account Plus (HSA Plus) Plan
The HSA Plus Plan provides health care coverage and the ability to contribute to a Health Savings Account (HSA). You can use the funds for out-of-pocket costs associated with your medical plan. With an HSA you have control of where, when and how you use your funds. You can even save the funds in your HSA and invest them for future expenses. The HSA is yours to keep if you move to another plan. Any unused balance can be carried over from year to year.
If your retirement date was January 1, 2013 or after, an optional participant-funded Health Saving Account (HSA) is available. You can open an HSA and make your own contribution directly to the account, up to the IRS limits, and deduct those contributions on your federal income tax return.
If your retirement date is prior to January 1, 2013, the plan includes an AEP-funded Health Savings Account (HSA) with funds contributed in full in January 2022. The amount of AEP’s contribution depends on the coverage level you elect. Your account is automatically set up by AEP when you enroll in the plan. You can also make your own contributions directly to the account, up to the IRS limits, and deduct those contributions on your federal income tax.
Health Savings Account Basic (HSA Basic) Plan
The HSA Basic Plan provides health care coverage and convenience with an optional participant-funded Health Savings Account (HSA) that you can use for out-of-pocket costs associated with your medical plan. Unlike the HRA and HSA Plus Plans, there is no annual AEP contribution to your HSA or any other account under this plan. Because you aren’t actively working and receiving a paycheck directly from AEP, you can’t elect to contribute to an HSA through AEP. You can open an HSA and make your own contributions directly to the account, up to the IRS limits, and deduct those contributions on your federal income tax return. With an HSA, you have control of where, when and how you use your HSA funds. You can even save the funds in your HSA and invest them for future expenses. The HSA is yours to keep if you move to another plan. Any unused balance can be carried over from year to year.
Retiree and surviving spouse/dependent medical plan contribution rates are dependent upon various factors, including, but not limited to, termination date, and age and years of service at the time of termination.
A personalized worksheet was mailed to your home address on October 13th which reflects the rates that are specific to you for 2022. You can also see your 2022 rates by clicking here, starting October 20th, 2021. Once you login, click Start Here and your updated contribution rates will be reflected as part of the 2022 enrollment process.
WHAT HAPPENS WHEN YOU TURN AGE 65?
Approximately two months prior to your 65th birthday, the AEP Benefits Center will send you information outlining eligibility and other details about benefits that will go into effect the first of the month in which you turn age 65, or the first of the month prior if your birth date falls on the first day of the month. The information will include the options and costs available to you under the Group Medicare Advantage Plans.
IMPORTANT: You must be enrolled in Medicare Parts A and B to be eligible to participate in AEP’s Group Medicare Advantage Plans upon turning age 65. If a covered dependent under the age of 65 becomes eligible for Medicare, for any reason, including disability, the plan will assume they are enrolled in Medicare Parts A and B and will coordinate its payment of benefits accordingly.
You will also receive a letter from Express Scripts Medicare with information about the group-based, company-sponsored Medicare Part D plan.
Please note that, when transitioning from an AEP under-age-65 medical plan to an AEP medical plan for participants age 65 and over, year-to-date accumulated deductibles and out-of-pocket maximum amounts do NOT transfer, due to rules governed by Medicare.
Waiving Medical Coverage
Even if you have previously waived AEP retiree medical coverage or do not elect it this Annual Enrollment, you may still elect this coverage in the future — either during a future Annual Enrollment or within 31 days of a qualified change in family status.
Surviving spouses and dependents: Once you waive AEP retiree medical coverage, you lose your eligibility for this coverage permanently and will not be able to enroll at a later date.
KNOW YOUR COSTS
Medical/Pharmacy Cost Transparency
As an AEP medical plan participant, you can activate Castlight as part of the annual enrollment process. This personalized health care advisor provides tips and reminders specific to your health care needs and allows you to research health care conditions and possible future treatments. You can use Castlight to find in-network medical, EAP and behavioral health providers, compare quality, cost and location, as well as find pharmacies and prescription costs. You can review HRA and HSA balances, detailed medical Explanation of Benefits and access your ID cards.
You may also download the Castlight app on your mobile device - go to the Apple App Store or the Android Google Play Store. Note, you will need to use your name exactly as it appears on your Anthem ID card when you register at mycastlight.com/aephealthnavigator.
If you have any questions, call 1-866-259-4428, 8:00 a.m. and 9:00 p.m. EST
If you need more information on the DMO plan, refer to the Aetna DMO Summary Plan Description at aepbenefits.com or contact Aetna at 1-800-243-1809.
To find a DMO primary care dentist click here.
Dental Plans
Retirees: Once you waive AEP dental coverage, you will lose your eligibility for this coverage permanently and will not be able to enroll at a later date. Note: exception for individuals on or after November 12, 2015 where AEP sold an operation. Please refer to the Aetna PPO and DMO Summary Plan Descriptions for additional details.
Surviving spouses and dependents: Once you waive AEP dental coverage, you will lose your eligibility for this coverage permanently and will not be able to enroll at a later date. Please refer to the Aetna PPO and DMO Summary Plan Descriptions for additional details.
Dental health is an important part of your overall health. Depending on where you live, you may have more than one dental plan option to choose from.
The dental options for 2022 are:
- Aetna Dental Preferred Provider Organization (DPPO) Plan: Offered in all areas.
- Aetna Dental Maintenance Organization (DMO) Plan: Offered in limited areas; availability is based on your home ZIP code.
DPPO Plan The DPPO Plan pays 100% of your preventive care expenses (subject to frequency limits) with no deductible, up to Aetna’s recognized charges. It also pays a percentage of Aetna’s recognized charges for most other expenses after you meet an annual deductible.
With the DPPO Plan option, you can visit a dentist who participates in the Aetna DPPO Plan network, or you can visit a dentist who does not participate in the Aetna dental network. You generally pay less out of your own pocket when you visit in-network dentists.
For more information, call Aetna at 1-800-243-1809.
DMO Plan With the DMO plan, you must choose a Primary Care Dentist (PCD) who participates in the Aetna DMO plan network. Each covered dental procedure has a set dollar copay that you must pay for services. There is no out-of-network coverage associated with the DMO plan so it’s important that you choose and visit a dentist who participates in the Aetna DMO network in order for services to be covered under the plan.
If you are currently enrolled in the DMO Plan, review your dental plan options to ensure the DMO Plan is still available to you based on your home ZIP code. If the DMO Plan is no longer available to you, you will be defaulted into the Dental Preferred Provider Organization (DPPO) Plan, covering your same eligible dependents, and you will not see the DMO Plan as a dental plan option.
Because there is no out-of-network coverage for the DMO plan, only participants who live in a DMO network area will be eligible to participate in the DMO plan. If you are eligible to participate in the DMO plan, it will appear as a dental plan option during the annual enrollment process. If you are enrolled in the DMO plan for the current year and you are no longer eligible for the DMO plan for subsequent year, you will automatically be defaulted into the DPPO plan covering the same eligible dependents, if you do not make an affirmative election during Annual Enrollment.
- To elect a DMO provider or confirm your existing dentist participates in the Aetna DMO network, contact Aetna at 1-800-243-1809.
- Please note: All dental providers do not participate in the DMO network so it’s recommended that you confirm whether or not your dental provider participates in the DMO network.
- Each covered family member you enroll can select their own PCD.
- You can change your PCD as often as once a month. Any change made on or prior to the 15th of the month will take effect the first of the next month. Any change made after the 15th will take effect the first of the month following next month.
To locate an EyeMed network provider, call EyeMed at 1-866-723-0513 or visit eyemed.com.
Vision Plan
Retirees: Even if you have previously waived AEP vision coverage or do not elect it this Annual Enrollment, you may still elect this coverage in the future — either during a future Annual Enrollment or within 31 days of a qualified change in family status.
Surviving spouses and dependents: Once you waive AEP vision coverage, you will lose your eligibility for this coverage permanently and will not be able to enroll at a later date.
AEP’s Comprehensive Vision Plan provides coverage through EyeMed Vision Care, in conjunction with Fidelity Security Life, for eye exams, contacts (including disposable contacts) and eyeglass lenses and frames. It also offers discounts on special features, such as scratch-resistant lenses, non-prescription sunglasses, laser eye surgery and more. Vision care discounts are also available through the Anthem medical plans, if enrolled.
Members who have Type 1 or Type 2 diabetes are eligible for a follow-up exam and additional testing twice per benefit year.
Create an account at their website to view their long list of special offers, track claims, find a provider and more.
This year, we’re adding more tiers of coverage, so you have more choice and flexibility when it comes to caring for your eyes. The In-Network Frame benefit now provides for the member to pay 20% of the balance over a $155 allowance, and the In-Network Contact Lenses benefit now provides for the member to pay for convention contacts at 85% of the balance over a $155 allowance and for disposable contacts at 100% of the balance over a $155 allowance. The new tiered copay for In-Network progressive standard and premium lenses range from a $75 copay (progressive standard lenses) to $95-$120 (progressive premium tier 1 – 3 lenses) to member’s paying $75 plus 80% of the balance over a $120 allowance (progressive premium lenses at tier 4).
Eyemed Secondary Purchase Plan After your initial benefits have been utilized, you are able to receive the following additional discounts when you use network providers:
- 20% discount off frames or lenses.
- 40% discount off a complete pair of eyeglasses.
- 15% discount off conventional contact lenses.
Solera Weight Management Program
AEP covers the cost of this confidential program for AEP medical plan participants and covered family members age 18 and older.
Some qualifying risk factors include Type 2 diabetes, obesity, high blood pressure and high cholesterol.
Losing 5 to 7 percent of your body weight actually lowers your risk of many chronic diseases and help to keep them in-check. In fact, that’s the goal of this nationally recognized lifestyle change program.
You’ll take a one-minute quiz asking about your risk factors to help you understand if this program can help you. Then, Solera will help you decide whether an in-person support group or an online option is the best fit for you.
Most programs include access to a personal health coach, a small group for support, and tools like a scale with wireless internet connectivity. At week 4 of the program all participants will receive a FitBit activity tracker.