Texas Health Aetna Select Plan 3000 (plan option ends Dec. 31, 2022)

Health Savings Account eligible

Plan overview

The Texas Health Aetna Select Plan 3000 is a high deductible health plan. Employees who enroll in this plan pay the full cost for all health care services and prescriptions received until the deductible is met. Then, the plan begins sharing costs, and employees pay 10% of the cost of health care services.

IMPORTANT NOTE: In order to enroll in this plan option, you must have an address listed in the HR system that is in one of these counties.

Health Savings Account

The Texas Health Aetna Select Plan 3000 comes with a Health Savings Account. The Health Savings Account is designed to allow participants to receive a triple tax advantage by putting money away to save for future health care expenses. Find out more here.

Where you can go for care

Network Doctors: This plan option has a narrow network made up of a select, local group of primary care doctors and specialists in the Dallas-Fort Worth area in Texas Health Aetna’s Open Access EPO Plus network.
Network Hospitals: This plan option has a narrow network made up of a select, local group of hospitals in the Dallas-Fort Worth area in Texas Health Aetna’s Open Access EPO Plus network.
Out-of-Network: There is no coverage under this plan option for services or care you receive from a doctor or hospital that is not in network unless it is for a true emergency.

To find a doctor or facility in the Texas Health Aetna network:

Visit texashealthaetna.com
Select “Click here to find a doctor” under the Find a Doctor section
Enter your home location (zip, city, county, or state) and click “Search”
Under Select a Plan, choose “Employer Plan — Open Access EPO Plus” as your plan and click “Continue”

To get the most up to date information, please contact Texas Health Aetna member services at 1-877-MyTHRLink (1-877-698-4754), prompt 1.

What you pay for care

Plan Features	Texas Health Aetna Select Plan 3000
Plan Features	Texas Health Aetna Open Access EPO Plus Preferred Network Doctors, Hospitals, and Free-standing Facilities
Network	Local, narrow network with select providers
Deductible	$3,000 individual / $6,000 family
Medical and Rx Out-of-Pocket Maximum¹	$6,750 individual / $13,500 family
HSA	Employees may contribute up to the IRS maximum limit of $3,650 (employee only coverage) or $7,300 (employee + family coverage)⁶. The Health Savings Account comes with: $19.23 per pay period for employee only coverage $38.46 per pay period for employee + family coverage
Office Visits	Full deductible, then 10%
Maternity Office Visits	Full deductible, then 10% for initial office visit, no cost for additional visits
Inpatient Hospital Care	Full deductible, then 10%
Virtual Care Services: Anytime MD	Full deductible, then $0
Emergency Room	Full deductible, then 10%
Urgent Care Center	Full deductible, then 10%
Outpatient Surgery²	Full deductible, then 10%
Routine Physicals³	$0
Well-Woman/Man Exams³ (Including Pap Test or PSA Test)	$0
Well-Child Care³ (Including Immunizations)	$0
Colonoscopy³	$0
Mammography⁴	$0
Outpatient Diagnostic Lab & X-ray (Excluding MRI, CT, PET Scans)²	Full deductible, then 10%
MRI, CT & PET Scans²	Full deductible, then 10%
Outpatient Therapy⁵	Full deductible, then 10%

1 Maximum includes deductible, co-insurance, and copays for medical care and prescriptions.

2 When your doctor requests tests or services such as lab work, X-rays, MRIs, CT scans, physical therapy, or rehabilitation at a free-standing facility that isn’t affiliated with a hospital, you should check to make sure they are in-network. Check with your insurance carrier to verify whether a facility and/or doctor is covered under your plan and to learn how much your coinsurance would be.

3 Well exams are covered in full if the claims administrator determines the physical is for preventive care. Additional screenings or services will be considered diagnostic services and will be covered after you pay the applicable copay or deductible and coinsurance. At the time of your preventive care visit, if other services are performed that are not preventive services, as determined by the claims administrator, they will not be paid at 100% even if they are submitted as part of a claim for preventive care.

4 One per year is covered. You pay the coinsurance for additional mammograms.

5 Up to a combined total of 60 visits per year are covered for outpatient physical, occupational, and speech therapy. Pulmonary and rehabilitation services are covered up to 20 visits. Up to 36 cardiac rehabilitation visits are covered.

6 For the purposes of HSA enrollment, Employee + Family coverage includes Employee + Spouse, Employee + Children, or Employee + Family coverage.

What you pay each paycheck

To view the costs per paycheck, click here.

Features of the plan

There are a variety of cool (and some free) features that come with this plan option. You can find a full list of features here.

Tips

Check out these tips that can help you get the care that is right for you while keeping your costs down.

WHO DO I CONTACT WITH QUESTIONS?

UnitedHealthCare:
- Phone: 1-877-698-4754, prompt 1
- Web: texashealthaetna.com
Benefits Support
- Speak with a member of Texas Health’s Benefit Support team by calling 1-877-MyTHRLink (1-877-698-4754) prompt 9 or emailing THRBenefitsSupport@texashealth.org.

Texas Health Aetna Select Plan 3000