Comprehensive medical coverage designed to help you and your family get the care you need at an affordable price.
We’re proud to offer you the following medical plan choices, designed to help you and your family get the care you need at an affordable price. We offer two Aetna medical plans to choose from: the Aetna Choice POS plan and the Aetna Healthfund (HSA Qualified) plan. Both provide comprehensive coverage designed to support your health and wellbeing. In addition, if you’re an employee in California or Hawaii, you have access to an additional plan option—the Kaiser HMO plan, which offers a convenient, integrated approach to care through in-network providers only. Explore each plan to find the coverage that best meets your needs and ensures you and your family stay healthy throughout the year. See your Benefits Guide for your cost for coverage.
Enroll in the Aetna Healthfund Plan (HSA Qualified) and get HSA contributions through HealthEquity.
Enterprise Wireless Solutions contribution*
for Employee Only coverage
for Employee + One or More coverage
Use this FREE money for eligible medical, dental, and vision expenses.
*This credit is prorated based on when your benefits begin.
Call the Aetna Health Concierge at 1-833-915-3870 (M-F, 8 a.m. to 6 p.m.)
Visit aetna.com.
The changes to your 2027 costs for services are noted below in purple.
| Plan Features | Aetna Choice POS | Aetna Healthfund Plan (HSA Qualified) | ||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Enterprise Wireless Solutions Annual HSA Contribution* Individual/Family |
N/A | $1,250 / $2,500 Prorated for the year, depending on date of enrollment |
||
| You pay: | You pay: | |||
| Annual Deductible | $1,000 Individual / $2,000 Family | $2,000 Individual / $4,000 Family | $2,000 Self Only** / $4,000 Employee + One or More** | |
| Annual Out-of-Pocket Maximum | $3,500 Individual / $7,000 Family | $7,000 Individual / $14,000 Family | $4,000 Self Only / $8,000 Employee + One or More |
$6,000 Self Only / $18,000 Employee + One or More |
| Preventive Care Visit | $0 copay | 40% after deductible | $0 copay | 40% after deductible |
| CVS Virtual Care – General Medical | $0 copay | Not covered | $55 copay, then 20% after deductible | Not covered |
| Primary Care/Telemedicine | $35 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Specialist | $45 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Lab & X-ray | Covered in full | 40% after deductible | 20% after deductible | 40% after deductible |
| Urgent Care | $45 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Emergency Room | $150 copay, then 20%, deductible waived | 20% after deductible | ||
| Inpatient Hospital | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
| Outpatient Mental Health | $35 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Chiropractic (35 visits/year) | $35 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Comprehensive Infertility | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
| Acupuncture (12 visits/year) | $35 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Hearing Exam (child & adult) 1 routine exam every 36 months |
20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
| Hearing Aid (child & adult) 1 pair every 36 months |
20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
*Your HSA is funded 50% upfront, with the remaining 50% spread over six months.
**This plan uses a family deductible, which means the total family deductible must be met before the plan begins paying for any individual’s care.
The changes to your 2027 costs for prescription drugs are noted below in purple.
| Plan Features | Aetna Choice POS | Aetna Healthfund Plan (HSA Qualified) | ||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Prescription Drugs: Retail (up to a 30-day supply) | ||||
| Generic | $10 copay | 20% | Certain Preventive Medications* Deductible waived: Generic covered in full and Brand Name 20% All Other Medications Generic, Brand Name, and Specialty medications, 20% after deductible |
40% after deductible |
| Preferred Brand | $45 copay | 20% | 40% after deductible | |
| Non-Preferred Brand | $70 copay | 20% | 40% after deductible | |
| Specialty** | 25% to $250 max | Not covered | Not covered | |
| Prescription Drugs: Mail Order (up to a 90-day supply) | ||||
| Generic | $20 copay | 20% | Certain Preventive Medications* Deductible waived: Generic covered in full and Brand Name 20% All Other Medications Generic, Brand Name, and Specialty medications, 20% after deductible |
40% after deductible |
| Preferred Brand | $90 copay | |||
| Non-Preferred Brand | $140 copay | |||
*Review the list of Aetna covered medications at aetna.com/individuals-families/find-a-medication.html. You will also find the HSA list of Certain Preventive Medications on this site by scrolling down to “More Coverage Details” and clicking on “Other Plan Information” to find the HSA Preventive Medicine List.
**After the first specialty drug fill at a retail or specialty pharmacy, subsequent fills must be through the Aetna Specialty Pharmacy network.
Aetna partners with GoodRx to ensure you get the best price on non-specialty generic drugs. Present your Aetna ID card and Aetna will automatically apply the lowest discount available—no additional steps needed!
How to Find a Provider? Visit healthy.kaiserpermanente.org/doctors-locations to find an in-network provider. There is no coverage for out-of-network providers, except in the case of an emergency. If you receive care from an out-of-network provider, you are responsible for 100% of the cost.
| Plan Features | HMO (CA) | HMO (HI) |
|---|---|---|
| In-Network Only | In-Network Only | |
| Enterprise Wireless Solutions Annual HSA Contribution Individual/Family |
N/A | N/A |
| You pay: | ||
| Annual Deductible Individual/Family |
$1,000 / $2,000 | None |
| Annual Out-of-Pocket Maximum Individual/Family |
$3,000 / $6,000 | $2,500 / $7,500 |
| Preventive Care Visit | Covered in full | Covered in full |
| Telehealth | Covered in full | Cost varies depending on service. |
| Physician Visit | $20 copay | $15 copay |
| Lab & X-ray | $10 per encounter | $15 per encounter |
| Urgent Care | $20 copay | $15 copay |
| Emergency Room* | 20% after deductible | 20% |
| Inpatient & Outpatient Hospital Services | 20% after deductible | 20% |
| Outpatient Mental Health Services | $20 copay | $15 copay |
| Chiropractic & Acupuncture (20 annual visits, combined limit) |
$15 copay | $15 copay |
| Comprehensive Infertility Services (Deductible waived, not subject to OOPM) |
50% Limited to one treatment cycle per lifetime. | Cost varies depending on service. Please refer to your plan documents for details. |
| Retail (up to a 30-day supply)** | ||
| Generic | $10 copay | $10 copay |
| Preferred Brand | $30 copay | $45 copay |
| Non-Preferred Brand | $30 copay | $45 copay |
| Specialty | 20% to $250 max | $200 copay |
| Mail Order (up to a 90-day supply)** | ||
| Generic | $20 copay | $20 copay |
| Preferred Brand | $60 copay | $90 copay |
| Non-Preferred Brand | $60 copay | $90 copay |
*Out-of-network care is covered for emergency room services.
**Review the list of Kaiser covered medications at Kaiser HMO Formulary List.
Insurance coverage can be complicated. Aetna Health Concierge can help you navigate the healthcare system when you need it most.
Benefit Concierge Services:
Your personal assistant will help you find care solutions that fit your needs and your budget.
Call 1-833-915-3870 to get connected.
Aetna Specialized Personal Health Advocate Aetna’s Specialized Personal Health Advocate is like having a healthcare expert just for you. With this program, you can get personalized support and care. Whether you’re exploring fertility options, need help with a premature baby, are looking for services related to gender-affirming care, need support for your emotional wellbeing, or would like to explore genetic condition testing and counseling, we’ve got you covered. Call the Concierge toll-free at 1-833-915-3870 and a Concierge representative can assist with connecting you to an appropriate personal health advocate.
Transform Oncology works with Aetna to assist you after a cancer diagnosis. Here’s what you may be eligible for:
Reach out to an Aetna Personal Navigator if you need assistance. Look for the “Request a call” button in the digital Cancer Support Center within Aetna Health.
Hinge Health helps you move better, reduce pain, and improve your quality of life—at no cost to you. This digital program, fully covered for employees and dependents 18+ on an Aetna medical plan, provides personalized support for chronic pain, peak performance, and women’s pelvic health, including care for pelvic floor disorders at any stage of life.
If you have questions, call 1-855-902-2777 or email hello@hingehealth.com. You can also visit hinge.health/ericssonenterprise to request a call with a Hinge Health professional.
Get convenient care for your mental and physical health—all in one place. From annual wellness exams to menopause support, reproductive health, and counseling, MinuteClinic offers more than 195 in-person and virtual services. Get started at cvs.com/content/womens-health-services.
Relief from menopause symptoms is just a click away. Gennev connects you with board-certified OB/GYNs and Registered Dietitian Nutritionists for personalized treatment plans, telehealth visits, and evidence-based care—available in all 50 states. Get started today at gennev.com.
Take control of perimenopause and menopause with Midi’s expert clinicians. Receive personalized Care Plans that may include prescriptions, supplements, lifestyle coaching, and ongoing support—all virtually. Visit joinmidi.com to learn more.
When choosing a medical plan, consider the premium costs, out-of-pocket expenses, and Enterprise Wireless Solutions HSA contribution. Let’s compare how the Choice POS and the Healthfund Plan (HSA Qualified) plans cover different scenarios. Please note, the following scenarios are fictitious examples and to be used for illustration only; actual costs may vary.
Employee Only, Low Plan Usage
Overall Health: Generally healthy with preventive care needs and one ongoing preventive medication.
Noah is in good health and focuses on preventive care. He schedules his annual wellness exam and recommended preventive screenings each year, which are covered at 100% under both plans. He also takes one preferred brand preventive medication each month to help manage a chronic condition.
What Noah Wants Most in a Plan: Lower overall costs while preparing for future healthcare expenses
| Estimated Treatments* | Aetna Choice POS | Aetna Healthfund Plan |
|---|---|---|
| In-Network Preventive Visits (Covered at 100%) | $0 | $0 |
| Annual Prescription Cost – Preferred Brand ($92/prescription) | $540.00 ($45 copay x 12 prescriptions) |
$220.80 ($18.40 x 12 prescriptions) Pay 20% (deductible waived) of the cost of the drug ($92) for certain preventive medications |
| Total Spent at Time of Care | $540.00 | $220.80 |
| HSA Employer Contribution | N/A | $1,250.00 Noah uses $220.80 of his employer HSA contribution to pay for the Total Spent at Time of Care and saves the remaining $1,029.20 for future medical expenses |
| Annual Premium Cost for Employee Only Coverage | $1,603.42 ($61.67 x 26 pay periods) |
$1,318.46 ($50.71 x 26 pay periods) |
| Noah’s Total Cost | $2,143.42 | $1,318.46 |
*The numbers used are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary.
Plan Selection: Noah chooses the Aetna Healthfund Plan. Here’s why:
Employee + Spouse, Moderate Plan Usage
Overall Health: Manages a few ongoing health conditions, sees her primary care provider regularly, and takes multiple maintenance medications.
Melissa and her husband visit their doctors several times a year for routine follow-up appointments. Melissa takes two brand-name maintenance medications each month to help manage a thyroid autoimmune condition and ADHD. They prefer the predictability of set copays for office visits and prescriptions instead of paying the full cost of care until meeting a deductible.
What Melissa Wants Most in a Plan: Convenience over cost
| Estimated Treatments* | Aetna Choice POS | Aetna Healthfund Plan |
|---|---|---|
| In-Network Preventive Visits (Covered at 100%) | $0 | $0 |
| Primary Care Doctor Visits (6 visits at $120 per office visit) | $210.00 ($35 copay x 6 visits) |
$720.00 ($120 x 6 visits) Pay the full cost until deductible is met |
| Annual Prescription Cost – Non-Preferred Brand (2 prescriptions: Aetna Choice $70 copay for each Rx; Aetna Healthfund: $100 each Rx, applied to deductible) | $1,680.00 ($70 copay x 24 prescriptions) |
$2,400.00 ($100 x 24 prescriptions) Pay the full cost until deductible is met |
| Total Spent at Time of Care | $1,890.00 | $3,120.00 |
| HSA Employer Contribution | N/A | $2,500.00 Melissa could use her HSA funds to help pay for Total Spent at Time of Care, with only $620 coming from her pocket. |
| Annual Premium Cost for Employee + Spouse Coverage | $4,275.18 ($164.43 x 26 pay periods) |
$3,042.26 ($117.01 x 26 pay periods) |
| Melissa’s Total Cost | $6,165.18 | $3,662.26 |
*The numbers used are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary.
Plan Selection: Melissa chooses the Aetna Choice POS. Here’s why:
Employee + Family, High Plan Usage
Overall Health: Generally healthy with a family and occasional unexpected medical needs.
Ethan and his spouse have two active children who enjoy sports and outdoor activities. Throughout the year, the family has a few unexpected medical needs, including emergency room visits for injuries. One child recently needed surgery, resulting in a short hospital stay. Ethan and his family want a plan that helps them manage larger healthcare expenses while also allowing them to save for future medical needs.
What Ethan Wants in a Plan: Plan for today, save for tomorrow
| Estimated Treatments* | Aetna Choice POS | Aetna Healthfund Plan |
|---|---|---|
| In-Network Preventive Visits (Covered at 100%) | $0 | $0 |
| Emergency Room Visits (2 visits at $3,400 per visit) | $1,660.00 ($150 copay + 20% of the remaining cost, deductible waived) |
$4,560.00 (full cost until deductible is met, then 20%) |
| Primary Care Visits for Children (5 visits at $120 per visit) | $175.00 ($35 x 5 visits) | $120.00 (20% coinsurance) |
| Hospitalization ($5,000 for the entire stay) | $1,800.00 ($1,000 deductible, then 20% coinsurance) |
$1,000.00 (20% coinsurance, deductible already met) |
| Total Spent at Time of Care | $3,635.00 | $5,680.00 |
| HSA Employer Contribution | N/A | $2,500.00 Ethan uses his HSA funds to help pay for Total Spent at Time of Care, with only $3,180 coming from his pocket. |
| Annual Premium Cost for Employee + Family Coverage | $8,829.08 ($339.58 x 26) |
$5,517.98 ($212.23 x 26) |
| Ethan’s Total Cost | $12,464.08 | $8,697.98 |
*The numbers used are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary.
Plan Selection: Ethan chooses the Aetna Healthfund Plan. Here’s why: