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Voluntary Fixed Benefits Plan


Have you ever skipped a doctor’s visit because you didn’t have insurance? Or let an illness go untreated? Or bought over-the-counter medicine instead of getting a prescription?

If any of these sound familiar, and if most of your medical expenses are for minor illnesses or injuries, the Aetna Voluntary Fixed Benefits Plan may be right for you.

The Voluntary Fixed Benefits Plan pays fixed cash payments for a wide range of covered services – such as doctor visits, outpatient procedures, prescriptions and more. These payments can be made directly to you or your health care provider, your choice.

Why consider a Voluntary Fixed Benefits Plan from Aetna?

  • Affordable prices at group rates
  • Cash payments to you or your doctor
  • Discounts from Aetna’s large, nationwide provider network
  • Easy payroll deduction

 

Coverage for a wide range of services*
While the Voluntary Fixed Benefits Plan is not traditional comprehensive medical coverage it still provides benefits to help with your health care needs. These include:

  • Inpatient benefits – Pays a fixed-dollar benefit per admission, plus a fixed-dollar benefit for each day you spend in the hospital up to a set number of days per year. There are also fixed-dollar benefits for physician services, surgery and anesthesia while you are in the hospital.
  • Outpatient benefits – Pays a fixed-dollar benefit for office visits, X-ray and lab services, outpatient anesthesia and surgery, emergency room and ambulance services, up to a set number of services per year.
  • Wellness benefits – Pays a fixed-dollar benefit for preventive services like an annual physical, gynecological exam, or well-baby or well-child visit, up to a set number of services per year.
  • Accident benefits – Pays a fixed-dollar benefit for injuries from an off-the-job accident.
  • Prescription drug benefits – Pays a fixed-dollar benefit for prescription drugs, up to a set number of monthly prescriptions per year.


The plan also includes additional features like:

  • Employee Assistance Program (EAP) – Pays for counseling services and other resources for you and your family to help with issues like substance abuse, workplace conflicts, marital strain, financial concerns and more.
  • Informed Health® Line – Allows you to speak to a registered nurse or access online information on thousands of health conditions and medications.
  • Online tools and information – Gives you access to a wealth of information to help you get the most for your health care dollars.
  • Discount programs – Provides discounts on a whole range of products and services, including gym memberships, weight-loss programs, hearing exams and devices, eye exams and lenses, acupuncture, vitamins, massage therapy and more!

*Please refer to your Benefits Summary for the dollar amount and service limits of your specific plan.

See any doctor – the choice is yours!
Doctors who participate in the Aetna network have negotiated their fees in advance, so your cost is generally lower when you use a physician in the Aetna network. However, you can visit any licensed doctor or specialist you wish – the choice is yours!

It’s important to remember, regardless of whether you use health care providers that are in the Aetna network or not, you may be required to pay the full amount of the bill at the time of service. The insurance plan pays the fixed benefit amount after you submit a claim. (Some doctors may submit your claims for you, and you can authorize Aetna to pay the fixed benefit directly to them if you wish.)

The Aetna Voluntary Fixed Benefits Plan – 
a simple, affordable way to help with your health care needs.

Talk to your employer about adding this plan to your benefits package.                  

The Aetna Voluntary Fixed Benefits Plan is underwritten by Aetna Life Insurance Company (Aetna). This plan is administered by Strategic Resource Company (SRC). 

This material is for information only. Health insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetna.com. 

Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Health insurance plans contain exclusions and limitations.

Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Aetna may receive a percentage of the fee you pay to the discount vendor. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Information is believed to be accurate as of the production date; however, it is subject to change.

The Aetna Voluntary Fixed Benefits Plan does not cover all health care expenses and has exclusions and limitations. Members should refer to their booklet certificate to determine which health care services are covered and to what extent. The following is a partial list of services and supplies that are generally not covered. However, your plan may contain exceptions to this list based on state mandates or the plan design purchased. Aetna Voluntary Fixed Benefits Plan exclusions:
  • Cosmetic surgery, including breast reduction
  • Custodial care
  • Experimental and investigational procedures
  • Infertility services, including but not limited to artificial insemination, advanced reproductive technologies, donor egg retrieval and reversal of sterilization
  • Nonmedically necessary services or supplies
  • Services received outside the United States
  • Services for education, special education or job training, whether or not given in a facility that also provides medical or psychiatric treatment

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