Updates For January 1, 2023 - December 31, 2023
Updates For January 1, 2023–December 31, 2023
Coverage for Implants Added to Aetna Dental Plans
Beginning on January 1, 2023, implant coverage has been added to the Aetna DPPO and Aetna DMO plans. Please review the 2023 plan summaries (under “Aetna Dental Plans” below) carefully, as certain restrictions apply.
Coverage for Acupuncture Added to Aetna Medical Plans
Beginning on January 1, 2023, the Aetna medical plans will cover acupuncture. The coverage is limited to 10 visits per calendar year:
- High Deductible Health Plan: member pays 10% coinsurance after the deductible has been satisfied.
- Network Core Plan: $30 copayment per visit.
- Choice Plan: in-network, $30 copayment per visit; out-of-network, member pays 30% coinsurance after the deductible has been satisfied.
Coverage for Hearing Aids Added to Aetna Medical Plans (sitused in New York)
Beginning on January 1, 2023, coverage under the Aetna medical plans will include hearing aids. The coverage is limited to 1 hearing aid per ear every 3 years.
- High Deductible Health Plan: member pays 10% coinsurance after deductible has been satisfied.
- Network Core Plan: covered at 100%.
- Choice Plan: in-network, member pays 15% coinsurance after deductible has been satisfied; out-of-network, member pays 35% coinsurance after deductible has been satisfied.
Aetna Telemedicine Through Teladoc
Aetna offers telemedicine services through Teladoc (PDF). Create an account via Aetna's Teladoc website or by calling 1 (855) 835-2362. For those enrolled in the Network Core or Choice Plans:
- General Medical follows the Primary Care Physician copayment - $30
- Behavioral Health follows the Behavioral Health office visit/outpatient copayment - $30
- Dermatology follows the Specialist copayment - $50
For those enrolled in the High Deductible Health Plan (HDHP), the amounts listed in the attached brochure will apply.
Aetna Prescription Drug Formulary
The Aetna formulary is called the Advanced Control Plan. Employees can check their medication by accessing the drug guide brochure (PDF).
Key for the Formulary:
- Generic (Tier 1): $20 copayment for a 30-day retail supply
PG = Preferred Generic
- Preferred Brand (Tier 2): $45 copayment for a 30-day retail supply
PB=Preferred Brand
- Non-Preferred (Tier 3): $70 copayment for a 30-day retail supply
NP=Non-preferred Brand and Generic**
- There is a $0 co-payment for generic preventive medications on this list (PDF).
- Aetna has several national chains in their Aetna National Pharmacy Network including CVS, Costco, Duane Reade, ShopRite, Stop and Shop, and Walgreens. Additionally, Aetna contracts with independent pharmacies.
- Mail order is available through Aetna Rx Home Delivery. Please enroll in mail order (PDF) if you would like to continue to participate and include a 90-day prescription from your doctor.
Consumer Core High Deductible Health Plan (HDHP) – 2023 Deductibles
The 2023 HSA deductibles will increase to $1,500 (individual) and $3,000 (family).
2023 HSA Contribution Limits
- Coverage Type: Individual $3,850
- Coverage Type: Family $7,750
PayFlex HSA Presentation (PDF)
PayFlex Mobile App for the HSA (PDF)
PayFlex HSA Fee Schedule (PDF)
Copayments for In-Network Mental Health and Substance Abuse (Outpatient) Visits
For the Network Core and Choice Plan medical plans, in-network mental health and substance abuse outpatient visits continue to be covered at the primary office visit copayment ($30) in 2023.
2023 Health Care FSA and Dependent Care FSA Limits
- The limit for the Health Care FSA (January 1, 2023–December 31, 2023) has increased to $3,050 ($127.08 per paycheck).
- The limit for the Dependent Care FSA (January 1, 2023–December 31, 2023) is unchanged at $5,000 ($208.33 per paycheck); $2,500 ($104.16 per paycheck) if both spouses contribute via separate employers.
You must enroll, during each Open Enrollment period, in order to participate in an FSA for the new plan year.
Eligible Expense Items List (scroll down to “Find Out if an Expense is Eligible”)