What is a High-Deductible Health Plan (HDHP) & How Does it Work?

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<li class="megamenumobile__tertiary--item"> <a class="megamenumobile__tertiary--link" href="/individuals-families/member-rights-resources.html" data-linklocation="Navigation" data-linktype="Regular" data-modal="Please Select">Health insurance rights and resources </a> </li> <li class="megamenumobile__tertiary--item"> <a class="megamenumobile__tertiary--link" href="https://www.aetna.com/about-us/contact-aetna.html#tab_content_section_responsivegrid_202619046_responsivegrid_tabs_link_tabs_1" data-linklocation="Navigation" data-linktype="Regular" data-modal="Please Select">Contact us </a> </li> <li class="megamenumobile__tertiary--item"> <a class="megamenumobile__tertiary--link" href="/faqs-health-insurance.html" data-linklocation="Navigation" data-linktype="Regular" data-modal="Please Select">Frequently asked questions </a> </li> <li class="megamenumobile__tertiary--item"> <a class="megamenumobile__tertiary--link" href="/individuals-families/prior-authorization-guidelines.html" data-linklocation="Navigation" data-linktype="Regular" data-modal="Please Select">Prior authorization guidelines </a> </li> </ul> </nav> </div> </li> <li class="megamenumobile__secondary--item"> </li> </ul> </nav> </div> </section> <section class="megamenumobile__panel--tertiary" id="idMegamenumobile__panel--tertiary"> </section> </div> </div> </div> </div> </div> <main> <div class="content_section" id="content__main"> <div class="pageherobanner"> <div class="hero_banner_ps_wrapper hero_banner_secondary "> <div class="hb_image "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/redesign/hero/20220911_CVS_Womens_Health_Day2_0547_T6_929872_1800x420.jpg" alt width="1800" height="420"/> </div> <div class="hb_content"> <div class="container"> <div class="row"> <div class="col-sm-12 col-md-11 col-lg-5 hb_content--wrapper"> <div class="hb_white_box "> <h1 class="hb_white_box_title page__title__hero">A simple guide to high-deductible health plans</h1> <div class="hb_white_box_subcopy rte-component-wraper mb-0"><p>Wondering if a high-deductible health plan (HDHP) is right for you? We’re here to answer your questions and help make your health care journey a little easier.</p> </div>    <div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="breadcrumb"> </div> <div class="responsivegrid"> <div> <div class="container "> <div class="row"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 aem-Grid--md--12 aem-Grid--xs--12 "> <div class="text aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--xs--none aem-GridColumn--default--6 aem-GridColumn--offset--default--0 aem-GridColumn--xs--12"><div class="rte-component-wraper component--default "> <h2><span class="title__block">What is an HDHP, and how does it work?</span></h2> <p> </p> <p>An HDHP has a higher deductible than a typical health plan. That simply means you pay out of pocket for your medical expenses until you reach a certain amount. Then, your plan begins to pay.</p> <p> </p> <p><strong>Savings tip:</strong> HDHPs have lower premiums. That means you pay less every month for your plan. Plus, you’re covered for many preventive services and screenings at no cost without having to meet your deductible.</p> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-extra-small "> </span> </div> <div class="table aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--10 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"><div class="cmp-table"> <div class="cmp-table__results"> <table class="cmp-table__results-table d-none d-md-table cmp-table__results-table-drop-shadow"> <thead> <tr class="cmp-table__results-table--heading heading-with-bg "> <th scope="col" class="thead-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>How it works</strong></p> </div> </div> </div> </th> <th scope="col" class="thead-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>You pay</strong></p> </div> </div> </div> </th> <th scope="col" class="thead-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Your plan pays</strong></p> </div> </div> </div> </th> </tr> </thead> <tbody class="cmp-table__result-table--body"> <tr class="row-variation"> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>First, you pay all your medical costs</strong><br /> When the plan year begins, you pay the full cost of your care until you reach a fixed dollar amount. (This is your deductible.)</p> </div> </div> </div> </td> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p>100%</p> </div> </div> </div> </td> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p>0%</p> </div> </div> </div> </td> </tr> <tr class="row-variation"> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Next, you and your plan share medical costs</strong><br /> After you meet your deductible, you pay a smaller portion of your medical costs. (This is your coinsurance.) Your plan pays the rest.</p> </div> </div> </div> </td> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p>20%*</p> </div> </div> </div> </td> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p>80%*</p> </div> </div> </div> </td> </tr> <tr class="row-variation"> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Then, your plan pays for all of your covered medical costs</strong><br /> Once you meet your out-of-pocket maximum (this is your deductible plus coinsurance limit), your plan pays for all covered medical services in full.</p> </div> </div> </div> </td> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p>0%</p> </div> </div> </div> </td> <td class="body-content-values"> <div> <div class="text"><div class="rte-component-wraper component--default "> <p>100%</p> </div> </div> </div> </td> </tr> </tbody> </table> <table class="cmp-table__results-table-mobile cmp-table__results-table-mobile-drop-shadow d-md-none d-table heading-with-bg"> <tbody class="cmp-table__results-table-mobile__inner"> <tr class="mobile-row mobile-row__first"> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>How it works</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>First, you pay all your medical costs</strong><br /> When the plan year begins, you pay the full cost of your care until you reach a fixed dollar amount. (This is your deductible.)</p> </div> </div> </div></td> </tr> <tr class="mobile-row "> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>You pay</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p>100%</p> </div> </div> </div></td> </tr> <tr class="mobile-row "> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Your plan pays</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p>0%</p> </div> </div> </div></td> </tr> <tr class="mobile-row mobile-row__first"> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>How it works</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Next, you and your plan share medical costs</strong><br /> After you meet your deductible, you pay a smaller portion of your medical costs. (This is your coinsurance.) Your plan pays the rest.</p> </div> </div> </div></td> </tr> <tr class="mobile-row "> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>You pay</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p>20%*</p> </div> </div> </div></td> </tr> <tr class="mobile-row "> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Your plan pays</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p>80%*</p> </div> </div> </div></td> </tr> <tr class="mobile-row mobile-row__first"> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>How it works</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Then, your plan pays for all of your covered medical costs</strong><br /> Once you meet your out-of-pocket maximum (this is your deductible plus coinsurance limit), your plan pays for all covered medical services in full.</p> </div> </div> </div></td> </tr> <tr class="mobile-row "> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>You pay</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p>0%</p> </div> </div> </div></td> </tr> <tr class="mobile-row "> <th scope="row"><div> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>Your plan pays</strong></p> </div> </div> </div></th> <td class="row-variation"><div> <div class="text"><div class="rte-component-wraper component--default "> <p>100%</p> </div> </div> </div></td> </tr> </tbody> </table> </div> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-small "> </span> </div> <div class="text aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--xs--none aem-GridColumn--default--6 aem-GridColumn--offset--default--0 aem-GridColumn--xs--12"><div class="rte-component-wraper component--default "> <p><span class="title--secondary">Everyone’s health needs are different</span></p> <h2><span class="title__block">We’ll help you decide if an HDHP is right for you</span></h2> </div> </div> <div class="tabs aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--xs--none aem-GridColumn--offset--md--0 aem-GridColumn--default--12 aem-GridColumn--offset--default--0 aem-GridColumn--xs--12 aem-GridColumn--md--none aem-GridColumn--md--12"><div class="tabsComponent component--fullwidth " data-cmp-is-async="tabs" data-content-well="yes"> <div class="tabs__container"> <button class="tab__item tab__item--active" role="tab" id="content_section_responsivegrid_responsivegrid_tabs_link_tabs_1" aria-selected="true" tabindex="0" aria-controls="1889005571_panel_1"> <span class="link__tab">Top advantages</span> </button> <button class="tab__item " role="tab" id="content_section_responsivegrid_responsivegrid_tabs_link_tabs_2" aria-selected="false" tabindex="-1" aria-controls="1889005571_panel_2"> <span class="link__tab">Things to consider</span> </button> </div> <div class="content__section "> <section class="content tab__panel tab__panel--dropShadow tab__panel--active"> <div class="title--secondary tab__panel--mobile-btn" role="heading" aria-level="3" aria-controls="1889005571_panel_1"> <button type="button" aria-expanded="true">Top advantages</button> </div> <div id="1889005571_panel_1" role="tabpanel" aria-labelledby="content_section_responsivegrid_responsivegrid_tabs_link_tabs_1" class="content__component" tabindex="0"> <div class="responsive-row"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 aem-Grid--xs--12 "> <div class="text aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"><div class="rte-component-wraper component--default "> <h4><span class="title__block">Top 5 advantages of HDHPs</span></h4> <p> </p> <p>An HDHP may make sense for you if you’re rarely sick or injured but can afford the higher upfront costs if the unexpected happens. Benefits include:</p> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-extra-small "> </span> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Lower_health_spend.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>Lower monthly premiums</strong></h5> <p style="text-align: left;">You can have peace of mind knowing you’re paying less for monthly coverage.</p> </div> </div> </div> </div> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Cost_control.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>Lower medical expenses</strong></h5> <p style="text-align: left;">If you rarely need to see a doctor or use your benefits, you may spend less on your monthly insurance payment.</p> </div> </div> </div> </div> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Network_of_health_professionals.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>Quality care for less</strong></h5> <p style="text-align: left;">Our plans include a broad network of providers. When you choose providers in our network, you get special discounts.</p> </div> </div> </div> </div> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Pay_Your_Premium.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>An account to help you save on health expenses</strong></h5> <p style="text-align: left;">An HDHP is the only plan that can be paired with a <a href="/individuals-families/using-your-aetna-benefits/health-savings-account.html" target="_self" class="link__text--inline" data-analytics-name="health savings account (HSA)">health savings account (HSA)</a>. An HSA helps you save pre-tax money for health expenses like deductibles and coinsurance. Even prescriptions, dental care and eyewear.</p> </div> </div> </div> </div> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Thumbs_up.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>Savings for the future</strong></h5> <p style="text-align: left;">When you add money to your HSA, you lower your taxable income. Your earnings are tax free. And your HSA is always yours, even if you leave the plan.</p> </div> </div> </div> </div> </div> </div> </div> </div> </section> <section class="content tab__panel tab__panel--dropShadow "> <div class="title--secondary tab__panel--mobile-btn" role="heading" aria-level="3" aria-controls="1889005571_panel_2"> <button type="button" aria-expanded="false">Things to consider</button> </div> <div id="1889005571_panel_2" role="tabpanel" aria-labelledby="content_section_responsivegrid_responsivegrid_tabs_link_tabs_2" class="content__component" tabindex="-1"> <div class="responsive-row"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 aem-Grid--xs--12 "> <div class="text aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"><div class="rte-component-wraper component--default "> <h4><span class="title__block">Top things to consider about HDHPs</span></h4> <p> </p> <p>An HDHP may not make sense for everyone. You’ll want to consider your lifestyle and health needs. For instance, if you have young kids, get ongoing treatment for a condition or take several medications, your upfront costs may be higher. Here are other things to keep in mind:</p> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-extra-small "> </span> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Cholesterol_management.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>These plans have higher deductibles.</strong></h5> <p style="text-align: left;">That means you pay for doctor visits, tests and prescriptions until you meet your deductible, then and your plan begins to pay. If you have an individual plan, the minimum deductible is $1,500. If you have a family plan, the minimum deductible is $3,000.*</p> </div> </div> </div> </div> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Emergency_Care.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>Medical emergencies can happen.</strong></h5> <p style="text-align: left;">Even if you’re fairly healthy, health needs and emergencies can pop up. Are you prepared to pay your full deductible up front?</p> </div> </div> </div> </div> </div> <div class="icontext aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1"> <div class="texticon texticon__inherited "> <div class="texticon__container "> <div class="texticon__wrapper texticon__iconwrapper align-items-start"> <div class="texticon__icon "> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/pictograms_2021/Pictogram_onWhite_Lower_health_spend.svg" alt/> </div> <div class="texticon__text rte-component-wraper inherited justified--left"> <h5><strong>You may be tempted to put off important care.</strong></h5> <p style="text-align: left;">Some people might skip a trip to their doctor or the ER because of the upfront cost. The good news is that a <a data-analytics-name="health savings account" href="/individuals-families/using-your-aetna-benefits/health-savings-account.html" class="link__text--inline" target="_self">health savings account</a> can help you cover these costs.</p> </div> </div> </div> </div> </div> </div> </div> </div> </section> </div> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-small "> </span> </div> <div class="inline-cta aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn--md--8 aem-GridColumn aem-GridColumn--offset--md--2 aem-GridColumn--xs--none aem-GridColumn--default--5 aem-GridColumn--offset--default--3 aem-GridColumn--xs--12 aem-GridColumn--md--none"><div class=" inlineCTACont "> <div class="imgCont"> <img class=" lazyload" data-src="/content/dam/aetna/asset-libraries/icons_2021/icon_information.svg" alt/> </div><div class="textCont"> <h2 class="title--secondary__big">Other plans may be available to you</h2> <p>Want to explore other coverage options? We’ll explain the differences between HMO, PPO, and POS plans to help you choose.</p> <div class="component__cta"> <div data-cmp-is="cta"> <div class="cta__linkswrapper "> <a class="link__text type__link__text " href="/health-guide/hmo-pos-ppo-hdhp-whats-the-difference.html" data-modal="Please Select" data-linktype="Regular" target="_self" role="link" data-analytics-name="Get help comparing plans" data-linklocation="discoverable" data-ctahrefholder="/content/aetna/en/health-guide/hmo-pos-ppo-hdhp-whats-the-difference.html">Get help comparing plans</a> </div> </div> </div> </div> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-small "> </span> </div> <div class="text aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--xs--none aem-GridColumn--default--6 aem-GridColumn--offset--default--0 aem-GridColumn--xs--12"><div class="rte-component-wraper component--default "> <h2><span class="title--secondary">High deductible health plan FAQs</span></h2> <p><span class="title__block">Think insurance is confusing? We’re here to help.</span></p> </div> </div> <div class="separator aem-GridColumn aem-GridColumn--default--12"><span class="keyline tb-margin-extra-small "> </span> </div> <div class="accordioncore accordion aem-GridColumn--md--10 aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--default--7 aem-GridColumn--offset--md--1 aem-GridColumn--xs--none aem-GridColumn--xs--12 aem-GridColumn--offset--default--1 aem-GridColumn--md--none"> <div class="accordian no--container component--responsive" data-cmp-is-async="accordion"> <div class="row"> <div class="accordian__main col-12 "> <div class="accordian__wrapper"> <div class="accordian__element " data-cmp-hook-accordion="item"> <div class="accordian__title title--secondary "> <h3 class="accordian__heading-item core"> <button id="link_content_section_responsivegrid_responsivegrid_accordioncore_1" class="accordian__button" type="button" aria-controls="604226662_1_element" aria-expanded="false">How can I get coverage or change my plan?</button> </h3> </div> <div data-cmp-hook-accordion="panel" id="604226662_1_element" class="accordian__elemcontent core__elemcontent" aria-labelledby="link_content_section_responsivegrid_responsivegrid_accordioncore_1"><div class="accordioncontent"><div class="content_wrapper"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 "> <div class="text aem-GridColumn aem-GridColumn--default--12"><div class="rte-component-wraper component--default "> <p>Most people change their plans during Open Enrollment. This is a period that happens once a year when you can sign up for insurance. You can also adjust or cancel your plan.</p> <p> </p> <p>Have a big life change or one coming up? Certain events, like getting married or losing your coverage, qualify you for a Special Enrollment Period. That means you can enroll in a plan or change your plan outside Open Enrollment.</p> </div> </div> </div> </div></div> </div> </div> <div class="accordian__element " data-cmp-hook-accordion="item"> <div class="accordian__title title--secondary "> <h3 class="accordian__heading-item core"> <button id="link_content_section_responsivegrid_responsivegrid_accordioncore_2" class="accordian__button" type="button" aria-controls="604226662_2_element" aria-expanded="false">What does it mean when “it’s covered”?</button> </h3> </div> <div data-cmp-hook-accordion="panel" id="604226662_2_element" class="accordian__elemcontent core__elemcontent" aria-labelledby="link_content_section_responsivegrid_responsivegrid_accordioncore_2"><div class="accordioncontent"><div class="content_wrapper"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 "> <div class="text aem-GridColumn aem-GridColumn--default--12"><div class="rte-component-wraper component--default "> <p>If a service is covered, that means your health plan will pay for some or all the cost. With an HDHP, you’re covered for medical services after you meet your plan deductible.</p> <p> </p> <p>Covered services include:</p> <p> </p> <ul> <li>Doctor visits</li> <li>Emergency care</li> <li>Hospital stays</li> <li>Prescription drugs and more</li> </ul> </div> </div> </div> </div></div> </div> </div> <div class="accordian__element " data-cmp-hook-accordion="item"> <div class="accordian__title title--secondary "> <h3 class="accordian__heading-item core"> <button id="link_content_section_responsivegrid_responsivegrid_accordioncore_3" class="accordian__button" type="button" aria-controls="604226662_3_element" aria-expanded="false">Does an HDHP cover preventive care?</button> </h3> </div> <div data-cmp-hook-accordion="panel" id="604226662_3_element" class="accordian__elemcontent core__elemcontent" aria-labelledby="link_content_section_responsivegrid_responsivegrid_accordioncore_3"><div class="accordioncontent"><div class="content_wrapper"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 "> <div class="text aem-GridColumn aem-GridColumn--default--12"><div class="rte-component-wraper component--default "> <p>HDHPs typically cover in-network preventive care in full without having to meet your deductible. This benefit can help you save. That’s because it can help prevent or find health issues before they become more costly.</p> <p> </p> <p>Examples of preventive care include:</p> <p> </p> <ul> <li>Blood pressure, diabetes and cholesterol tests</li> <li>Routine prenatal and well-child care</li> <li>Flu shots and other routine vaccines</li> <li>Cancer screenings, including mammograms and colonoscopies</li> <li>Screening services for heart disease, infectious disease, mental health conditions, obstetric and gynecological conditions, and more</li> </ul> <p>Note: Preventive care does not include services to treat an existing illness, injury, or condition.</p> </div> </div> </div> </div></div> </div> </div> <div class="accordian__element " data-cmp-hook-accordion="item"> <div class="accordian__title title--secondary "> <h3 class="accordian__heading-item core"> <button id="link_content_section_responsivegrid_responsivegrid_accordioncore_4" class="accordian__button" type="button" aria-controls="604226662_4_element" aria-expanded="false">Why is staying in network important?</button> </h3> </div> <div data-cmp-hook-accordion="panel" id="604226662_4_element" class="accordian__elemcontent core__elemcontent" aria-labelledby="link_content_section_responsivegrid_responsivegrid_accordioncore_4"><div class="accordioncontent"><div class="content_wrapper"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 "> <div class="text aem-GridColumn aem-GridColumn--default--12"><div class="rte-component-wraper component--default "> <p>Choosing network providers can save you money. And here’s why: The providers in our network have agreed to special, contracted rates. That makes it less costly for you.</p> <p> </p> <p>Some plans include out-of-network coverage. Just keep in mind that providers who are not in our network are not contracted with us. And they may charge higher rates. Another thing to consider is that your out-of-network deductible is separate from your in-network deductible. So even if you’ve met your in-network deductible, you would still be responsible for the cost of any out-of-network care.</p> </div> </div> </div> </div></div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="disclaimer"><div class="cmp-disclaimer component--left" data-cmp-is-async="disclaimer"> <div class="container"> <div class="row"> <div class="col-md-10 disclaimer__parentContainer"> <div class="disclaimer__wrapper option-b"> <div class="row--inner"> <div class="disclaimer__contentwrapper "> <h2 class="title__section">Notes</h2> <div class="disclaimer__description"> <div class="rte-component-wraper component--default "> <p>*FOR COST-SHARING DETAILS: This is a typical example. 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Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?<br /> </p> <p><a data-analytics-name="back" data-linktype="Regular" href="/individuals-families/find-a-medication/2020-aetna-funding-advantage-small-group-value-plus-plan.html" class="link__text--back" target="_self">back</a></p> </div> </div> </div> <div class="component__cta "> <a href="#" class="modalContinueBtn btn--primary type__btn--primary ">Continue</a> </div> </div> </div> </div> </div> </div> <div class="interstitial section"><div class="aetna-modal" data-cmp-is="modal"> <div class="modal__box " id="applied-behavior-analysis" role="dialog" title="Applied Behavior Analysis Medical Necessity Guide" tabindex="-1" aria-labelledby="modal-heading-234773723"> <div class="modal__inner"> <button type="button" aria-label="Close" class="modal__close"></button> <div class="modal__content">  <h2 id="modal-heading-234773723" class="title__block center">Applied Behavior Analysis Medical Necessity Guide</h2> <div class="component__main"> <div class="text"><div class="rte-component-wraper component--default "> <p><strong>By clicking on “I Accept”, I acknowledge and accept that:<br /> </strong></p> <p>The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.</p> <p>Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.</p> <p>The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.</p> <p>Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change.</p> <p>Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law.</p> </div> </div> </div> <div class="component__cta "> <a href="#" class="modalContinueBtn btn--primary type__btn--primary ">I Accept</a> </div> </div> </div> </div> </div> </div> <div class="interstitial section"><div class="aetna-modal" data-cmp-is="modal"> <div class="modal__box " id="exit-cvs-caremark" role="dialog" title="Aetna® is proud to be part of the CVS® family." tabindex="-1" aria-labelledby="modal-heading-28807244"> <div class="modal__inner"> <button type="button" aria-label="Close" class="modal__close"></button> <div class="modal__content">  <h2 id="modal-heading-28807244" class="title__block ">Aetna® is proud to be part of the CVS® family.</h2> <div class="component__main"> <div class="text"><div class="rte-component-wraper component--default "> <p>You are now being directed to CVS Caremark<sup>®</sup> site.</p> </div> </div> </div> <div class="component__cta "> <a href="#" class="modalContinueBtn btn--primary type__btn--primary ">Continue</a> </div> </div> </div> </div> </div> </div> <div class="interstitial section"><div class="aetna-modal" data-cmp-is="modal"> <div class="modal__box modal--blocked " id="asam-modal" role="dialog" title="ASAM Terms and conditions" tabindex="-1" aria-labelledby="modal-heading-1817940071"> <div class="modal__inner"> <button type="button" aria-label="Close" class="modal__close"></button> <div class="modal__content">  <h2 id="modal-heading-1817940071" class="title__block ">ASAM Terms and conditions</h2> <div class="component__main"> <div class="text"><div class="rte-component-wraper component--default "> <p>By clicking on “I accept”, I acknowledge and accept that:</p> <p> </p> </div> </div> <div class="text"><div class="rte-component-wraper component--default "> <p>Licensee's use and interpretation of the American Society of Addiction Medicine’s ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits.</p> <p> </p> <p>This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose.</p> <p> </p> <p>Copyright 2015 by the American Society of Addiction Medicine. Reprinted with permission. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM.</p> </div> </div> </div> <div class="component__cta "> <a href="#" class="modalContinueBtn btn--primary type__btn--primary ">I accept</a> </div> </div> </div> </div> </div> </div> <div class="interstitial section"><div class="aetna-modal" data-cmp-is="modal"> <div class="modal__box modal--blocked " id="cpt-modal" role="dialog" title="Precertification lists" tabindex="-1" aria-labelledby="modal-heading-1737369633"> <div class="modal__inner"> <button type="button" aria-label="Close" class="modal__close"></button> <div class="modal__content">  <h2 id="modal-heading-1737369633" class="title__block ">Precertification lists</h2> <div class="component__main"> <div class="text"><div class="rte-component-wraper component--default "> <p>By clicking on “I accept”, I acknowledge and accept that:</p> <p> </p> </div> </div> <div class="text"><div class="rte-component-wraper component--default "> <p>Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept".</p> <p> </p> <ul> <li>The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members.</li> <li>Applies to: Aetna Choice<sup>®</sup> POS, Aetna Choice POS II, Aetna Medicare<sup>℠</sup> Plan (PPO), Aetna Medicare Plan (HMO), all Aetna HealthFund<sup>®</sup> products, Aetna Health Network Only<sup>℠</sup>, Aetna Health Network Option<sup>℠</sup>, Aetna Open Access<sup>®</sup> Elect Choice<sup>®</sup>, Aetna Open Access HMO, Aetna Open Access Managed Choice<sup>®</sup>, Open Access Aetna Select<sup>℠</sup>, Elect Choice, HMO, Managed Choice POS, Open Choice<sup>®</sup>, Quality Point-of-Service<sup>®</sup> (QPOS<sup>®</sup>), and Aetna Select<sup>℠</sup> benefits plans and all products that may include the Aexcel<sup>®</sup>, Choose and Save<sup>℠</sup>, Aetna Performance Network or Savings Plus networks. Not all plans are offered in all service areas.</li> <li>All services deemed "never effective" are excluded from coverage. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. Visit the secure website, available through www.aetna.com, for more information. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search."</li> <li>The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT<sup>®</sup>), copyright 2023 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians.</li> <li>The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply.</li> </ul> <p> </p> <h3><strong>LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT<sup>®</sup>")</strong></h3> <p> </p> <ul> <li>CPT only Copyright 2023 American Medical Association. All Rights Reserved. CPT is a registered trademark of the American Medical Association. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt.</li> </ul> <p> </p> <h3><strong>U.S. Government Rights</strong></h3> <p> </p> <ul> <li>This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.</li> </ul> <p> </p> <h3><strong>Disclaimer of Warranties and Liabilities.</strong></h3> <p> </p> <ul> <li>CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.</li> <li>This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.</li> <li>Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept".</li> <li>The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services.</li> <li>This information is neither an offer of coverage nor medical advice. It is only a partial, general description of plan or program benefits and does not constitute a contract. In case of a conflict between your plan documents and this information, the plan documents will govern.</li> </ul> </div> </div> </div> <div class="component__cta "> <a href="#" class="modalContinueBtn btn--primary type__btn--primary ">I accept</a> </div> </div> </div> </div> </div> </div> <div class="interstitial section"><div class="aetna-modal" data-cmp-is="modal"> <div class="modal__box modal--blocked " id="dcpb-modal" role="dialog" title="Dental clinical policy bulletins" tabindex="-1" aria-labelledby="modal-heading-1767983030"> <div class="modal__inner"> <button type="button" aria-label="Close" class="modal__close"></button> <div class="modal__content">  <h2 id="modal-heading-1767983030" class="title__block ">Dental clinical policy bulletins</h2> <div class="component__main"> <div class="text"><div class="rte-component-wraper component--default "> <p>By clicking on “I accept”, I acknowledge and accept that:</p> <p> </p> </div> </div> <div class="text"><div class="rte-component-wraper component--default "> <ul> <li>Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Treating providers are solely responsible for dental advice and treatment of members. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider.</li> <li>While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Your benefits plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government.</li> <li>Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change.</li> <li>Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies.</li> <li>Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met.</li> </ul> </div> </div> </div> <div class="component__cta "> <a href="#" class="modalContinueBtn btn--primary type__btn--primary ">I accept</a> </div> </div> </div> </div> </div> </div> <div class="interstitial section"><div class="aetna-modal" data-cmp-is="modal"> <div class="modal__box modal--blocked " id="mcpbs-modal" role="dialog" title="Medical clinical policy bulletins" tabindex="-1" aria-labelledby="modal-heading-1142802819"> <div class="modal__inner"> <button type="button" aria-label="Close" class="modal__close"></button> <div class="modal__content">  <h2 id="modal-heading-1142802819" class="title__block ">Medical clinical policy bulletins</h2> <div class="component__main"> <div class="text"><div class="rte-component-wraper component--default "> <p>By clicking on “I accept”, I acknowledge and accept that:</p> <p> </p> </div> </div> <div class="text"><div class="rte-component-wraper component--default " data-linklocationGeneral="discoverable"> <p>Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept".</p> <p> </p> <ul> <li>Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider.</li> <li>While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental, investigational, unproven, or cosmetic. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors).</li> <li>Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error.</li> <li>CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. New and revised codes are added to the CPBs as they are updated. When billing, you must use the most appropriate code as of the effective date of the submission. Unlisted, unspecified and nonspecific codes should be avoided.</li> <li>Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern.</li> <li>In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. </li> </ul> <p><a href="https://www.cms.gov/Center/special-topic/medicare-coverage-center.html" target="_blank" class="link__text" data-analytics-name="See CMS's Medicare Coverage Center" data-modal="exit" data-linktype="Regular">See CMS's Medicare Coverage Center</a></p> <p> </p> <ul> <li>Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change.</li> <li>Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. Under certain circumstances, your physician may request a peer to peer review if they have a question or wish to discuss a medical necessity precertification determination made by our medical director in accordance with Aetna’s Clinical Policy Bulletin.</li> <li>While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans.</li> </ul> <p><a href="/individuals-families/member-rights-resources/claims-coverage/aetna-external-review-program.html" target="_self" class="link__text" data-analytics-name="See Aetna's External Review Program" data-modal="Please Select" data-linktype="Regular">See Aetna's External Review Program</a></p> <p> </p> <ul> <li>The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT®), copyright 2015 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians.</li> <li>The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply.</li> </ul> <p> </p> <h3>LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT®")</h3> <p> </p> <p>CPT only copyright 2015 American Medical Association. All Rights Reserved. CPT is a registered trademark of the American Medical Association.</p> <p> </p> <p>You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT.</p> <p> </p> <p>Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt.</p> <p> </p> <p><a href="http://www.ama-assn.org/go/cpt" target="_blank" class="link__text" data-analytics-name="Go to the American Medical Association Web site" data-modal="exit" data-linktype="Regular">Go to the American Medical Association Web site</a></p> <p> </p> <h3><strong>U.S. Government Rights</strong></h3> <p> </p> <p>This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.</p> <p> </p> <h3><strong>Disclaimer of Warranties and Liabilities.</strong></h3> <p> </p> <p>CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.</p> <p> </p> <p>This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.</p> <p> </p> <p>Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept".</p> <p> </p> <p>The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services.</p> <p> </p> <p>This information is neither an offer of coverage nor medical advice. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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