2024 Archdiocese of Atlanta / Lay Employee Quick Guide - Flipbook - Page 9
Your plan features a POS Network
Your Point of Service (POS) network negotiates contracts with physicians and other certified healthcare
providers. Under these contracts, providers furnish medical services for predetermined prices that are lower
than they would normally charge. This means cost savings for you! These providers are called participating or
in-network providers.
Using your POS network is convenient and easy.
Participating providers are conveniently located in urban and rural areas.
Emergency care and affiliated providers.
Treatment in a hospital emergency room, including professional services will be payable as shown in the
Schedule of Medical Benefits in the Plan Document.
Freedom from claim forms.
You won’t need to complete claim forms or other paperwork when you visit a participating provider. Just pay
your co-pay, and you’re on your way!
If you use a non-participating provider, you may be required to cover the cost of the service and then submit
your claim to the address on the back of your Archdiocese Health ID card.
(like mammograms, including 3-D mammograms and colonoscopy)
at 100% without having to meet your deductible when you use an in-network
provider; and routine exams are covered in your in-network physican's office
with an office visit co-pay, without having to meet your deductible?
Telemedicine Coverage
Telemedicine is the practice of using technology (video conferencing, email and/or telephone calls) to
deliver medical care at a distance. The plan will cover primary care physician (PCP) and specialist
telemedicine calls and appointments at the office visit co-pay. Use the Provider Directory to check if your
provider offers telemedicine.
Hearing aid benefit
The Group Health program covers hearing aids as prescribed by a physician or audiologist. The maximum
benefit is $4,000 ($2,000/ear, if done individually) and is available once every four years.
Finding a Network Provider
To determine a provider’s participation in your POS network, access the Provider Directory online or call
your Provider Participation line:
• Aetna: 1-800-343-3140
http://www.aetna.com/docfind/custom/mymeritain
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