Medical
Evoque offers a choice of three medical plans. While the plans differ in some respects, they have one important similarity — a focus on prevention.
All three plans are administered by Aetna and offer preventive care at no cost (in-network only) for prescription and vision coverage, help for plan participants managing chronic conditions and wellness-focused features. You can locate a doctor or facility through Aetna’s Find A Doctor Online Directory: aetna.com/docfind/home.do. Please keep in mind that the availability of any particular provider cannot be guaranteed.
EXCLUSIVE PROVIDER ORGANIZATION
With the Exclusive Provider Organization (EPO) option, you receive comprehensive coverage for a range of services. You must use in-network providers. There are no out-of-network benefits.
EPO at a Glance
- Moderate monthly contribution
- Low deductible and coinsurance
- No claim forms
- No out-of-network benefits
- The EPO utilizes the Open Access Aetna Select network
HIGH DEDUCTIBLE HEALTH PLAN
This plan is covered in two sections, the High Deductible Health Plan (HDHP) and the Health Savings Account (HSA).
The HDHP is similar to the PPO in that you have the option to choose any provider when you need care. However, in exchange for a lower per-paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs.
With lower premiums and an out-of-pocket cap mandated by federal law, HSA-compatible health insurance like the Brookfield HDHP typically saves money compared to a PPO for both high- and low-frequency users of health care.
HDHP at a Glance
- Lower monthly contribution
- Freedom to go out-of-network
- No claim forms for in-network services
- Participants responsible for amounts up to deductible and out-of-network charges in excess of Aetna contracted rates
- The HDHP utilizes the Aetna Choice POS II network
If you select the High Deductible Health Plan, you may be eligible to participate in a Health Savings Account.
PREFERRED PROVIDER ORGANIZATION
The Preferred Provider Organization (PPO) option offers the freedom to see any provider when you need care. When you use providers from within the Aetna PPO network, you receive benefits at the discounted network cost.
PPO at a Glance
- Higher monthly contribution
- Freedom to go out-of-network
- No claim forms for in-network services
- Participants responsible for amounts up to deductible and out-of-network charges in excess of Aetna contracted rates
- The PPO utilizes the Aetna Choice POS II network
MEDICAL PLAN ENHANCEMENTS
Our benefits program includes new covered medical procedures and health aids, through health plans designed to meet the diverse needs of our team members. Read on to see what’s new from your Evoque Health Benefits in 2023.
Hinge Health
It can be difficult to manage chronic pain. Evoque is offering Hinge Health at no additional cost for those enrolled in an Evoque medical plan. Hinge Health is a digital exercise therapy program for back, knee, hip, neck or shoulder pain. It features wearable motion sensors to guide you through the program, a library of educational resources and a personalized health coach who will be there to support you every step of the way. To learn more, call 855-902-2777 or email help@hingehealth.com.
Teladoc
If you enrolled in an Aetna medical plan through Evoque, you have access to Teladoc. Teladoc allows you to get 24/7 access to board-certified doctors and pediatricians by online video, phone or mobile app. There’s no need to hassle with waiting rooms, and it’s a fraction of the cost of an urgent care visit. You can also receive behavioral health care through Teladoc at no cost to you if you’re in the EPO or PPO plan; subject to deductible, no coinsurance, in the HDHP per IRS guidelines. To get started, go online to www.teladoc.com/Aetna and register.
Progyny Family Building
Evoque wants to support you on your path to parenthood. That’s why we’re offering Progyny. Progyny’s mission is to make your dream of parenthood come true through a healthy, timely and supported fertility journey. Progyny’s Smart Cycle benefit supports all paths to parenthood and connects you to a dedicated patient advocate who will guide you throughout the process. With best-in-class fertility specialists and an integrated pharmacy solution, you have access to the most advanced, effective fertility treatment possible. Your coverage includes three Smart Cycles of integrated medical and prescription fertility treatments. To get started, call 844-930-3356.