Medical Plan Options

We’re proud to offer you three Aetna medical plans designed to help you and your family get the care you need at an affordable price. Find a provider at aetna.com. If you have questions about your Aetna coverage, call Car Toys’ dedicated Aetna concierge line at 833-313-1969.

Preferred Provider Organization (PPO)

The PPO plans offer the flexibility to choose an in-network or out-of-network provider each time you need care. Keep in mind, you will save money when you visit in-network providers. Office visits, specialist visits, and urgent care visits are subject to a copay with some limitations. Other services are subject to coinsurance after your deductible is met.

Qualified High Deductible Health Plan (QHDHP) with Health Savings Account (HSA)

The QHDHP with HSA plan pairs a Qualified High Deductible Health Plan with a Health Savings Account. With this plan, you are responsible for most expenses, up to the calendar year deductible. After you meet the calendar year deductible, you will share a percentage of the expenses, known as coinsurance. The out-of-pocket maximum limits the total amount you could be responsible for in a given year. When you enroll in the QHDHP with HSA plan, you are eligible to open an HSA to set aside pre-tax dollars to pay for medical, prescription drug, dental, and vision care needs. You can even use it to cover the expenses of your spouse and dependents, even if they are not on your plan.

Plan Features	Silver Plan Aetna PPO		Gold Plan Aetna PPO		Premier HSA Plan Aetna QHDHP with HSA
	In-Network	Out-of- Network	In-Network	Out-of- Network	In-Network	Out-of- Network
Calendar Year Deductible Individual/Family	$4,500 / $13,500	$8,500 / $25,500	$3,000 / $9,000	$5,500 / $16,500	$2,250 / $4,500	$4,000 / $8,000
Calendar Year Out-of-Pocket Maximum Individual/Family	$8,200 / $16,400	$16,400 / $32,800	$8,200 / $16,400	$16,400 / $32,800	$5,000 / $10,000	$10,000 / $20,000
Car Toys Annual HSA Contribution Individual/Individual + 1 or more (Family)	N/A		N/A		$1,000 / $1,200
	You pay:		You pay:		You pay:
Preventive Care	Covered in full	50% after deductible	Covered in full	50% after deductible	Covered in full	50% after deductible
Virtual Visit	$55 copay (dw)	Not available	$45 copay (dw)	Not available	20% after deductible	Not available
Primary Care Visit	Visits 1-3: $55 copay (dw) Visits 4+: 30% after deductible	50% after deductible	Visits 1-6: $45 copay (dw) Visits 7+: 20% after deductible	50% after deductible	20% after deductible	50% after deductible
Specialist Visit	$70 copay then 30% after deductible	50% after deductible	$60 copay then 20% after deductible	50% after deductible	20% after deductible	50% after deductible
Retail Walk-in Clinic	$55 copay then 30% after deductible	Not covered	$45 copay then 20% after deductible	Not covered	20% after deductible	Not covered
Urgent Care	$70 copay then 30% after deductible	50% after deductible	$60 copay then 20% after deductible	50% after deductible	20% after deductible	50% after deductible
Emergency Room	$100 copay then 20% after deductible	$100 copay then 20% after deductible	20% after deductible	20% after deductible	20% after deductible	20% after deductible
Outpatient Rehab (20 visits/year)	$70 copay then 30% after deductible	50% after deductible	$60 copay then 20% after deductible	50% after deductible	20% after deductible	50% after deductible
Inpatient Hospital Services	$200 copay then 30% after deductible	50% after deductible	$200 copay then 20% after deductible	50% after deductible	20% after deductible	50% after deductible
Outpatient Mental Health	$55 copay (dw)	50% after deductible	$45 copay (dw)	50% after deductible	20% after deductible	50% after deductible
Chiropractic Care (20 visits/year)	$70 copay then 30% after deductible	50% after deductible	$60 copay then 20% after deductible	50% after deductible	20% after deductible	50% after deductible
Prescription Drugs: Retail (up to a 30-day supply)
Generic	$30 copay	40%	$25 copay	40%	20% after deductible
Preferred Brand-Name	$70 copay	40%	$60 copay	40%
Non-Preferred Generic & Brand-Name	50% (dw)	40%	50% (dw)	40%
Specialty	30% ($150 max)	Not covered	30% ($150 max)	Not covered
Prescription Drugs: Mail Order (up to a 90-day supply)
Generic	$60 copay	Not covered	$50 copay	Not covered	20% after deductible	Not covered
Preferred Brand-Name	$120 copay		$100 copay
Non-Preferred Generic & Brand-Name	50% (dw)		50% (dw)

Save $$ with the Prescription Mail Order Program

Through Aetna Rx Home Delivery, prescription home delivery services help reduce trips to the local pharmacy and save you money with discounted prices. You can receive up to a 90-day supply—usually at a lower cost than you would pay at a retail pharmacy. Only certain prescription drugs are available through mail order. Please visit aetna.com for more information. Note: If you purchase a prescription drug from an out-of-network pharmacy, you are responsible for any difference between what the out-of-network pharmacy charges and the amount Aetna would have paid for the same drug product dispensed by an in-network pharmacy. Review the Benefit Guide or benefit summaries for detailed information on your medical plans.

Medical Coverage Video