Plan Overview & Documents
2022-2023 plan documents
2021-2022 plan documents
- SHP Summary of Benefits and Coverage (pdf) – 6-page chart explaining your SHP benefits
- SHP Certificate of Coverage (pdf) - 128- page document with complete details about SHP
*For an accommodation for this PDF, please contact firstname.lastname@example.org.
Cost Sharing for Medical Services
- Typical copays at other participating ("in-network") providers:
- $25 for routine medical visits (tests and procedures will cost more)
- $50 for urgent care visits (tests and procedures will cost more)
- $10 for mental health visits
- Emergency room care carries a $100 copay
- No copay for medically necessary ambulance transports
For summary information on other services and services at out-of-network providers, refer to your 6-page SHP Summary of Benefits and Coverage. You can log in to the Aetna member website for cost estimates for common procedures, diagnostic tests, and office visits.