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Plan Overview & Documents

2022-2023 plan documents

2021-2022 plan documents

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.

ID cards

COVID-19 testing/treatment

Finding participating providers

Prescription coverage