Plan Overview & Documents

2024-2025 Plan Documents

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.