I'm planning a trip out of the country. Will my health insurance cover me?
In a life- or limb-threatening emergency, you will be covered anywhere in the world as if you were at home. You may have to pay for services up front and file a claim for reimbursement from our insurance carrier upon your return.
Also covered are illnesses (i.e. strep throat) which are not life-threatening, but still need medical attention. The specific definition in the master plan document reads as follows, "An emergency medical condition is a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention could place their health in jeopardy. For example, you get strep throat. While it is not life threatening, treatment is required. Preferred benefits would be applied because treatment was necessary."
Example: You take a trip to Italy and decide that you will have your annual physical, get a flu shot, or some other type of routine care. This would NOT be covered under the circumstances.
The defining key to remember is that the medical service you receive while away from home will not be covered if it is ROUTINE in nature. This applies to the POSII and the Aetna Select plans.
What if I'm on vacation out of state and my child has a medical emergency (bad cold, fever, severe allergy attack)?
Aetna Select Plan members: Call Member Services or go online to Aetna Navigator and ask for the nearest in-network Urgent Care facility or participating medical provider.
POS II members: Same as above – OR, you may visit the nearest medical provider who may be IN or OUT of network.