Take a quick look at key features of the CRC Retiree Medical Plan. For details, see the summary plan description.
| Benefits | |
|---|---|
| In-Network | |
Annual Deductible |
|
| Individual | $300 |
| Family | $600 |
Out-of-Pocket Maximum |
|
| Individual | $1,500 |
| Family | $3,000 |
| Benefits | |
|---|---|
| In-Network* | |
| What You Pay Services subject to deductible unless otherwise specified. |
|
Preventive Care
|
$0 copay, no deductible |
Office Visits |
$20 copay; $40 specialist copay |
Vision Care |
|
|
$0 copay; one per calendar year |
|
Aetna Discount Program |
Other Outpatient Services
|
10% |
Inpatient/Outpatient Facility & Services
|
10% |
Skilled Nursing Facility |
10% |
Mental Health/ |
|
|
10% (must be pre-certified) |
|
$20 copay ($40 specialist copay) |
Other Services
|
10% |
Emergency Room |
10% at both network and non-network facility |
| *All benefit levels are in-network and after deductible. | |
| Benefit | |
|---|---|
| Express Scripts | |
Out-of-Pocket (OOP) Drug Limit |
$1,000 separate annual OOP maximum per person |
Retail |
|
|
$10 copay |
|
$30 copay |
|
$50 copay |
Mail Order |
|
|
$20 copay |
|
$60 copay |
|
$100 copay |
