Meritain Health, an Aetna company, offers a Copay Plan designed to provide affordable, predictable healthcare costs. With this plan, you pay a fixed copayment for covered medical services, such as doctor visits, prescriptions, and specialist care, making it easier to manage out-of-pocket expenses. The plan gives you access to Aetna’s extensive national network of providers, ensuring quality care and flexibility in choosing healthcare professionals. Meritain Health’s Copay Plan is a convenient solution for individuals and families seeking comprehensive coverage with straightforward costs.
KCOI is continuing a Domestic Tier, which allows employees to take advantage of services done at KCOI.
| Per Pay Period Premium | |
|---|---|
| Copay Plan | |
| Employee | $95.00 |
| Employee + Spouse | $352.00 |
| Employee + Child(ren) | $279.50 |
| Employee + Family | $444.50 |
| Copay Plan | |
|---|---|
| Network | Aetna Choice® POS II |
| Domestic Tier: benefits when using KCOI or KCOA physicians & services | |
| Annual Deductible (Individual/Family) | $0 / $0 |
| Out-of-Pocket Maximum (Individual/Family) | $3,500 / $7,000 |
| Co-Insurance (Member's Responsibility) | 0% |
| Covered Services (Outpatient Specialis | 0% |
| General Services (In-Network) | |
| Annual Deductible Individual | $1,250 |
| Annual Deductible Family | $2,500 |
| Annual Out-of-Pocket Limit Individual | $3,500 |
| Annual Out-of-Pocket Limit Family | $7,000 |
| Co-Insurance (Member’s Responsibility) | 20% |
| Office Services (In-Network) | |
| Office Visits/Exam | $25 Co-pay |
| Specialist Visit | $50 Co-pay |
| Urgent Care | $50 Co-pay |
| Preventive Care | No charge |
| Outpatient Diagnostic (lab / X-ray) |
Lab: No charge X-Ray: $50 copay |
| Complex Imaging (MRI, CT / PET scans) | Deductible, then 20% |
| Hospital Services (In-Network) | |
| Ambulance | $200 Copay, then deductible |
| Emergency Room | $200 Copay, then deductible |
| Inpatient Hospital Stay | Deductible, then 20% |
| Outpatient Surgery | Deductible, then 20% |
| Prescription Drugs (through Payer Matrix & Magellen - Tiers 1 / 2 / 3 / 4) | |
| Retail Pharmacy (30-day supply) | $3 / $12 / $40 / $65 |
| Mail Order (90-day supply) | 2.5x Retail |
| Preferred Specialty | 30% up to $150 |
| Non-Preferred Specialty | 30% up to $250 |
Our four medical plan options are offered through Meritain Health an Aetna Company. Need to connect?
Meritain Aetna Network
Technical support: 800-925-2272
Meritain portal support: servicehelp@meritain.com