Medical Insurance

The following plan information applies to the current medical insurance plans -- effective July 1, 2009 through June 30, 2010:

• RiceCare HMO Summary of Benefits [pdf]
• RiceCare Flexplan (POS) Summary of Benefits [pdf]
• RiceCare PPO Summary of Benefits [pdf]
• RiceCare Catastrophic Plan Summary of Benefits [pdf]

Network

• Search for your doctor in the Aetna network (en espanol) -- please use the following Aetna plan names:

  • RiceCare HMO = Aetna Standard Plans, HMO
  • RiceCare Flexplan (POS) = Aetna Open Access Plans, Aetna Choice ™ POS (Open Access)
  • RiceCare PPO = Aetna Standard Plans, Open Choice® PPO
  • RiceCare Catastrophic Plan does not have a network

Please note the for the RiceCare Flexplan (POS), you only receive the $25 primary care physician (PCP) copayment for your selected PCP.  Any other physician (even if a PCP that you have not designated) will have the $35 copayment applied.

Prescription Drugs

• Search Aetna's Drug Formulary for your medications (select "Three Tier Open Formulary" and select "Medication Search") or
• Aetna's Preferred Drug List Information Website 
• Get the Aetna Rx Home Delivery order form (in both English and Spanish)

How the Plan Works

Ever wonder how Aetna decides what to cover and what not to cover?  Besides what is explicitly noted in our plan documents below, you can view Aetna's Clinical Policy Bulletins, that detail Aetna’s policy regarding the experimental and investigational status and medical necessity of medical technologies and other services for the purposes of making coverage decisions under Aetna administered health benefit plans.

ID Cards

Need an ID fast? Aetna Navigator can help

Did you know that you can print a temporary ID from your secure member website,  Aetna Navigator? Anytime, anywhere -- simply log into Aetna Navigator and select ID Card under the Requests & Changes menu. A temporary ID lets you visit your doctor and fill a prescription when you haven't yet received your permanent ID card. Use your permanent ID card once you receive it. If you ever need to replace your ID card, you can order one online too. Your replacement ID card should arrive within 7-10 business days.

Claims Forms

• Aetna Claims Form - PPO and Catastrophic Plans  [pdf]
• Aetna Claims Form - Flexplan (POS) Non-Network  [pdf]
• HMO and Flexplan (POS) network services should not require a claim.  If you need Aetna to reimburse for a network service, write a letter to Aetna with a copy of your receipt (send it to the claims address on your ID Card).

Discounts

When you enroll in an Aetna medical plan through Rice, you are eligible for the following additional services through Aetna (some items may require you log into Aetna Navigator to view):

• Waterpik Discount Program -- purchase a Waterpik Ultra Dental Water Jet or a Waterpik Sensonic Professional Sonic Toothbrush for a discount (call 1-800-290-1568 and use the promotional code: AetnaWP09).
• Epic Dental Discounts -- You and your family have access to savings on oral health care products through our discount program with Epic Dental — free of charge! The program offers discounts on a wide array of Epic products that contain xylitol — a natural sweetener shown to stop tooth decay. Use Epic Dental products to help fight cavities and keep your smile the best it can be!  Go online call 1-800-494-3742.
• eDiets discount for Aetna members -- get discounts for eDiets weight loss programs.  To enroll call:1-800-265-6170.
• Weight management discounts -- Jenny Craig program discount.
• Hearing discounts -- save on hearing exams, hearing services and hearing aids.
• Mayo Clinic bookstore discounts -- use discount code AetnaMayo.
• SpaWish gift certificate discounts -- Shopping cart promotion code: Aetna84572.
• Aetna Natural Alternatives Plan Information and Provider Listing -- Chiropractors, Massage Therapists, etc.
• Aetna Natural Products Information -- order health-related products through Vitamin Advantage or Natural Products.
• Aetna GlobalFit-- receive discounts on membership at participating, independent health clubs.
• Vision discounts -- get discounts on eye exams, lenses, frames and contact lenses.
• Zagat Healthy Dining discounts.

Additional Medical Plan Documentation

• Medical Program -- overall medical plan wrap document (this contains the overriding aspects of the medical program regardless of the plan in which the employee is enrolled).
• Appendix A - RiceCare HMO -- specifics for the HMO plan.
• Appendix B - RiceCare Flexplan (POS) -- specifics for the Flexplan (POS) plan.
• Appendix C - RiceCare PPO -- specifics for the PPO plan.
• Appendix D - RiceCare Catastrophic -- specifics for the Catastrophic plan.

How to Contact Aetna

Please use the following telephone numbers to contact Aetna:

or log in to Aetna Navigator online.