Public Employee Press

Aetna raises members’ co-pays and costs

Aetna will raise its co-pays for emergency room treatment and hospital admissions in 2008, and for out-of-network treatment it will increase co-pays and triple uncovered out-of-pocket expenditures.

The Aetna-USHC managed care plans are among the health-care plans New York City offers employees. The Aetna-USHC plans raised the possibility of pulling out of the city benefits program if they weren’t allowed to implement the modifications.

The major in-network changes are:
• an annual $15,000 limit on advanced reproductive technology,
• an increase of the emergency room co-pay to $75 from $35, and
• an increase of the hospital administrationco-pay to $300 from $100.

The out-of-network changes include:
• an increase in co-insurance to 30 percent from 20 percent
• an increase of the out-of-pocket maximum expenditures for individuals to $3,000 from $2,500 and for families to $9,000 from $7,500. (After these thresholds are met, Aetna picks up the entire expenditure.)

As PEP went to press, Aetna was expected to write its subscribers about the changes. Information is also available on the Office of Labor Relations’ section of the city Web site. (Go to www.nyc.gov and click on Office of Labor Relations in the file for city agencies.)

Employees may change plans from Nov. 1 to Nov. 30. The coverage changes take effect in the first week of payroll in 2008. Aetna’s Medicare-HMO programs for retirees are not affected by the changes.