Basic Essential Plan

Aetna Select℠ (Open Access)

Visit any doctor in the Aetna network without a referral.

Is This the Plan for You?

See any doctor in the network
Aetna’s National network allows you to seek care within the State or outside of Florida within our network of providers
You pay a copay/coinsurance after deductible when you receive care from network providers – NO REFERRALS NEEDED
You pay the entire cost if you receive care from a nonnetwork provider, except in a health emergency
Preventive Care covered 100%
You will pay a higher individual deductible* and out-of-pocket maximum compared to the other medical plans offered by PCS.
You pay a co-pay for PCP visits, TelaDoc^® visits and prescriptions (expect brand specialty drugs) that are not subject to the deductible.
Aetna In-Touch Care, Informed Health Line, and the Aetna Maternity programs included at no extra cost

*Please note this plan does not qualify for a Health Savings Account (HSA) since there are services built into the plan design that are not subject to the deductible. However, you can contribute to a Health Care Flexible Spending Account (FSA) to pay your eligible out-of-pocket expenses tax-free.

Downloads

2024 Summary of Benefits and Coverage (PDF) »

2024 Aetna Pharmacy Drug Guide Aetna Standard Plan (PDF) »

2024 Changes to your prescription drug coverage (PDF) »

2024 Aetna Standard Preventive Medicine List (PDF) »

2024 Chronic Medicine List (PDF) »

2024 HCR Preventive Care Drug List (PDF) »

More information about the Open Access Plan: English (PDF) | Spanish (PDF)

How the Plan Works

This plan lets you visit any doctor in the Aetna network without a referral, it’s entirely up to you. Visit your Primary Care Physician (PCP) or go directly to another network doctor.

Enjoy the Advantages of a PCP

Working with a PCP gives you a chance to visit a doctor who will get to know your personal health care needs. Your PCP can give you every day care and treat you for certain illnesses and injuries, knows your health patterns and risks, and can guide you on important health decisions.

Plan Highlights

Deductible: Individual $2,300 Family $6,900

What you pay for care received

Doctor office visits: $50 per visit for PCP 30% after deductible per visit for Specialist
Hospital Stay: 30% coinsurance after deductible
Emergency Room: 30% coinsurance after deductible
Urgent Care: 30% coinsurance after deductible

Prescription Drugs
Retail 30 day supply / Retail or Mail order 30-90 day supply

Generic: $15 / $30 (90 day supply)
Preferred Brand: $60 / $120 (90 day supply)
Non-Preferred Brand: $90 / $180 (90 day supply) (copay after deductible)
Specialty: 30% coinsurance / $0 if enrolled in Prudent RX (30 days only)
Pharmacy deductible: Individual $250 / Family $500 only for Non-Preferred Brand and Specialty

Pinellas has implemented PrudentRX effective 1/1/2022. Specialty drugs are the most expensive, high-technology and self-administered injectable medications not available on other levels. May be eligible for $0 co-pay under PrudentRx program. If not enrolled, 30% coinsurance applies.

Questions?
Visit pcsb.org/pharmacy for a list of covered medications and additional details on the PrudentRx program. Or call PrudentRx, 1-800-578-4403, Monday through Friday, 8 AM to 8 PM ET.

Look up your prescriptions for the Aetna Standard Plan formulary (PDF) »
Learn more about the Maintenance Choice Program here (PDF) »

Annual Medical & Pharmacy out-of-pocket max

Individual: $8,550
Family: $17,100

Preventive care: Covered 100% (for specific services, frequency limitations may apply)

Teladoc Benefits

General Medical: $40 per visit / treatment for flu, allergies, bronchitis, and more
Mental Health: Support for stress, anxiety, depression, and more
Appointments available by video only to members and eligible dependents 18 and older
Therapist, Psychologist free / session
Psychiatrist free / evaluation
(Ongoing sessions) free / session

Find a PCP or doctor in the network

Find a doctor »