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Choice POS II

Visit any doctor without a referral.

Is This the Plan for You?

  • Annual Deductible: Individual $500 / Family $1,000
  • See any doctor in or out of the network
  • Out-of-network coverage
  • Aetna’s National network allows you to seek care within the State or outside of Florida
  • You pay a coinsurance when you receive care from network providers - NO REFERRALS NEEDED
  • You pay a higher cost if you receive care from a non-network provider
  • No primary care physician required
  • Preventive Care covered 100%
  • Aetna In-Touch Care, Informed Health Line, and the Aetna Maternity programs included at no extra cost

How the Plan Works

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

Annual Deductible: Individual $500 / Family $1,000

What you pay for care received in network
  • Doctor office visits: 20% after deductible per visit for PCP / 20% after deductible per visit for Specialist
  • Hospital Stay: $500 copay/day first 5 days per stay
  • Emergency Room: 20% after deductible (waived if admitted)
  • Urgent Care: 20% after deductible
What you pay for care received out of network
  • Doctor office visits: 40% after deductible per visit by PCP / 40% after deductible per visit for Specialist
  • Hospital Stay: 40% after deductible
  • Urgent Care: 40% after deductible
  • Emergency Room: 20% after deductible (waived if admitted)
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.

Visit 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 out-of-pocket max (does not include prescription copays)
  • Individual: $5,000
  • Family: $10,000
Annual Pharmacy out-of-pocket max (does not include medical copays)
  • Individual: $2,000
  • Family: $4,000

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

Teladoc Benefits
  • General Medical: $25 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 $80 or less / session
  • Psychiatrist $160 or less / evaluation
  • (Ongoing sessions) $90 or less / session
  • Your cost for Mental Health visits is 20% coinsurance after deductible is met

Find a PCP or doctor in the network

Find a PCP or doctor in the network

Got a Question? Call 1-866-253-0599

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