Dealer Tire partners with Aetna to offer medical and prescription drug insurance.

Plan Highlights

You have the option of choosing one of four plans through Aetna. Our plans offer coverage for most healthcare services. When you receive care in-network you benefit from our negotiated discounts with Aetna.

If enrolled in one of the PPO plans, regular Teladoc visits are covered at 100% — no cost to you! Register for Teladoc today at https://member.teladoc.com/aetna or call 855.835.2362.

Click the below links to view your 2022 medical SBCs:

PPO1: Summary of Benefit & Coverage
PPO2: Summary of Benefit & Coverage
PPO3: Summary of Benefit & Coverage
HSA: Summary of Benefit & Coverage
Aetna Member Site

Visit www.aetna.com to take advantage of all the helpful tools and resources available including the following.

  • In-network provider and pharmacy searches
  • A list of prescription drugs covered by our plans
  • Access to temporary ID cards and means to order another ID card
  • Information regarding paid and pending claims

Important Insurance Terms

Deductible: the amount of money you are responsible for paying up-front before your plan shares your costs

Coinsurance: the percentage you and the plan pay; in our plans, you pay a smaller percentage and the plan pays a larger percentage

Copay: a fixed amount for certain services you pay in some of our plans

Out-of-pocket maximum: the limit on your expenses; once you reach this limit, the plan covers all eligible expenses for the remainder of the plan year

Prescription Formulary: List of prescriptions covered by your plan.  Your Aetna plans access the Aetna Standard Open Formulary listing.

 

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What is a Network?

A network is a group of providers your plan contracts with at discounted rates. You will almost always pay less when you receive care in-network.

If you choose to see an out-of-network provider, you may be balance billed, which means you will be responsible for charges above Aetna’s reimbursement amount. 

Click here to find an in-network provider! The plans below will access the ‘Aetna Choice POS II (Open Access) Network’.

 

Medical Plan Details

This is a high-level summary of your benefit coverage. Full coverage details are available in your SBC, Summary of Benefits and Coverage documents. In the event there is a discrepancy between what is reflected in this guide and what is communicated in your Summary of Benefits and Coverage documents, the terms of your Summary of Benefits and Coverage document will prevail. 

AETNA
PPO 1 PPO 2 PPO 3 HSA Plan
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
Calendar Year Deductible
Embedded* Embedded* Embedded* Embedded*
Individual $300 $550 $550 $1,100 $1,050 $3,600 $2,800 $2,800
Family $900 $1,650 $1,650 $3,300 $3,150 $10,800 $5,000 $5,600
Coinsurance
90% 70% 80% 60% 70% 40% 80% 60%
Out-of-Pocket Maximum (includes deductible)
Embedded* Embedded* Embedded* Embedded*
Individual $3,000 $4,850 $3,500 $5,900 $7,500 $11,600 $4,000 $4,500
Family $6,000 $10,300 $7,000 $12,900 $15,000 $34,800 $8,000 $9,000
Preventive Care
No Cost Ded + 30% No Cost Ded + 40% No Cost Ded + 60% No Cost Ded + 40%
Physician Office Visits
Primary Care Visit $25 copay Ded + 30% $30 copay Ded + 40% $75 copay Ded + 60% Ded + 20% Ded + 40%
Specialist Visit $35 copay Ded + 30% $40 copay Ded + 40% $100 copay Ded + 60% Ded + 20% Ded + 40%
Hospital Care
Emergency Room $250 copay $250 copay $250 copay $250 copay Ded + 30% Ded + 60% Ded + 20% Ded + 20%
Inpatient Coverage Ded + 10% Ded + 30% Ded + 20% Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Outpatient Surgery Ded + 10% Ded + 30% Ded + 20% Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Outpatient Short-Term Therapy (limited to 60 visits per year)
Speech $35 Copay Ded + 30% $40 Copay Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Physical $35 Copay Ded + 30% $40 Copay Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Occupational $35 Copay Ded + 30% $40 Copay Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Mental Health Services
Inpatient Ded + 10% Ded + 30% Ded + 20% Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Office Visits $35 Copay Ded + 30% $40 Copay Ded + 40% $100 copay Ded + 60% Ded + 20% Ded + 40%
Urgent Care
$50 Copay Ded + 30% $75 Copay Ded + 40% Ded + 30% Ded + 60% Ded + 20% Ded + 40%
Prescription Drugs
Deductible N/A N/A N/A N/A $150 / $450 $150 / $450 Included in medical Included in medical
 • Retail
Tier 1 $15 copay Not Covered $15 copay Not Covered $10 copay Not Covered Ded + 20% Not Covered
Tier 2 $25 copay Not Covered $30 copay Not Covered $50 copay Not Covered Ded + 20% Not Covered
Tier 3 $45 copay Not Covered $50 copay Not Covered $75 copay Not Covered Ded + 20% Not Covered
Tier 4 20% up to $200 Not Covered 20% up to $200 Not Covered Not Covered Ded + 20% Not Covered
 • Mail Order
Tier 1 $30 copay N/A $30 copay N/A $20 copay N/A Ded + 20% Not Covered
Tier 2 $50 copay N/A $60 copay N/A $100 copay N/A Ded + 20% Not Covered
Tier 3 $90 copay N/A $100 copay N/A $150 copay N/A Ded + 20% Not Covered
Tier 4 20% up to $200 N/A 20% up to $200 N/A N/A Ded + 20% Not Covered

* Embedded plans are important to consider if you are going to cover family members on your plan.

With family coverage in embedded plans, the individual deductible and out-of-pocket maximum still applies to each individual on the plan. You can satisfy the individual limit and the plan begins covering your eligible expenses. Additionally, once a combination of family members satisfies the full family deductible and out-of-pocket maximum, the plan begins covering all family members eligible expenses.