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Health Insurance

The VUMC Health Plan is designed to give you and your family excellent care and great value, with convenient access to compassionate, high-quality providers.

See:   • Options     • Networks     • Prescriptions     • Eligibility     • Enrolling     • Making changes     • FAQs

Health Plan Options

Need help deciding? See Which Health Plan Option Should I Choose?

 

VUMC offers three PPO (preferred provider organization) health plan options: Aetna Plus, Aetna Select and Aetna HealthFund. All three options include:

  • Prescription drug coverage with Navitus
  • 100% coverage for preventive care and screenings, with no deductible or copay (as long as the service meets the guidelines for a preventive care service and is not for screening of a diagnosis)
  • Ability to see any provider or specialist without a referral
  • Emergency room visits, diagnostic testing, and hospital inpatient and outpatient services
  • Mental health visits and/or inpatient services
  • Skilled nursing, home health care and hospice care
  • Physical, speech and occupational therapy; cardiac rehab services
  • Chiropractic care

This chart (see a full-size version) and the text below gives a brief overview of each plan option. For full details, see the Evidence of Coverage booklet for each plan option.

health plan options chart

Aetna Plus

  • Lowest payroll premiums
  • Moderate deductibles and coinsurance
  • Copay required for primary care visits
  • Gold plan type (as compared to the national healthcare exchange)
  • See a chart showing an overview of costs

Aetna Select

  • Highest payroll premiums
  • Lowest deductibles and coinsurance
  • Copay required for primary care visits
  • Gold plan type (as compared to the national healthcare exchange)
  • See a chart showing an overview of costs

Aetna HealthFund

  • Modest payroll premiums
  • Highest deductibles but VUMC contributes towards your deductible through the HealthFund
  • Lowest coinsurance
  • No copay required for primary care visits
  • Gold plan type (as compared to the national healthcare exchange)
  • See a chart showing an overview of costs

Provider Networks

All three of VUMC's health plan options use the same provider networks. A provider network is a list of the doctors, other health care providers and hospitals that the plan has contracted with to provide medical care. Here are the networks:

  • Vanderbilt Health Affiliated Network. VHAN is the foundation of VUMC's health plan and offers you access to more than 3,500 providers and 50 hospitals at affordable rates. Click here to learn more.
  • Aetna National Network. While the VHAN network usually gives you the most affordable rates, there may be times you see a provider in the Aetna National Network. These providers have a contract with Aetna to provide services at a lower rate than an out-of-network provider. Click here to find an Aetna National Network provider.
  • Out-of-Network. You’ll pay more if you use doctors, providers, and hospitals outside of the network, and you may have higher out-of-pocket costs for services. This is because these providers do not have a contract with Aetna.

Resources

 


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