2026 AtlantiCare Benefits Booklet

MEDICAL

WELCOME....................................2 WHAT’S NEW..............................3 HOW TO ENROLL......................4 HEALTHCARE TRANSFORMATION CONSORTIUM (HTC)...............6 GETTING TO KNOW YOUR PLAN.................................7 MEDICAL......................................8 PRESCRIPTION DRUG.......... 17 FQHC........................................... 19 ADDITIONAL MEDICAL PLAN RESOURCES................. 20 WELLNESS PROGRAM......... 21 DENTAL...................................... 23 VISION........................................ 25 LIFE INSURANCE.................... 28 DISABILITY............................... 30 VOLUNTARY OFFERINGS... 31 EDUCATIONAL SUPPORT & CAREER DEVELOPMENT...................... 31 FINANCIAL WELL-BEING.... 32 HEALTH &WELLNESS.......... 33 SAVINGS.................................... 34 VOLUNTARY BENEFITS....... 35 SPENDING ACCOUNTS............................... 38 RETIREMENT BENEFITS................................... 39 CONTACTS................................ 41 LEGAL NOTICES....................... 43 WELLNESS CHECKLIST........ 45

You have two choices in Medical Plan Coverage: • Aetna Select Plan • Aetna Choice Plan

Plans At A Glance – both plans provide: Free Preventive Care – Preventive services are covered at 100%, ensuring you receive important checkups, screenings, and immunizations without any out-of-pocket cost. This helps you stay on top of your health and catch potential issues early. Financial Protection – Annual out-of-pocket maximums provide a safeguard by capping the total amount you may pay each year. Once you reach this limit, the plan pays 100% of covered services for the remainder of the year, giving you peace of mind and financial security.

Network Access –With a wide network of doctors, specialists, and healthcare facilities, you’ll have more options when choosing where and fromwhom to receive care. This not only ofers convenience but can also lead to lower costs when you stay within the network. You do not need a referral to see any network doctor. Health Programs and Resources – A variety of programs and tools are available to support your health and wellness goals. From condition management resources and telehealth services to wellness coaching and digital apps, these oferings are designed to help you make the most of your coverage and stay healthy throughout the year.

Aetna Select Plan The Aetna Select Plan ofers a lower biweekly contribution; and with this Plan, you are also eligible for an AtlantiCare-funded Health Reimbursement Account (HRA) to help you to ofset some of your out-of-pocket costs. Wellness Credits earned in 2025 will be applied to your HRA in 2026. This plan allows for more afordable out-of-pocket costs when you receive care from Inner Circle Tier 1 or HTC Tier 2 providers.

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