Medical Plans
The City of Scottsdale offers you a choice between three types of medical plans.
- City of Scottsdale Aetna Choice CPOSII HSA Plan
- City of Scottsdale Aetna Select Plan (formerly the EPO)
- City of Scottsdale Aetna Choice Plan
Monthly Benefit Premiums
Hearing Flier
Vision Care Flier
Aetna Select Summary Plan Description
CHIP Ammendment
Aetna Choice POSII Summary Plan Description
CHIP Ammendment
Aetna Choice POSII HSA Summary Plan Description
CHIP Ammendment
Why does the City of Scottsdale need to know the Social Security Number of all of my dependents?
We ask for this information to comply with Medicare reporting requirements (Section 111 of Public Law 100-173, also known as the "Medicare, Medicaid and SCHIP Extension Act of 2007"). When you make a claim, the law requires self-insurers like the City of Scottsdale to report specific information to the Department of Health and Human Services so it can coordinate Medicare payments with other insurance. The Centers for Medicare & Medicaid Services (CMS), part of the federal Department of Health and Human Services, uses this information to identify Medicare beneficiaries and coordinate Medicare payments. Note that the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act Privacy Rule require Medicare to protect individual privacy and confidentiality while performing these duties. Aetna, our health plan, is considered a "Responsible Reporting Entity" under the Mandatory Insurer Reporting Law, and they have to check with the federal government on the Medicare eligibility of each party making an injury claim. Therefore, all dependent Social Security Numbers need to be sent to Medicare.
For details, see the "Why do I need to know about this legislation?" section of "Introduction to Section 111 Mandatory Medicare Secondary Payer Reporting"
Do you want to compare Prescriptions costs?
Here are 2 prescription drug lists. We encourage you to compare with other pharmacy's to ensure you receiving the best deal. Some generic drugs are cheaper than others, depending on which pharmacy you go to.
Aetna Choice CPOSII + HSA Plan |
Aetna Select Plan |
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In-Network Benefits |
Out-of-Network Benefits |
In-Network Benefits |
Out-of-Network Benefits |
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Choice of Physician |
Choice of in-network physician(s) or out-of-network physician(s) |
Choice of in-network physician(s) only, no pre-selection of a primary care physician necessary |
Choice of in-network physician(s) |
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Deductible per
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$1,250 Individual $2,500 Family |
$3,500 Individual $7,000 Family |
None |
$500 Individual $1,000 Family |
$2,000 Individual $4,000 Family |
Annual Out-of-Pocket Maximum |
$4,000 Individual $8,000 Family |
$6,000 Individual $12,000 Family |
$1,500 Individual $3,000 Family |
$3,000 Individual $6,000 Family |
$4,000 Individual $8,000 Family |
Basic Care |
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Primary Physician Office Visits (Family & Gen. Practice, Int. Medicine, & Pediatrician) |
90% after deductible |
70% after deductible |
$20 co-pay |
$20 co-pay per visit |
70% after deductible |
Specialist Physician Office Visit |
90% after deductible |
70% after deductible |
$40 co-pay |
$40 co-pay per visit |
70% after deductible |
Outpatient X-ray & Laboratory |
90% after deductible |
70% after deductible |
No co-pay/$40 for complex imaging |
90% after deductible |
70% after deductible |
Physical, Occupational, Speech Therapy (max 60 visits per plan year) |
90% after deductible |
70% after deductible |
$20 co-pay |
90% after deductible |
70% after deductible |
Hearing & Vision |
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Hearing Examinations |
100%, no deductible |
No benefit |
100%, no co-pay |
No benefit |
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Vision Examinations |
100%, no deductible
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No benefit |
100%, no co-pay |
100%, no co-pay |
No benefit |
Vision Materials (frames, lenses, contacts, etc.) |
Discounts available through EyeMed Vision Program |
Discounts available through EyeMed Vision Program |
Discounts available through EyeMed Vision Program |
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Wellness |
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Routine Physicals, Exams, Pap Smears, Mammograms, Immunizations |
100% no deductible |
70% after deductible |
No co-pay |
No co-pay |
70% after deductible |
Well Baby Care |
100% no deductible |
70% after deductible |
No co-pay |
No co-pay |
70% after deductible |
Chiropractor (maximum 20 visits per plan year) |
90% after deductible |
70% after deductible |
$20 co-pay |
90% after deductible |
70% after deductible |
Maternity Care |
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Office Visits |
90% after deductible |
70% after deductible |
$20 co-pay |
$20 co-pay first visit only |
70% after deductible |
Delivery |
90% after deductible |
70% after deductible |
$300 co-pay (per mother and child) |
90% after deductible |
70% after deductible |
Inpatient Hospital Care & Outpatient Surgery |
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Inpatient Hospital |
90% after deductible |
70% after deductible |
$300 co-pay |
90% after deductible |
70% after deductible |
Outpatient Surgery |
90% after deductible |
70% after deductible |
$150 co-pay |
90% after deductible |
70% after deductible |
Emergency Care & Urgent Care |
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Emergency Room (waived if admitted) |
90% after deductible
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$100 co-pay, plus 10% co-insurance after in-network deductible |
$150 co-pay |
$150 co-pay, plus 10% co-insurance after deductible |
$150 co-pay, plus 10% co-insurance after in-network deductible |
Urgent Care Facility |
90% after deductible
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$50 co-pay, plus 10% co-insurance after in-network deductible |
$50 co-pay |
$50 co-pay, plus 10% co-insurance after deductible |
$50 co-pay, plus 10% co-insurance after in-network deductible |
Ambulance |
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Ground |
90% after deductible |
70% after deductible |
No co-pay |
90% after deductible |
90% after deductible |
Air |
90% after deductible |
70% after deductible |
No co-pay |
90% after deductible |
90% after deductible |
Extended Care |
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Home Health Care (maximum 40 visits per plan year) |
90% after deductible |
70% after deductible |
$20 co-pay |
90% after deductible |
70% after deductible |
Skilled Nursing (maximum 60 days) |
90% after deductible |
70% after deductible |
$150 co-pay |
90% after deductible |
70% after deductible |
Hospice Care |
90% after deductible |
70% after deductible |
No co-pay |
90% after deductible |
70% after deductible |
Prescriptions |
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| If you choose a brand name drug over an available generic drug, you will pay the generic co-pay plus the difference in cost between the generic drug and the brand name drug. If your doctor indicates that you must take the brand name drug, then you will pay only the applicable brand drug co-pay. | |||||
Preventive Generic |
$10 co-pay |
50% after deductible |
$10 co-pay |
$10 co-pay |
50% co-insurance |
Preventive Brand Name |
20% co-insurance |
50% after deductible
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20% co-insurance |
20% co-insurance |
50% co-insurance |
Preventive Non-Formulary |
40% co-insurance |
50% after deductible
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40% co-insurance |
40% co-insurance |
50% co-insurance |
Non-Preventive Generic |
Covered at 100% after plan deductible and $10 co-pay |
50% after deductible |
$10 co-pay |
$10 co-pay |
50% co-insurance |
Non-Preventive Brand Name |
Covered at 100% after plan deductible and 20% co-insurance ($30 min-$50 max) |
50% after deductible |
20% co-insurance |
20% co-insurance |
50% co-insurance |
Non-Preventive Non-Formulary |
Covered at 100% after plan deductible and 40% co-insurance ($50 min-$100 max) |
50% after deductible |
40% co-insurance |
40% co-insurance |
50% co-insurance |
Preventive Mail Order Generic |
$20 (90-day supply) |
No benefit |
$20 |
$20 (90-day supply) |
No benefit |
Preventive Mail Order Brand Name |
$60 (90-day supply) |
No benefit |
$60 |
$60 (90-day supply) |
No benefit |
Preventive Mail Order Non-Formulary |
$110 (90-day supply) |
No benefit |
$110 |
$110 (90-day supply) |
No benefit |
Non-Preventive Mail Order Generic |
Covered at 100% after plan deductible and $20 co-pay |
No benefit |
$20 |
$20 (90-day supply) |
No benefit |
Non-Preventive Mail Order Brand Name |
Covered at 100% after plan deductible and $60 co-pay |
No benefit |
$60 |
$60 (90-day supply) |
No benefit |
Non-Preventive Mail Order Non-Formulary |
Covered at 100% after plan deductible and $1100 co-pay |
No benefit |
$110 |
$110 (90-day supply) |
No benefit |
EMPLOYEE ASSISTANCE PROGRAM |
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This program provides ancillary work-life benefits at no cost to employees and family members for a wide array of non-medical issues, such as stress management, marriage and family issues, et. The EAP also includes referral services for child and elder care, adoption assistance, legal assistance and other services. |
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Mental Health |
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Behavioral Health Outpatient Psychological Consultations |
90% after deductible, through Aetna |
$20 co-pay, through CIGNA |
$20 co-pay, through CIGNA |
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Non-CIGNA Behavioral Health Outpatient Psychological Consultations |
Aetna In-network 90% after deductible, out-of-network 70% after deductible |
No benefit |
CIGNA in-network 90% after deductible; 70% out-of-network after deductible |
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Behavioral Health Inpatient Care |
Aetna In-network 90% after deductible |
$150 co-pay |
90% after deductible - CIGNA in-network |
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Behavioral Health Inpatient Care |
Aetna Out-of-network 70% after deductible
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No benefit |
70% after deductible - non-CIGNA in-network
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Maximum Lifetime Benefit |
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Lifetime Maximum |
Unlimited |
Unlimited |
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This guide represents a summary of benefits provided by the City of Scottsdale to benefited employees. Every effort has been made to report information accurately. All information, including the amount of any benefit and employee eligibility of benefits, is subject to and governed by the terms and conditions of the applicable policy or plan documents. In all cases where any of the information provided in this guide differs from the amount of benefit actually provided by the policy or plan, the terms of the legal documents will control.
