HomeMy WebLinkAboutSBC Member Letter - English
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including
Aetna Life Insurance Company and its affiliates (Aetna).
Easy-to-read document helps you understand your benefits
You’ll receive a Summary of Benefits and Coverage (SBC) with your enrollment materials this year.
As part of the health care reform law, the government established a new health plan information
document called the Summary of Benefits and Coverage (SBC). The SBC will help you understand and
compare different medical plan options. It provides an overview of each medical plan in a standard
format and is written in easy-to-understand language.
The Summary of Benefits and Coverage includes three parts:
• Benefits and coverage information
• Coverage examples
• A link to a Uniform Glossary
Benefits and coverage information
This section includes a chart that lists the main features of your medical plan option(s). It answers
fundamental questions about the coverage levels of the plan options. It also provides specific
information about coverage for different services, such as office visits, prescription drugs and
emergency room services.
Coverage examples
The coverage examples on the last two pages of the document show how the plan might cover
medical care for two specific scenarios – “Having a Baby” and “Managing Type 2 Diabetes.” The
examples show what the plan would pay and what the patient would pay based on a common set of
assumptions. It is important to note that these are examples only. They should not be used to
estimate your actual costs under the plan.
Uniform Glossary
The SBC explains how to access or request a glossary with definitions for common health insurance
and medical terms, such as copayment and deductible. There may be differences between terms
found in the Uniform Glossary and those in your health plan documents. In these instances, you
should go by the terms in your health plan document.
Call Aetna Member Services if you have questions about your plan
Use the toll-free number on your Aetna medical ID card for any questions you may have. You can also
e-mail your questions to Member Services. Just log in to your secure Aetna Navigator® member
website and click Contact Us.