Employees can choose from two medical plans administered by Aetna®. All of our medical plan options include free* care within the RWJBarnabas Health system.

Reminder: You will need to update your insurance information in MyChart with your new Aetna ID card; click here for instructions.

Aetna® Medical Plan Options:

• Core Plan – The lowest-cost medical option for employees who primarily use care within the RWJBarnabas Health system and our partner systems through the HTC. Care received within the Premier tier is free* for Core Plan members.
• Flex Plan – Designed for employees who live in New Jersey, but want to pay less out-of-pocket when receiving care outside the RWJBarnabas Health system or in other states. Payroll contributions are higher for this plan. This plan also includes free* care within the RWJBarnabas Health system.
• Out-of-Area Plan – Designed for employees who live outside of New Jersey. Employees can still access free* care within the RWJBarnabas Health System, and will also have lower out-of-pocket costs when accessing care outside of New Jersey.

Finding Your ID Card:

You should have received a hard copy of the combined Medical & Pharmacy ID card in the mail in December. To access the digital version of the ID card, log in to the Aetna portal here or download the Aetna mobile app.  Note: You can also access a “prescription drug only” version of the ID card in the CVS Caremark portal or mobile app.

Below is a sample of the ID card (your specific card may note a different plan or network name, depending on which plan you enrolled in). Your member ID should have 10 total characters (including the “W” to start). The prescription drug information can be found on the back side of the ID card.

Medical Plan Tiers

Note: Services rendered by an in-network physician at a Premier facility (Inpatient/Outpatient/ER) will be covered at 100%. Lab services (such as labs drawn at LabCorp and Quest) continue to be covered at 100% in the Extended Tier.

How much will I pay for care?

Your out-of-pocket costs for care depend on the plan you select and which network tier the provider is in. You can use care across any of the network tiers in your plan throughout the year.

To search for a specific provider’s tier, visit the Aetna resource page or call the Aetna Concierge at 855-546-5415. You can also call our Care Navigation team at 1-844-424-2628 for assistance with finding a provider or booking an appointment.

• Premier Tier: Using providers in the Premier tier will be most cost effective for you. No matter which medical plan option you choose, care within the Premier Tier will be at no cost* to you.
• Extended Tier: You’ll have some out-of-pocket costs for most services. The Extended Tier continues to include many large provider groups – for example, Summit Health, Advocare and Axia. In addition, we have added our Healthcare Transformation Consortium (HTC) partners into the Extended Tier. Learn more about the HTC here.
  • Note: Office visits in the Extended Tier are subject to copays only – the deductible and coinsurance do not apply to those visits. Additionally, eligible services performed by an Extended Tier provider at a Premier (Tier 1) facility – which includes all RWJBH inpatient and outpatient locations – will be covered at 100%*.
• Aetna Network Tier: The Aetna Network tier includes all providers in Aetna’s national network. The costs for services in the Aetna Network tier are higher than services on the Premier or Extended tiers.
• Out-of-Network: Out-of-Network providers do not participate in Aetna’s provider network. If you’re enrolled in the Flex or Out-of-Area medical plans, you’ll experience significant costs with out-of-network providers. There is no coverage for out-of-network providers on the Core Plan; you are responsible for 100% of the cost of out-of-network care.

All plans include a $0 telemedicine benefit through KeyCare. Click here for more information.

What services are covered?

You can view the plan summaries by clicking on the name of each plan here: Core Plan, Flex Plan, and Out-of-Area Plan.

You can view the Summary of Benefits and Coverage for additional plan design details, found on the Aetna^® website.

*Payroll deductions and Emergency Room copay ($200) still apply.