During the COVID-19 pandemic, refer to the Benefits Updates webpage for relevant information.
The Aetna Princeton Health Plan (PHP) is a point-of-service plan where costs are less when using providers in the plan’s network. Individuals can access doctors, hospitals, and providers outside of the network without a referral for an additional cost. The PHP includes the Prescription Drug Plan.
- Highest contribution offered.
- Aetna Choice POS II (open access) Network of providers.
- In-network preventive services e.g. annual exams, colonoscopies, and mammograms covered at 100%.
- Prescriptions and copayment services e.g., office visits, telemedicine, and urgent care, are covered before deductible.
- After meeting the annual deductibles, coverage begins for all other medical services.
- After reaching the out-of-pocket maximums (OPMs), services are covered at 100%. OPMs are based on the employee’s annual base salary as of January 1 or the date of hire, if later.
- In-network providers deliver coverage at the lowest cost.
- Out-of-network reimbursements are limited; rates are determined by our insurance carriers using data provided by Medicare. Review the Summary Plan Description for additional information.
- Primary care physician (PCP) is not required but is highly recommended and does not introduce referral requirements.
- Referral is not required to see a specialist.
To maximize benefits and minimize costs, consider using the following providers and resources:
- Preferred Labs and Specialists
- Independent Radiology Centers and Independent Facilities for Outpatient Services
- Urgent Care Centers
- Health Advocate
- My Health Coach
- Aetna’s Mobile App
- Centers for Excellence and Institutes of Quality
- Fertility & Family-Planning Benefits (Kindbody)
Mental Health Services
- Teladoc Mental Health
- Employee Assistance Program (EAP) by Carebridge
- Inpathy, Aetna's in-network telemental health services provider (also known as Televideo): Call (800) 442-8938. Residents outside of New Jersey, New York, or Pennsylvania should call (800) 535-6689. Visits are covered at the same cost as in-network mental health visits under the Princeton medical plan.
If there are any discrepancies between the information in this publication, verbal representations, and the plan documents, the plan documents always govern. Although Princeton intends to continue these benefits, the University reserves the right to amend or terminate these plans at any time.