Postdoctoral Associates 2020

Medical Insurance

Visit the medical comparison chart below to learn more about your options.

Yale Health

Yale’s flagship plan, offers a variety of on-site health care services including primary care, specialty care, 24/7 acute care, radiology, lab, and pharmacy. When your condition requires specialized care or a hospitalization, there’s an extensive network of specialists drawn largely from the faculty of Yale School of Medicine. Emergency care is covered globally.

Flexible Spending Account (FSA)

With a Flexible Spending Account (FSA), you can reduce your taxable earnings and receive reimbursement of eligible out-of-pocket expenses. Yale offers two kinds of FSA: a healthcare and a dependent care FSA. You must enroll or re-enroll in an FSA during Yale’s annual enrollment. Remember to plan carefully as your FSA funds will not roll over to the following year.

Aetna

Alternately, you may enroll in Aetna Choice or Aetna Smart Care Plan—with Health Savings Account (HSA) and Personal Accident coverage through Yale’s Aetna program.

If you choose the Aetna Smart Care Plan and elect an HSA, the University will make a one-time deposit into your account, of $500, $750, or $1,000 depending on your coverage election (new enrollments only). Aetna Accident Coverage provides lumpsum benefits for covered accidents and some hospital stays—free of charge—for you and your covered dependents.

Health Savings Account (HSA) with Aetna Smart Care

You can open a Health Savings Account (HSA) anytime to cover eligible healthcare expenses. Unused funds will roll over from year to year—and earn interest. If you contribute to an HSA, you can also open a limited purpose FSA to cover certain dental and vision expenses.

Aetna Minute Clinic®

Aetna Minute Clinic is a walk-in medical clinic, located in select CVS pharmacy locations and Target stores, offer preventive health screening, routine immunizations, women’s services, treatment of minor illnesses and injuries and more. Access is free for Aetna members, but there is a charge for Aetna SmartCare participants.

Dental Insurance

Delta Dental is Yale’s exclusive dental carrier. Now is the time to make changes to dependent or family dental coverage. In addition to the information below, dental reimbursement is provided for $3,500 maximum, per person (review Dental Plan documents for more information).

  • 100% for Preventive & Diagnostic
  • 80% for Basic Restorative*
  • 50% for Major Restorative*
  • 50% coverage†* for Orthodontia

Orthodontia

* Subject to yearly maximum; † $2,000 lifetime maximum

Vision Insurance

EyeMed

EyeMed offers two options: EyeMed Basic, which provides allowances for frames and lenses, and EyeMed Enhanced, which also covers eye exams and more frequent hardware allowances as well as other valuable enhancements.

Benefits Resources and Rates

Find links to provider documents and websites, benefits counseling resources, and helpful information on key benefits, such as Retirement, Paid Time Off, and more.

Medical Dental & Vision Other

Signature Benefits

The university values its community members and regularly evaluates and adds to its menu of impressive signature benefits, including our Yale Advantages employee discount program.

Now is the time to take charge of your health and financial well-being by learning more about your full benefit offering at Yale, including home and family, personal, health and wellness, and educational benefits.

Home & family personal health & wellness education

Compare Plans

In-Network Benefits
Plan Information Yale Health
(Footnote 1)
Aetna smart care
(with Health Savings Account and Personal assistant)
Aetna Choice

Legacy aetna choice

 (closed to new enrollments)

In-Network Deductible
(Footnote 2)
None $1,500/$3,000 single/family $850/$1,700 single/family $150/$300 single/family
Co-Insurance
(Footnote 3)
None 10% 10% 0%
Annual Out-of-pocket Limit (includes deductible)
(Footnote 4)
$3,000/$6,000 single/family $4,000/$6,850 single/family $4,000/$6,850 single/family N/A
Health Savings Account Monthly Employer Contribution
(Footnote 5)
N/A $50 Single
$75 Single + Child(ren)
$75 Single + Spouse
$100 Family
N/A N/A
Prescription Drugs
(Footnote 6)

$10 Preferred
$35 Alternative
40% Non-preferred & Specialty (min/max $50/$100)

Co-pays apply when purchased at the Yale Health pharmacy, outside pharmacy prescriptions are the greater of 20% of the cost or the co-pay

Copay without a deductible applies to certain Preventive drugs. Visit 2020 Benefit Enrollment Page for a list. If not on the preventive list, deductible and coinsurance will apply.

After Deductible is met, the following copays apply:
$10 Preferred
$35 Alternative
40% Non-preferred & Specialty (min/max $50/$100)

$10 Preferred
$35 Alternative
40% Non-preferred & Specialty (min/max $50/$100)
$10 Preferred
$35 Alternative
40% Non-preferred & Specialty (min/max $50/$100)
Durable Medical Equipment 10% coinsurance 10% coinsurance 10% coinsurance N/A
Preventative Care $0 $0 $0 $0
Office Visit PCP/
Mental Health Specialist
$0 Deductible and coinsurance apply $25 $25
Office Visit: Specialist
(Footnote 1)
$0 Deductible and coinsurance apply $40 $40
Emergency Room $150 (waived if admitted) Deductible and coinsurance apply $150 (waived if admitted) $150 (waived if admitted)
Teladoc N/A Deductible and coinsurance apply $25 $25
Advocacy Services N/A Included Included Included
Urgent Care $0 Mon-Fri 8am-6pm,
(After hours $20)
Deductible and coinsurance apply $50 $50
Routine Eye Exams
(Footnote 1)
$0 Deductible and coinsurance apply $40 $40
Physical Therapy/Chiropractic Physical therapy: $0
Chiropractic: up to 12 visits per year, at a $50 reimbursement per visit
Deductible and coinsurance apply $40 (reviewed for medical necessity after 25 visits) $40 (reviewed for medical necessity after 25 visits)
Inpatient Hospital $300 Deductible and coinsurance apply Deductible and coinsurance apply $300
Outpatient Surgical $200 Deductible and coinsurance apply Deductible and coinsurance apply $200
Diagnostic X-ray/Lab $20 (x-ray) outside Yale Health Deductible and coinsurance apply Deductible and coinsurance apply $20 (x-ray)
Complex Imaging (MRI, CT Scan, etc.) $100 outside Yale Health Deductible and coinsurance apply Deductible and coinsurance apply $100
Out-of-Network Benefits
Plan Information Yale Health
(Footnote 1)
Aetna smart care plan
(with Health Savings Account and Personal assistant)
Aetna Choice

Legacy aetna choice

 (closed to new enrollments)

Out-of-Network Deductible
(Footnote 2)
N/A $1,500/$3,000
single/family
$2,000/$4,000
single/family
$2,000/$4,000
single/family
Co-Insurance
(Footnote 3)
N/A 30% 30% 30%

Annual Out-of-pocket Limit (includes deductible)
(Footnote 4)

N/A $6,500/$13,000
single/family
$6,000/$12,000
single/family
$6,000/$12,000
single/family
University Infertility Benefits
Plan INformation Yale Health
(Footnote 1)
Aetna smart care plan
(with Health Savings Account and Personal assistant)
Aetna Choice

Legacy aetna choice

 (closed to new enrollments)

Infertility Services
(Footnote 7)
$20,000 Lifetime maximum; Pre-authorization required. $20,000 Lifetime maximum; Pre-authorization required. $20,000 Lifetime maximum; Pre-authorization required. $20,000 Lifetime maximum; Pre-authorization required.
In-Vitro Fertilization & ART
(Footnote 7)
Four (4) cycles, Lifetime maximum; Pre-authorization required. Four (4) cycles, Lifetime maximum; Pre-authorization required. Four (4) cycles, Lifetime maximum; Pre-authorization required. Four (4) cycles, Lifetime maximum; Pre-authorization required.

Footnotes:

  1. Yale Health only provides out-of-area coverage for emergency and urgent care. A $50 late cancellation or no show penalty may apply to certain services. See Yale Health website and plan document for details.
  2. The amount of out-of-pocket expenses you must pay for service before the plan pays any expenses per calendar year.
  3. The amount you must pay for services, after the deductible has been paid.
  4. The maximum amount you have to pay toward the cost of your medical care in the course of one year, including co-insurance and deductible.
  5. If eligible, the HSA employer contribution will be prorated for non calendar year effective dates. The employer contribution requires HSA eligibility, account set up, and is contingent on enrollment in the Aetna Smart Care plan.
  6. If a Preferred drug is available and an Alternative or Non-preferred drug is dispensed, you will be charged the applicable co-pay plus the difference in cost between the Alternative or Non-preferred drug and Preferred drug cost even if your provider requests the Alternative drug. In most cases, the Preferred drug is the same chemical entity/active ingredient as the Non-preferred drug.
  7. In-Vitro Fertilization & Advanced Reproductive Technology (ART), are subject to life time limit of four (4) cycles. Artificial insemination (IUI) is subject to the $20,000 limit. See Plan Documents & Notices for plan details. This is a lifetime limit per contract regardless of carrier chosen.

This chart is a summary of the benefits provided under each option. For complete details, refer to the Yale Health and Aetna Plan Summary of Benefits and Plan documents located on the benefits website at

The applicable plan documents govern all questions of interpretation.

Do you have other insurance?

For members covered by more than one insurance plan (such as your employer plan and your spouse’s employer plan) Coordination of Benefits (COB) is the method used by Yale Health to determine which plan pays first, which pays second, and the amount paid by each plan. Yale Health will use the COB method to ensure that members covered by more than one insurance plan will receive the benefits they are entitled to while avoiding overpayment by either plan.

If you are enrolled in an insurance plan in addition to Yale Health, you must provide information about that plan to Yale Health on the Insurance Information Update (COB) form.

Failure to disclose this may affect the terms of your coverage or denial of claims. Visit Health Coverage for more information about coordination of benefits.

Provider Contact Information

For Contact Telephone
Medical Yale Health 203-432-0246
  Aetna 866-253-8886
Vision EyeMed 866-299-1358
Dental Delta 800-494-4138
  CIGNA 800-367-1037
Flexible Spending Accounts (FSA)
Commuter
Tuition Reimbursement
Yale Spending Account 877-352-5552; #6
Counseling and Support Services Magellan Health Services 800-327-9240
403 (b) Plans TIAA 855-250-5424
Staff Pension Plan ALIGHT 877-352-5552; #5