Preferred Plans Overview
Open Choice and Point of Service plans are available through the BMCS Health Care Consortium. To get the most out of your benefits program, below are some key terms you will need to understand.
- Referral: Documentation from your PCP authorizing care at a participating specialist for covered services.
- Preauthorization: Approval from Aetna for non-emergency or elective hospital admissions and procedures before the admission or procedure. For in-network (referred) services, your participating provider will contact Aetna for authorization. For out-of-network (self-referred) services, you are responsible for obtaining approval for certain services.
- Designated Site: PCPs are required to choose one radiology, physical therapy, occupational therapy, laboratory, and routine foot care provider for all of their Aetna members.
Aetna Open Choice Plans
With Aetna Open Choice plans, you do not need to enroll with a primary care physician and never need referrals for care or services. The Aetna Open Choice plan allows you to choose your own doctors and hospitals. Maximize coverage by accessing your care through Aetna Open Choice’s network of hospitals, doctors, and specialists.
You have the freedom to select providers who do not participate in the Aetna Open Choice network. However, if you receive services from out-of-network providers, you will have higher out-of-pocket costs and may have to submit your claim for reimbursement.
- Aetna Account Login: Click the link to go to the secure Aetna member login page.
- In-network Rates & Allowed Amounts: Click on the link for specific information about covered items and services.
- Notice of Special Rights Enrollment: Download to learn about special enrollment eligibility.
- Price Transparency: Click to learn more about price transparency.
BMCS Point of Service Plans (POS)
The Point of Service (POS) plan lets you maintain freedom of choice by allowing you to select your own doctors and hospitals. You maximize your coverage by having care provided or referred by your primary care physician (PCP).
With a POS plan, you also have the freedom to self-refer your care to providers who do not participate in our network. Higher out-of-pocket costs apply. Note that this program may not cover all your health care services.
For more information regarding your medical plans, go to www.bmshc.aetna.com.