Medical Plan Information

    • Aetna Medical Benefit Comparison October 2022 - This document outlines the plans available to employees effective 1/1/23 along with their costs. These mirror the plans that are currently available under the state's School Employee Health Benefit Program. 

    • Aetna DocFind - This document outlines how to determine if your providers are in-network. You will need to search as a guest and use the following information to perform an accurate search: 

    New Plan Name

    Search using this Plan Name on Aetna’s website

    Aetna Open Access Managed Choice 10

    Managed Choice POS (Open Access)

    Aetna Open Access Managed Choice 15

    Managed Choice POS (Open Access)

    Aetna NJ Educators Health Plan (NJ EHP)

    Managed Choice POS (Open Access)

    Aetna NJ Garden State Plan (NJ GSP)

    (NJ) Aetna Whole Health New Jersey Choice POS II 4

    Aenta Enrollment Form  - The completed form should be emailed to Manal Fouad by 11/9/2022. In section D1 you will need to write the plan you are selecting from the following choices:

    • Aetna Open Access Managed Choice 10 (OAMC 10)  (State Plan Equivalent = NJ DIRECT 10)
    • Aetna Open Access Managed Choice 15 (OAMC 15) (State Plan Equivalent = NJ DIRECT 15)
    • Aetna NJ EHP  (State Plan Equivalent = NJ EHP)
    • Aetna NJ GSP (State Plan Equivalent = NJ GSP)

    Transition of Care Form

    Aetna Health App & New Member Website Flyer

    Aetna 2023 Pricing Teladoc Member Flyer

Prescription Plan Information

  • Aetna’s pharmacy network is a broad national network that includes 66,000  pharmacies nationwide and includes most chains and many independent pharmacies. The formularies with Aetna are comparable to those with Optum Rx, but they may differ from one pharmacy benefit manager to another.  It is important to attend one of the educational meetings or watch the recording that will be made available to ensure you have everything you need to properly search for your medication and understand how it’s covered.   Please follow these important steps:

    1. Attempt to fill your current medication one final time prior to 12/31/22.
    2. Your medication may require Prior Authorization with Aetna.  Not all medications require this, but many do (especially brand-name meds). We strongly encourage you to search the online Rx Formulary with Aetna using the following link  to confirm whether your doctor needs to request the authorization or not:  https://www.aetna.com/individuals-families/find-a-medication.html
      1. If you are enrolled in the NJ EHP or NJ GSP:  Select 2023 under “Choose A Plan Year” and  the NJ Educators Health Plan Formulary under “Choose A Plan”.
      2. If you are enrolled in the OAMC 10 or OAMC 15 (NJ Direct 10 and NJ Direct 15 Equivalents):  Select 2023 under “Choose A Plan Year” and Standard Opt Out Plan with ACSF under “Choose A Plan”.
      3. Click "View Pharmacy Plan" to find your medication or to download the guide.
    3. The first time you visit your pharmacy on or after 1/1/23 be sure to confirm with the pharmacy they are using your new Aetna member ID. 

    Mail Order Form

    Search for a Pharmacy (use the "Find a Pharmacy" option)

     

Cost Information

Flexible Spending Accounts

Waiving Coverage

Dental Plan Information


  • Questions about your medical, dental or vision benefits? Please contact:

    Ms. Manal Fouad

    973-663-5780, ext. 5024 ~ mfouad@jefftwp.org