Health & Dental Insurance
Health Coverage
As a NAF instrumentality of the Federal Government, the Marine Corps NAF community offers health insurance through the Department of Defense (DoD) Uniform Health Plan (UHP). Aetna US Healthcare (AUSHC) is currently the third party administrator for the DoD UHP. DoD UHP includes coverage for medical and dental. Health Maintenance Organizations (HMOs) are available in some geographic locations, in addition to the DoD UHP. Under the DoD UHP there are two different benefit options available. Employees electing to enroll in the DoD UHP are mandated into the plan that is available in their geographic area. Listed below is a description of the available plans. For additional information, or specific plan coverage, please contact your local personnel office.
- Managed Care Plan POS II
This plan is known as a "preferred provider" plan. As a member of this plan, each member is required to seek medical care from a list of participating providers, known as "network providers". If care is obtained outside of this network, benefits will be paid at a lesser level. There is no requirement for a PCP with the Open Choice plan. - Traditional Choice
This plan is known as a traditional "indemnity" plan. There are no networks to follow, there is no requirement to select a PCP. Under this plan, each member has an annual deductible and specific co-insurance limits.
To determine which plan is available in your geographic area, contact your local personnel office.
Aetna International
Aetna International is an overseas benefit for Aetna participants that makes sure you are taken care if in the event of routine or emergency medical or dental situations during your employment overseas. It provides portable and comprehensive worldwide medical and dental coverage that offers you the flexibility to access care from the provider of your choice anywhere in the world. Aetna has establised relationships with leading hospitals and other medical facilities throughout the world to make it as easy as possible for you to get proper medical attention, When you need it, Where you need it.
When you access care at an Aetna International contracted direct-pay medical facility provider, your out-of-pocket expenses may be reduced because you'll generally be responsible for a smaller portion of the bill and Aetna will pay the facility directly for any remaining covered expenses according to your specific benefits coverage.
To contact an Aetna International Customer Service Representative, please call 888-506-2278, or collect at 813-775-0189. For more information about Aetna International, please log onto: www.aetnainternational.com . You can also contact an Aetna International representative by email at agbservice@aetna.com
Aetna's multilingual member service professionals are available 24 hours a day, via telephone, fax or e-mail to respond to members' international benefits needs. They can also assist you with locating a health care professional in your area, questions regarding claims, benefit levels and coverage. They also provide Global Claim Processing, in virtually any language with three reimbursement options, to include via check, wire, or Electronic Funds Transfer (EFT).
Dental Coverage
Enrollment in the dental plan is only offered to participants of the DoD UHP medical plan. If you are enrolled in an HMO plan that doesn't offer dental coverage then you may be eligible to enroll in the Aetna Dental plan. If you are enrolled in an HMO that offers dental coverage then your only option for dental insurance is with that HMO. You will not be eligible for dental coverage through Aetna. IF YOU ARE NOT ENROLLED IN ONE OF THE MARINE CORPS SPONSORED MEDICAL PLANS, ENROLLMENT IN THE SELF INSURED DENTAL PLAN IS NOT AUTHORIZED. If you are enrolled in the fully insured Stand Alone Dental Plan coverage can not be continued after employment.
Stand Alone Dental Plan
Effective 1 January 2008 a Stand Alone Dental Plan was implemented.
Enrollment in the Stand Alone Dental (SAD) plan is offered to eligible employees who are NOT participating in a Marine Corps Sponsored medical plan. The Stand Alone Dental Plan coverage can not be continued after employment.
Machine Readable Files (MRF's)
Aetna - Machine Readable Files (MRFs)
Medicare Part D
Health Maintenance Organizations:
In addition to the DoD UHP, there may be an HMO available in your area. The HMOs currenlty available to eligible civilian Marine Corps NAF employees are:
Northern Virginia - Kaiser Mid Atlantic
Southern California - Kaiser California
Hawaii - Kaiser Hawaii
Hawaii - HMSA
