Low Monthly Premium The Aqua Allowance Health and Wellness Card The Aqua Deductible Out-of-Pocket Expenses The Aqua Safety Net Pharmacy Benefit What’s Not Included Benefits Packages Aqua FAQs

 

Aqua Out-of-Pocket Expenses.

After meeting your deductible, you no longer pay all the costs for medical services. Depending on the covered service, you pay a coinsurance up to an out-of-pocket maximum. Aqua pays the balance.

How it Works.

Once your deductible is met, Aqua pays most of the cost for care for covered expenses and you pay a coinsurance. For most services, this is 20% for services in the Aqua Network and 50% for out-of-network services. To keep your financial health intact, there is an annual out-of-pocket maximum.

Aqua Network of Providers.

The out-of-pocket maximum is lower when you stay within the Aqua Network, but you have full control over where to receive your care. There are literally thousands of in-network providers from which to choose.

Cost of Care.

With Aqua Network providers, you will typically pay 20% of the lower, discounted rate for covered services, and 50% for out-of-network services. The Aqua Allowance and the Aqua Deductible do not count toward your out-of-pocket maximum but all coinsurance payments do count toward the out-of-pocket maximum.

Annual Plan.

At the beginning of the plan year, you have your full Aqua Allowance and must meet your deductible before coinsurance takes effect. The out-of-pocket maximum is an annual maximum.