Aetna Mid-Atlantic HMO
Leesa
on 11/9/05 7:53 pm - MD
on 11/9/05 7:53 pm - MD
Whether Aetna Mid-Atlantic HMO covers, or not, will depend on the type of group plan offered by your husband's employer. They may have to if the employer has more than 50 employees and the health plan contract is governed by Maryland law, and the health plan is not self-funded.
If there are fewer than 50 employees, Aetna is not required to include the coverage, and you need to contact the HR department of the employer to see if they have purchased the rider providing coverage (insurance companies are not required to sell the rider, if requested).
If the plan is self-funded, it means the employer is, technically, the insurer and the insurance company has been out-sourced to administer the plan. In that case, it's the employer who decides whether to include the coverage, not the insurance company.
Bottom line, you need more information, as one person's experience with a particular insurance company may not be the same with the same company if the underlying plan for the employer is different.