Skip to content Accessibility info
As of December 19, 2024 Aetna/Meritain and Trinity Health (parent company of St Joe's Hospital in Syracuse, NY) are still in active negotiations to renew their in-network contractual agreement which is set to expire on December 31, 2024. Meritain has mailed letters to any Jefferson-Lewis Healthcare members who qualify for continuing care that could be potentially impacted by the expiration of this agreement. We will continue to post updates on this as they become available.

POS Plan PPO Out-of-Network Co-Pays, Deductibles & Allowances

Effective 7/1/25

ServiceCo-Pay
Individual DeductiblePer Person Annual Deductible - $483

Maximum Medical Annual Out-of-Pocket (includes deductible) - $1,415

The medical out of pocket maximums for the out of network POS Plan only includes the medical deductible and the medical coinsurance. There is no out of pocket maximum for prescription drugs.

Sample coverage examples can be found on page 6 on the Summary Benefit Comparison

Family DeductiblePer Family Annual Deductible - $1,448

Maximum Medical Annual Out-of-Pocket (includes deductible) - $4,211

The medical out of pocket maximums for the out of network POS Plan only includes the medical deductible and the medical coinsurance. There is no out of pocket maximum for prescription drugs.

Sample coverage examples can be found on page 6 on the Summary Benefit Comparison

Vision AllowancesExam - $61
Lenses (Single) - $50
Lenses (Bifocal) - $70
Lenses (Trifocal) - $91
Frames - $61
Contacts - $152