Aetna HDHP with HSA

The Aetna High Deductible Health Plan (HDHP) with Health Savings Account (HSA)is a high deductible plan that provides comprehensive medical coverage through in-network providers who are affiliated with the Plan or through out-of-network providers who do not participate in the Plan's network. In-network preventive care is paid at 100%, with no coinsurance, no deductible and no copayment. All other services are subject to the deductible, coinsurance, and/or copays. It is important to note that the deductible applies to prescription drugs as well. 

The tax-advantaged HSA is what really sets the HDHP apart from other traditional medical plans. The HSA allows you to contribute money from your paycheck, tax-free, into your HSA to help cover your deductible and other qualified healthcare expenses. Segal also makes contributions to your HSA. With an HSA, you’ll have the potential to build more savings for healthcare expenses or additional retirement savings through self-directed investment options.

Provider Network. The Aetna HDHP with HSA uses the Aetna Choice® POS II (Open Access) provider network. If you call a provider to check their network status, please be sure to ask specifically if they are in-network, rather than if they accept the coverage. Some providers accept the coverage, but on an out-of-network basis, which generally costs more.

Prescription drug coverage is provided through OptumRx. It is important that you understand how the prescription drug plan works for the Aetna HDHP plan.

In 2026 the Aetna HDHP deductibles and out-of-pocket maximum amounts are changing, and Segal's contribution to your HSA is also increasing. 

Provision	2026 Amount
Deductible	·In-Network: $1,850/$3,700* ·Out-of-Network: $4,750/$9,500*
Out-of-pocket Maximum	·In-Network: $4,750/$9,500* ·Out-of-Network: $8,750/$17,500*
Coinsurance	·In-Network: 10%  Out-of-Network: 40%
Company HSA Contribution	$750/$1,500*

*Employee/Employee plus One or Employee plus Family

You have access to the Aetna Back and Joint Care Services Partnership with Hinge Health.

• Manage chronic back and joint pain or get support for women's pelvic health with digital exercise therapy.
• Engage with a physical therapist virtually for more recent musculoskeletal issues.
• Avoid common musculoskeletal conditions through the wellness program.
• The Hinge Health program is included on your Aetna member website, with a direct connection to the Hinge Health online screener.

The Aetna HDHP Transform Oncology program includes resources and support you may need to manage your cancer care, understand your benefits and locate the right providers.

• Personal Navigator. Your dedicated advocate who will provide you and your caretaker with personalized support.
• Guided Genetic Health® program. Genetic counseling and testing can help guide your treatment and assess your risk of developing other forms of cancer.
• Aetna Cancer Support Center. Providing resources to your fingertips, serving as your trusted source for information and guidance on what to expect while managing cancer treatment and care.

The Aetna HDHP includes a variety of transition assistance transgender services*, such as:

• Behavioral health services. Your mental well-being is important and talking to a behavioral health provider before your gender affirmation surgery is a requirement for your transition planning.
• Hormone therapy and medications (covered under OptumRx). Used to make you more masculine or more feminine.
• Gender affirmation surgery and gender support services. Aetna Concierge Services can help you find an appropriate surgeon and work with your surgeon to get all the precertifications needed.
• Reproductive services. You may be covered for in vitro fertilization services (note that ART reproductive services are only covered under the Aetna HDHP, not under the Aetna PPO).
• Staying healthy after your surgery. You’re covered for preventive health services based on your birth anatomy, including certain cancer screenings.

*Coverage for gender transition services depends on certain federal laws.

The Aetna HDHP with HSA is covering 3 lifetime attempts of Advanced Reproductive Technology (ART) infertility treatment as long as the definition of infertility is met and prior required steps are taken. Please see the Summary of Benefits, Booklet Certificate and Schedule of Benefits for full details and limitations.  Note: The Aetna PPO does not include ART coverage. 

The Aetna HDHP with HSA also provides access to even more helpful services at no extra cost, including:

• Mental health support
• Aetna Concierge and 24-hour nurse line for personalized customer assistance and registered nurse availability
• CVS Minute Clinic for virtual or in-person evaluation, diagnosis, and treatment of minor injuries and illnesses
• Aetna Maternity Program for support before, during and after pregnancy

View the 2026 Aetna HDHP Summary of Benefits and Coverage (SBC) and the 2026 Aetna HDHP Summary of Benefits. 

Learn more about how the HSA works.

View the 2026 Aetna HDHP Booklet Certificate and the 2026 Aetna HDHP Schedule of Benefits for the details of your healthcare benefits, your share of the costs and which services are covered.