Human Resources

NAF Medical Benefits

Maximum Allowable Amount: 
As indicated in the open enrollment newsletters – Effective January 2015, the Aetna plan added the new provision called Maximum Allowable Amount. This provision limits the amount the plan will pay for certain procedures, even if you use an in network medical provider. If you elect to have a procedure on this list, and your provider charges more than the Maximum Allowable Amount, you will be responsible to pay the difference, so it’s important that you visit 
Aetna to verify the cost of the applicable procedures before you have them done. The list of applicable procedures includes, but not limited to: CT Scans and MRIs; Hernia Surgery, Tonsillectomy, Carpal Tunnel Surgery; Cataract Surgery; Scope procedures such as colonoscopy and endoscopy. Go to Aetna's website, log-in and click “I Want to View Deductibles and Plan Limits.” Scroll to the bottom and look for Maximum Allowable Amount.

Get more information on the Aetna Health Plans.