DOCSLIB.ORG

Dod NAF Health Benefits Program Aetna Traditional Choice Plan

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Dod NAF Health Benefits Program Aetna Traditional Choice Plan nafhealthplans.com DoD NAF Health Benefits Program Aetna Traditional Choice Plan 2020 Summary Plan Description Contents Welcome ............................................................................................................................................. 1 Understanding the Terms ................................................................................................................ 1 Amendment and Termination of the Plan ......................................................................................... 1 Plan Administration .......................................................................................................................... 1 Eligibility and Enrollment .................................................................................................................. 2 Who Is Eligible ................................................................................................................................. 2 Active Employees ........................................................................................................................ 2 Retired Employees ....................................................................................................................... 2 Dependents ................................................................................................................................. 3 How To Enroll .................................................................................................................................. 3 Newly Eligible Employees ............................................................................................................ 4 Open Enrollment .......................................................................................................................... 4 Retired Employees ....................................................................................................................... 5 Status Changes ........................................................................................................................... 5 When Coverage Begins ................................................................................................................... 7 Newly Eligible Employees ............................................................................................................ 7 Open Enrollment .......................................................................................................................... 7 Status Changes ........................................................................................................................... 7 Qualified Medical Child Support Order ......................................................................................... 7 How You Pay for Coverage ............................................................................................................. 7 Active Employees ........................................................................................................................ 7 Retired Employees ....................................................................................................................... 7 Your Medical ID Card....................................................................................................................... 8 Your Medical Plan at a Glance .......................................................................................................... 9 Summary of Benefits ....................................................................................................................... 9 Cost Sharing .............................................................................................................................. 11 Covered Services ....................................................................................................................... 12 How the Plan Works ........................................................................................................................ 21 Precertification ............................................................................................................................... 21 When You Need To Precertify Care ........................................................................................... 21 If You Don’t Precertify or If Precertification Is Denied ................................................................. 22 Coordination With Other Plans ....................................................................................................... 23 Effect of Another Plan on This Plan’s Benefits ............................................................................... 23 TRICARE ................................................................................................................................... 24 Coordination With Medicare ........................................................................................................... 25 Plan Options for Those Who Are Eligible for Medicare ............................................................... 25 Medicare Eligibility ..................................................................................................................... 25 When This Plan Is Primary ......................................................................................................... 25 When Medicare Is Primary ......................................................................................................... 26 Subrogation and Right of Recovery ............................................................................................... 27 Definitions .................................................................................................................................. 27 Right of Recovery ...................................................................................................................... 27 When You Accept Plan Benefits ................................................................................................ 28 What the Plan Covers ...................................................................................................................... 30 Preventive Care ............................................................................................................................. 30 Routine Physical Exams and Well Child Visits ........................................................................... 30 Routine Ob/Gynecological Exams .............................................................................................. 30 Routine Cancer Screenings ....................................................................................................... 30 Screening and Counseling Services........................................................................................... 31 Contents ii Proprietary Vision and Hearing Exams ............................................................................................................. 31 Routine Eye Exams ................................................................................................................... 31 Routine Hearing Exams ............................................................................................................. 31 Office Visits .................................................................................................................................... 32 Walk-In Clinics ........................................................................................................................... 32 Telehealth Physician Consultations – For Actives and Retirees Under 65 ................................. 32 Spinal Manipulation .................................................................................................................... 32 Outpatient Diagnostic Testing ........................................................................................................ 32 Diagnostic X-Ray and Laboratory Tests ..................................................................................... 32 MRI, PET Scan, and CAT Scan ................................................................................................. 32 Hospital Services ........................................................................................................................... 33 Urgent and Emergency Care ......................................................................................................... 33 Urgent Care ............................................................................................................................... 33 Emergency Care ........................................................................................................................ 33 Ambulance ................................................................................................................................. 33 Surgery and Anesthesia ................................................................................................................. 34 Pre-Operative Testing ................................................................................................................ 34 Oral Surgery .............................................................................................................................. 34 Outpatient Surgery ..................................................................................................................... 35 Reconstructive Surgery .............................................................................................................
Load more

Recommended publications
  • Gold & Platinum Awards June// 6/1/17 - 6/30/17
    GOLD & PLATINUM AWARDS JUNE// 6/1/17 - 6/30/17 MULTI PLATINUM SINGLE // 34 Cert Date// Title// Artist// Genre// Label// Plat Level// Rel. Date// We Own It R&B/ 6/27/2017 2 Chainz Def Jam 5/21/2013 (Fast & Furious) Hip Hop 6/27/2017 Scars To Your Beautiful Alessia Cara Pop Def Jam 11/13/2015 R&B/ 6/5/2017 Caroline Amine Republic Records 8/26/2016 Hip Hop 6/20/2017 I Will Not Bow Breaking Benjamin Rock Hollywood Records 8/11/2009 6/23/2017 Count On Me Bruno Mars Pop Atlantic Records 5/11/2010 Calvin Harris & 6/19/2017 How Deep Is Your Love Pop Columbia 7/17/2015 Disciples This Is What You Calvin Harris & 6/19/2017 Pop Columbia 4/29/2016 Came For Rihanna This Is What You Calvin Harris & 6/19/2017 Pop Columbia 4/29/2016 Came For Rihanna Calvin Harris Feat. 6/19/2017 Blame Dance/Elec Columbia 9/7/2014 John Newman R&B/ 6/19/2017 I’m The One Dj Khaled Epic 4/28/2017 Hip Hop 6/9/2017 Cool Kids Echosmith Pop Warner Bros. Records 7/2/2013 6/20/2017 Thinking Out Loud Ed Sheeran Pop Atlantic Records 9/24/2014 6/20/2017 Thinking Out Loud Ed Sheeran Pop Atlantic Records 9/24/2014 www.riaa.com // // GOLD & PLATINUM AWARDS JUNE// 6/1/17 - 6/30/17 6/20/2017 Starving Hailee Steinfeld Pop Republic Records 7/15/2016 6/22/2017 Roar Katy Perry Pop Capitol Records 8/12/2013 R&B/ 6/23/2017 Location Khalid RCA 5/27/2016 Hip Hop R&B/ 6/30/2017 Tunnel Vision Kodak Black Atlantic Records 2/17/2017 Hip Hop 6/6/2017 Ispy (Feat.
    [Show full text]
  • CALENDAR Absolute
    8 NEW MUSICAL EXPRESS * Friday. November 23. 1962 laWteeslctoumse.tvoisoiutorr abnadcwk etolcooumre JOHNNY TILLOTSON LONNIE DONEGAN present the INcontrasttotheclamoursurroundingmany LONNIE DONEGAN'S four -week spellat New York's American disc stars when they come to this country, Village Gate jazz club brought some forthright comments the visit of Johnny Tillotson has so far gone unsung to PICK a large extent-principally because he is not making on his own ability-and the abilities of British -made artists- of the any concert appearances on thisoccasion.But the when I spoke to him on his return at the weekend. arrival of a guest from the States, who has previously " We settled down all right after PICK-UPS enjoyed a No. 1 hit in Britain, cannot go unheralded- a shaky start," he said.Shaky ? 1111111111111111111111M111111111111111111111 particularly when it happens to be his first visit here. " Yes-that's how you get wheni le his Johnny arrives at a singularly appropriate time, for yousing My OldMan's A waxing of" Send Me The Pillow You Dream On " has By MIKE Dustman'toStanGetzfans," recently been faring extremely welt, despite intense compe- replied Lonnie. tition from two cover versions by British artists. HELLICAR This disc also marked Johnny's comeback tothe NME "This was the situation, Greenwich Chart,after an absence of more than18months--and Village, where our club was situated, MIIII1111111111111111111111111111111111111111111 doubtless his return ea favour was sparked off by the present is a tourist attraction.The ()bibis notable increase in popularity of c -and -w a jazz dub.As a result, during the ht was two years ago this week that Johnny made his hit week you get very severe jazz fans,Silvester's orchestra playing hot jazz parade debutinBritain, withhisintriguing recording of very miserable just sitting wondering-and then hearing the same band Poetry In Motion." adisc"whiCh was to oliimb to the tap whatonearthyouare sinigingwith Dizzy Gillespie sitting in.The of thetable.
    [Show full text]
  • Reed First Pages
    4. Northern England 1. Progress in Hell Northern England was both the center of the European industrial revolution and the birthplace of industrial music. From the early nineteenth century, coal and steel works fueled the economies of cities like Manchester and She!eld and shaped their culture and urban aesthetics. By 1970, the region’s continuous mandate of progress had paved roads and erected buildings that told 150 years of industrial history in their ugly, collisive urban planning—ever new growth amidst the expanding junkyard of old progress. In the BBC documentary Synth Britannia, the narrator declares that “Victorian slums had been torn down and replaced by ultramodern concrete highrises,” but the images on the screen show more brick ruins than clean futurescapes, ceaselessly "ashing dystopian sky- lines of colorless smoke.1 Chris Watson of the She!eld band Cabaret Voltaire recalls in the late 1960s “being taken on school trips round the steelworks . just seeing it as a vision of hell, you know, never ever wanting to do that.”2 #is outdated hell smoldered in spite of the city’s supposed growth and improve- ment; a$er all, She!eld had signi%cantly enlarged its administrative territory in 1967, and a year later the M1 motorway opened easy passage to London 170 miles south, and wasn’t that progress? Institutional modernization neither erased northern England’s nineteenth- century combination of working-class pride and disenfranchisement nor of- fered many genuinely new possibilities within culture and labor, the Open Uni- versity notwithstanding. In literature and the arts, it was a long-acknowledged truism that any municipal attempt at utopia would result in totalitarianism.
    [Show full text]
  • My Bloody Valentine's Loveless David R
    Florida State University Libraries Electronic Theses, Treatises and Dissertations The Graduate School 2006 My Bloody Valentine's Loveless David R. Fisher Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected] THE FLORIDA STATE UNIVERSITY COLLEGE OF MUSIC MY BLOODY VALENTINE’S LOVELESS By David R. Fisher A thesis submitted to the College of Music In partial fulfillment of the requirements for the degree of Master of Music Degree Awarded: Spring Semester, 2006 The members of the Committee approve the thesis of David Fisher on March 29, 2006. ______________________________ Charles E. Brewer Professor Directing Thesis ______________________________ Frank Gunderson Committee Member ______________________________ Evan Jones Outside Committee M ember The Office of Graduate Studies has verified and approved the above named committee members. ii TABLE OF CONTENTS List of Tables......................................................................................................................iv Abstract................................................................................................................................v 1. THE ORIGINS OF THE SHOEGAZER.........................................................................1 2. A BIOGRAPHICAL ACCOUNT OF MY BLOODY VALENTINE.………..………17 3. AN ANALYSIS OF MY BLOODY VALENTINE’S LOVELESS...............................28 4. LOVELESS AND ITS LEGACY...................................................................................50 BIBLIOGRAPHY..............................................................................................................63
    [Show full text]
  • The Educative Experience of Punk Learners
    University of Denver Digital Commons @ DU Electronic Theses and Dissertations Graduate Studies 6-1-2014 "Punk Has Always Been My School": The Educative Experience of Punk Learners Rebekah A. Cordova University of Denver Follow this and additional works at: https://digitalcommons.du.edu/etd Part of the Curriculum and Instruction Commons Recommended Citation Cordova, Rebekah A., ""Punk Has Always Been My School": The Educative Experience of Punk Learners" (2014). Electronic Theses and Dissertations. 142. https://digitalcommons.du.edu/etd/142 This Dissertation is brought to you for free and open access by the Graduate Studies at Digital Commons @ DU. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ DU. For more information, please contact [email protected],[email protected]. “Punk Has Always Been My School”: The Educative Experience of Punk Learners __________ A Dissertation Presented to the Faculty of the Morgridge College of Education University of Denver __________ In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy __________ by Rebekah A. Cordova June 2014 Advisor: Dr. Bruce Uhrmacher i ©Copyright by Rebekah A. Cordova 2014 All Rights Reserved ii Author: Rebekah A. Cordova Title: “Punk has always been my school”: The educative experience of punk learners Advisor: Dr. Bruce Uhrmacher Degree Date: June 2014 ABSTRACT Punk music, ideology, and community have been a piece of United States culture since the early-1970s. Although varied scholarship on Punk exists in a variety of disciplines, the educative aspect of Punk engagement, specifically the Do-It-Yourself (DIY) ethos, has yet to be fully explored by the Education discipline.
    [Show full text]
  • 2016 Nielsen Music U.S. Mid-Year Report
    2016 NIELSEN MUSIC U.S. MID-YEAR REPORT 2016 NIELSEN MUSIC MID-YEAR U.S. REPORT Copyright © 2016 The Nielsen Company 1 2016 MID-YEAR HIGHLIGHTS AND ANALYSIS Nielsen, the music industry’s leading data information provider presents the 2016 U.S. Music mid-year report for the 6-month period of January 1, 2016 through June 30, 2016. • Audio has surpassed Video as the leading Streaming format in 2016. Audio share of streaming is 54% in 2016, growing from 44% through the first six months of 2015. • There are 3 albums that have sold over 1 Million units so far this year (Adele/25, Drake/Views and Beyonce/Lemonade), while there was only 1 at this time last year (Taylor Swift/1989). • Creative release strategies, driven mostly by digital formats, continue to be a major story. Drake’s “Views”, Beyonce’s “Lemonade” and Kanye Wests “The Life of Pablo” have all been successful this year and are led by digital formats. Also, 2016 saw the first album to chart based solely on streaming activity, when Chance the Rapper debuted at #8 in its first week with 57M audio streams. • Digital purchasing has seen the largest decline of all formats with Digital tracks down 24% and digital albums down 18%. Total digital purchasing (Albums + Track Equivalents) is down 21% vs. the first half of 2015. However, factoring in the gains in streaming and total digital consumption is up 15%. • Vinyl continues to become a bigger piece of the physical music business. Vinyl LPs now comprise nearly 12% of the physical business in the first half of 2016, which far surpasses last year’s record pace of 9%.
    [Show full text]
  • ACT Early Milestone Moments
    Milestone Moments Learn the Signs. Act Early. Learn the Signs. Act Early. www.cdc.gov/milestones 1-800-CDC-INFO Adapted from CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5, Fifth Edition, edited by Steven Shelov and Tanya Remer Altmann © 1991, 1993, 1998, 2004, 2009 by the American Academy of Pediatrics and You can follow your child’s development by watching how he or BRIGHT FUTURES: GUIDELINES FOR HEALTH SUPERVISION OF INFANTS, CHILDREN, AND ADOLESCENTS, Third she plays, learns, speaks, and acts. Edition, edited by Joseph Hagan, Jr., Judith S. Shaw, and Paula M. Duncan, 2008, Elk Grove Village, IL: American Academy of Pediatrics. Special acknowledgements to Susan P. Berger, PhD; Jenny Burt, PhD; Margaret Greco, MD; Katie Green, MPH, Look inside for milestones to watch for in your child and how you CHES; Georgina Peacock, MD, MPH; Lara Robinson, PhD, MPH; Camille Smith, MS, EdS; Julia Whitney, BS; and can help your child learn and grow. Rebecca Wolf, MA. Centers for Disease Centers for Disease Control and Prevention Control and Prevention www.cdc.gov/milestones www.cdc.gov/milestones 1-800-CDC-INFO 1-800-CDC-INFO 220788 Milestone Moments How your child plays, learns, speaks, and acts offers important clues about your child’s development. Developmental milestones are things most children can do by a certain age. The lists that follow have milestones to look for when your child is: 2 Months ............................................................... page 3 – 6 Check the milestones your child has reached at each age. 4 Months ............................................................... page 7 –10 Take this with you and talk with your child’s doctor at every visit about the milestones your child has reached and what to 6 Months ..............................................................
    [Show full text]
  • As Part of Its Mission, for a Quarter of a Century, the Shaker Heights School
    january | february 2004 Preparing Tomorrow’s Leaders s part of its mission, for a quarter of a century, the Shaker Heights School System has been active in international programs to prepare students as leaders and citizens for the future in a Amulti-cultural society and global economy. Over the past 25 years, well over 2,500 students have gained from intercultural opportunities by spending time with families in other nations, learning their cultures, customs and major landmarks for up to an entire semester. The program is growing. This year, with the addition of a new program in China, six other countries will be involved. What's more, every few years, members of the Shaker High School choir, orchestra and band travel abroad, performing in musical ensembles in places such as Germany, Czech Republic, Austria, France, Italy, and England. These enriching opportunities enable students to learn more about themselves, as well as other parts of the world. The Shaker Heights City Schools can make a world of difference to succeed in a different world. Smythe, Cramer Co. is delighted to call Shaker Heights “home!” Smythe, Cramer Co. ~ Shaker Heights Office 20710 Chagrin Blvd., Shaker Heights, Ohio 44122 Phone: 216.751.8550 Equal Housing Opportunity VOLUME 22 NUMBER 1 JANUARY | FEBRUARY 2004 820 26 15 2004 Shaker Preschool Programs 20 Prime Times Shaker's senior adults find fun, fitness and friendship BY AMY GARVEY 26 Extracurricular Activities When school's out, Shaker teachers enjoy interesting pastimes BY DALE CALLENDER AGGOR 32 Summer Fiction
    [Show full text]
  • Florida Early Learning and Developmental Standards Introduction
    FLORIDA EARLY LEARNING AND DEVELOPMENTAL STANDARDS INTRODUCTION INTRODUCTION INTRODUCTION INTRODUCTION INTRODUCTION INTRODUCTION The first five years of life is a period of rapid development for young children. The first five years of life is a period of rapid development for young children. Recent research supports that every child is born with well-developed senses and reflexes. Recent research supports that every child is born with well-developed senses Beginning at birth, young infants are able to form relationships with adults, develop trust, and reflexes. Beginning at birth, young infants are able to form relationships with and explore the world. With adequate nutrition, an appropriate environment, and nurturing adults, develop trust, and explore the world. With adequate nutrition, an appropriate by responsive adults, young children become actively engaged in exploration and in learning environment, and nurturing by responsive adults, young children become actively about their environments. Each child’s special temperament and family context ensure that, engagedwhile development in exploration will follow and a somewhatin learning predictable about their sequence, environments. the child’s Each development child’s specialwill be unique. temperament and family context ensure that, while development will follow a somewhat predictable sequence, the child’s development will be unique. Florida’s Early Learning and Developmental Standards is a comprehensive document containingFlorida’s age-appropriate Early Learning information and Developmental and reflections Standardsabout how youngis a comprehensive children explore, documentcreate, and containingthink. The age-appropriateStandards are grounded information in Florida’s and reflections conviction aboutthat children’s how young early childrenexperiences explore, are directly create, relatedand think. to laterThe Standardssuccess in are school, grounded in the in workforce, Florida’s conviction and in life.
    [Show full text]
  • Pdufa Reauthorization Performance Goals and Procedures Fiscal Years 2023 Through 2027
    PDUFA REAUTHORIZATION PERFORMANCE GOALS AND PROCEDURES FISCAL YEARS 2023 THROUGH 2027 I. ENSURING THE EFFECTIVENESS OF THE HUMAN DRUG REVIEW PROGRAM A. Review Performance Goals B. Program for Enhanced Review Transparency and Communication for NME NDAs and Original BLAs C. New Molecular Entity (NME) Milestones and Postmarketing Requirements (PMRs) D. Split Real Time Application Review (STAR) Pilot Program E. Expedited Reviews F. Review of Proprietary Names to Reduce Medication Errors G. Major Dispute Resolution H. Clinical Holds I. Special Protocol Question Assessment and Agreement J. Meeting Management Goals K. Enhancing Regulatory Science and Expediting Drug Development L. Enhancing Regulatory Decision Tools to Support Drug Development and Review M. Enhancement and Modernization of the FDA Drug Safety System N. Enhancements Related to Product Quality Reviews, Chemistry, Manufacturing, and Controls Approaches, and Advancing the Utilization of Innovative Manufacturing Technologies O. Enhancing CBER’s Capacity to Support Development, Review, and Approval of Cell and Gene Therapy Products P. Supporting Review of New Allergenic Extract Products II. CONTINUED ENHANCEMENT OF USER FEE RESOURCE MANAGEMENT A. Resource Capacity Planning B. Financial Transparency 1 III. IMPROVING FDA HIRING AND RETENTION OF REVIEW STAFF A. Set Clear Goals for Human Drug Review Program Hiring B. Assessment of Hiring and Retention IV. INFORMATION TECHNOLOGY AND BIOINFORMATICS GOALS A. Enhancing Transparency and Leveraging Modern Technology B. Expanding and Enhancing
    [Show full text]
  • DC Biog Current
    THE DIVINE COMEDY – A BIOGRAPHY The Divine Comedy is Neil Hannon. Over the years, the name has encompassed other musicians, but the driving force of the band and its main (sometimes only!) member has always been Neil Hannon. He chose the name 'The Divine Comedy' aged 18, almost at random. He and two Enniskillen school friends needed a new name for their band and Neil spotted a copy of Dante’s epic poem on the family bookshelf. It stuck, and a year later it was the name under which the trio signed to Irish run indie Setanta Records. They left Northern Ireland, moved into a squat in London, released a mini-album, 1990’s REM/Ride influenced 'Fanfare for the Comic Muse' and ‘91’s ‘Europop’ E.P. then split up. Neil's bandmates went to university and Neil returned home. Retaining the name, he spent 18 months living in his parents’ attic, sleeping during the day, watching old movies and writing songs at night. Influenced by everything from Jacques Brel, Scott Walker and Michael Nyman to "A Room with a View", Wordsworth, and Mr Benn, these songs eventually evolved into two albums. The first of these, ‘Liberation’ was released in 1993. Totally different to anything else around, and indeed his previous work, he now considers it his first album proper. The press adored it. The NME described it as "..an array of seductive yarns.. glorious, gleeful tunesmanship." Dave Cavanagh, writing in Select said "...one of the bountiful, overflowing joys of the year. Any year." Melody Maker described it as "An album that could make any listener want to stumble up to him and proclaim ‘Neil, you’re a genius’".
    [Show full text]
  • TODDLER: 16 to 36 Months Fant & in to S D ’ D O I L E H Welcome to Ohio’S R O Field Infant & Toddler Field Guide Guide
    TODDLER: 16 to 36 Months fant & In To s d ’ d o i l e h Welcome to Ohio’s r O Field Infant & Toddler Field Guide Guide Toddler 16 to 36 Months Get the Complete Field Guide Online – What’s Inside Including These ADDITIONAL Sections: Introduction (Sets the stage for understanding and using the Field Guide) These vignettes capture a moment in time in child care programs based • What is the Field Guide • Glossary • “More About” Listing on real-life challenges. The vignettes • Using the Field Guide • Library of Resources • Out of the Mouths enable you to “see” and “hear” • Details of Vignette • References of Babes children and care teachers during Layout • Vignette Table • Create Your play, learning, and caregiving routines • Acknowledgments of Contents Own Vignette and the interactions involved. After reading a vignette, the reader walks through a series of questions and possible teaching strategy solutions. Infant Vignettes (Birth to 8 Months) These strategies are then woven into a fi nal “Putting It All Together” vignette Mobile Infant Vignettes (6 to 18 Months) depicting a more developmentally appropriate child-teacher encounter. • Vignette Table of Contents Visit www.occrra.org to download any and all sections • Details of Vignette Layout of the Infant & Toddler Field Guide. • Toddler Vignettes (16 to 36 Months) Create Your Own Vignette Do you have a real-life situation that you would like to address? The “Create Your Own Vignette” Template provides you with the opportunity by taking you through the “Watch,” “Ask Yourself/Give It a Try” and “Putting It All Together” process. You can create questions, strategies and possible resolutions by using the blank vignette template found in the Field Guide Introduction Section.
    [Show full text]