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Frequent Questions

AFSPA Wellness Programs Frequent Questions

We offer reasonable pricing health care plans, insurance packages based on
financial conditions of clients.

  • For Self Only (401) enrollment, the deductible is $300 for in-network providers (including Guam) and providers outside the U.S., and $400 for out-of-network providers (including Guam).
  • For Self Plus One (403) enrollment, the deductible is $600 for in-network providers (including Guam) and providers outside the U.S., and $800 for out-of-network providers (including Guam).
  • Under a Self and Family (402) enrollment, the deductible is $600 for in-network providers (including Guam) and providers outside the U.S., and $800 for out-of-network providers (including Guam).

Aetna’s secure member website is a system that provides members with access to information and tools regarding their health. Every enrollee and dependents ages 14 and older have their own separate login credentials for this site.

Many FSBP programs are housed in your Aetna’s secure member website account, including signing up for wellness incentives, seeing your Health Risk Assessment results, opting into electronic funds transfer (EFT), learning more about the quality and cost of your health care, and viewing your Explanations of Benefits (EOBs).

The Member Portal is a custom system for AFSPA members. It can be used to upload claims, update addresses, and enroll in and manage certain Ancillary Insurance Programs. The Member Portal is only open to the AFSPA member, not dependents. We recommend having a Member Portal account in order to allow for the fastest processing of claims.

For those benefits where copayments, coinsurance or deductibles apply, we pay 100% of the Plan allowance for the rest of the calendar year after your expenses total to:

  • For Self Only enrollment $5,000 and for Self Plus One or Self and Family enrollment $7,000 for in-network providers (including Guam) and providers outside the 50 United States and when you use the Plan’s network retail pharmacy through Express Scripts (ESI), or home delivery (mail order) through the Express Scripts PharmacySM, or purchase prescriptions outside the 50 United States from a retail pharmacy or Military Treatment Facility (including Guam);
  • For Self Only enrollment $7,000 and for Self Plus One or Self and Family enrollment $9,000 for in- and out-of-network providers combined (including Guam) and when you use the Plan’s network retail pharmacy through Express Scripts or home delivery (mail order) through the Express Scripts PharmacySM or purchase prescriptions outside the 50 United States from a retail pharmacy or Military Treatment Facility (including Guam).

For Self Plus One and Self and Family enrollments, once any individual family member reaches the Self Only catastrophic protection out-of-pocket maximum during the calendar year, that member’s claims will no longer be subject to associated cost-sharing amounts for the rest of the year. All other family members will be required to meet the balance of the catastrophic protection out-of-pocket maximum.

Any expenses incurred that apply toward the catastrophic out-of-pocket maximum for in-network or out-of-network apply toward both in and out-of-network limits.

This catastrophic protection out-of-pocket maximum is combined for medical/surgical, mental health/substance misuse disorder, and pharmacy. There are some expenses that do not fall under this provision; see your FSBP Brochure , Section 4, Your Costs for Covered Services. 

Enroll in a wellness program today