CSC Core Access HDHP – Out-of-Area Feature

Access to care providers with no referrals required.

The CSC Core Access HDHP Out-of-Area Feature is only available to employees in locations not served by the CSC Preferred or Core Access HDHP network (In-Area Feature)

How the Out-of-Area Feature works

When you enroll in the CSC Core Access HDHP, you have the option of enrolling in the Health Savings Account (HSA). This is a tax-favored account that you can use to help pay current qualified medical expenses or save for future expenses. Learn more.

The Out-of-Area Feature is an indemnity, or fee-for-service, benefit. This is a traditional style health benefit that gives you freedom of choice. There is only one level of benefits and no requirement to select a PCP. When you need care, you simply choose any licensed doctor or other health care provider and make an appointment.

Under the Out-of-Area Feature, you pay health care providers directly for their services. Then you file a claim with Aetna for reimbursement. Once you have met your plan's calendar year deductible, the plan generally pays a percentage of the reasonable and customary charges for most covered services, and you pay the rest. "Reasonable and customary" (R&C) is the maximum amount that will be considered an allowable expense. If a charge exceeds the reasonable and customary limit, you pay the difference in addition to your share of coinsurance. If you enroll in the Health Savings Account, you may use it to pay your share of qualified medical expenses covered under the plan.

The Out-of-Area Feature pays benefits at 100%, with no deductible required, for preventive services such as routine physical exams and cancer screenings.

The Out-of-Area Feature protects you against the high cost of a major illness by the annual coinsurance or "out-of-pocket" limit. Once your total coinsurance payments for the year reach this limit, the plan pays 100% for covered services for the rest of the calendar year.