This section is a user guide to your LM HealthWorks Plan that takes you step-by-step through the process of seeking care and using your benefits

How to Seek Care, In Network

Follow these steps for in-network care

seek-icon-in-01.gif Show your medical ID card.
seek-icon-in-02.gif In most cases, you pay nothing at the time of your visit.
seek-icon-in-03.gif In order for benefits to be paid, a claim must be filed. Your in-network provider takes care of this for you.
seek-icon-in-07.gif Once your provider’s office files a claim, you will receive an Explanation of Benefits (EOB) statement by mail that shows the total charge for care and the amount the plan will pay. It also shows how much of the deductible you’ve met, and how much remains to be met. Remember, you can “turn off” paper EOBs at Aetna Navigator and just receive them online.
seek-icon-out-03.gif You pay your share of covered expenses as shown on your EOB when your provider’s office sends you the bill.

Here’s how it works… After the deductible is met, you and the plan share in the cost of your care. You pay a percentage of your expense (called coinsurance). For covered preventive care services, the plan typically plan pays 100% with no deductible. The Benefits Summary chart shows how you and the plan share expenses.

Remember: Once you’ve met your annual deductible and met the out-of-pocket maximum, the plan pays 100% for covered expenses.*

Once you become a member of the LM HealthWorks Plan and register for Aetna Navigator, you can check the status of a claim and progress toward your deductible at Aetna Navigator. If the provider bill and your EOB are not showing the same amount you should pay out of pocket, call the LM HealthWorks Plan at 1-877-458-4975 for further clarification.

Not yet an LM HealthWorks Plan member?
Use this guest ID and password to visit Aetna Navigator and see what you’d be able to do as a member.

User Name/Guest ID: cpos2guest1
Password: cpos2guest1

* Excludes prescription drugs. You do not have to meet a deductible before the plan pays prescription drug benefits.

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