The LM HealthWorks Plan allows you to select from in-network providers who offer health care services at negotiated, discounted fees. Aetna as the network administrator has an expansive network of providers nationwide. If you use a health care provider who is in the network, the plan will pay a portion of the eligible contracted charge for your covered expenses once you satisfy the annual deductible. You pay the remaining portion, which is called coinsurance. When you use in-network providers, you generally save on out-of-pocket expenses.
You can also receive care from out-of-network providers. However, when you visit an out-of-network provider, you must meet a higher annual deductible, you pay a higher coinsurance amount and you need to file a claim for reimbursement. In addition to your coinsurance amount, you are also responsible for paying the provider for amounts in excess of what the plan has determined is a reasonable and customary charge. For more detailed information, click here.
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