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Index
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Index
A
adoption, 10-12, 68
Aetna Member Services, 2,
12, 20-22,
36-38, 44,
49-50, 60-61,
65
ambulatory surgical center, 35
B
benefit pre-determination, 1,
22, 36,
66,
74
birth, 10-12,
23
C
case management, 1-2, 30,
38, 66
chemical dependency, 2,
4-5, 18-19,
30-36, 40-41,
42-43, 46-48, 60,
67, 71,
79
children, 7-9, 12-13,
15, 23,
55-57
chiropractic care, 40, 78
claims, 1-2, 4-5,
14, 16,
17, 19,
21, 24,
28, 47,
49-50, 61-63
denial and reconsideration, 61-62
filing, 49, 60-61
outside the U.S., 27, 50
classes of coverage, 8
continuation coverage (COBRA), 56
coordination of benefits, 2,
37, 47-48
dental claims, 37
medical, mental health and
chemical dependency, 47
prescriptions, 2, 48
co-payments, 5, 14,
19-23, 25-26,
28, 42-43,
47,
49, 65,
67, 73,
78-79
lab work, 5, 19-20,
42
office visit, 5, 19-21,
42, 78-79
prescription, 25-26, 28,
43, 47,
73, 78
preventive care, 23, 42-43,
78
cosmetic procedures/treatment, 40
coverage, 1, 5,
7-16, 18,
21, 26, 30, 32,
35-37, 47-48,
50, 51-52, 54-57,
63, 65,
67-70, 74-75,
77-79
of a child, 8, 12-16,
48, 55-57,
65, 67-69,
74
retirees covered by two plans, 9,
48
ways it can end, 13-16, 70
covered expenses, 5,
19, 27,
31, 35,
37, 41, 42-43,
46-48, 67
custodial care, 67, 71
D
deductibles, 21,
65
dental expenses, 37
dependent child, 7-8, 12-13,
16, 36,
40, 48,
55-57, 68,
75
divorce, 13, 48,
55-57
double coverage, 9
durable medical equipment, 1,
18, 36,
77
E
eligibility, 5,
7-8, 10-11,
15-16, 21,
29, 36,
53, 54,
56, 63,
69
eligible dependents, 7-11,
13-16,
69
adding a dependent, 10
deleting a dependent, 10
emergencies, 35
Employee Retirement Income Security Act (ERISA), 6,
50, 57,
59, 62-65
enrollment, 3, 7,
9-14, 66-67
equipment rentals, 36
experimental treatment, 17,
27, 39,
40, 70,
76
explanation of benefits (EOB), 43,
49, 70
extended-care facilities, 18,
37
eyeglasses, 37,
41
H
hearing aids, 36, 38
hospice care, 1, 18, 36,
77
hospital, 1, 4,
17-19, 21-22,
29, 35-38,
40
I
immunizations, 23
inpatient care, 32,
34, 47, 77-79
in-vitro fertilization, 41
K
L
leave of absence, 9,
13
leaving ExxonMobil, 13
lifetime maximum, 27,
31, 40,
47, 72,
77
M
Magellan Health Services, 2,
4-5, 18-19,
30-32, 34
mail-order service, 5
maintenance care, 40
mammograms, 23
marriage, 10,
13, 68,
75
medical necessity, 17,
41, 71-72
medical pre-certification, 72
mental health and chemical dependency coverage
in an emergency, 32
MHPPO, 4, 30-32,
72
pre-certification, 30
provider, 4, 30-31,
72
Medco, 2, 24-29, 50,
60, 67
N
network, 19-22,
31-32, 46-48, 73,
77-79
locations, 20-23
services, 20-23
non-network, 4-6, 20-22,
32-33, 43-48, 73, 77-79
nurse, 5, 35-36,
38,
41, 51-53,
67, 71,
73
nursing care, 1, 18, 36,
38, 71,
77
O
occupational therapy, 36
office visits, 19,
20, 23,
31, 42,
67, 79
oral surgery, 37
orthotics, 37,
40
out-of-network area, 4,
18, 20,
22, 42,
73, 77-79
out-of-pocket limits, 45-46
outpatient care, 31-32,
34
outside the U.S.,
claims, 50
mental health care, 33
P
physical therapy, 36
physician, 4, 19-21,
23, 27,
35-39, 40-41,
44-45, 52,
61, 65,
71-72, 74-76,
78
POS II, 4,
17-20, 77
pre-certification, 1-2,
5, 18-19, 30-32,
46, 72,
77
pre-determination of benefits, 23,
37-38, 43, 74
pre-existing conditions, 11-12
pregnancy, 11, 17,
19, 36, 41
prescription drugs, 2,
5, 24-25, 41-42,
45, 47,
67, 72-74,
78
preventive care, 5,
17, 21,
23,
36, 43,
78
primary participant, 22,
25-26,
74, 79
primary plan, 14-15,
29, 47-48
R
reasonable and customary, 5,
19, 21-22,
38, 40, 43-47,
73, 77
retiree, 3, 7-11,
14-16, 26,
30, 47-48,
51, 54-56,
58, 67-71,
74-75
covered by two plans, 9, 48
Medicare, 7-8, 14-15,
55, 67
suspended, 8, 15-16,
75
right of reimbursement, 50
room and board, 18,
36-37,
75
S
separation, 13,
55-56
skilled-nursing care, 1, 18, 36,
38, 71,
77
speech therapy, 37,
41
surgical procedures, 22,
35, 40,
45
survivors, 3, 9,
11, 54-55,
58, 71
surviving spouse, 8, 15,
55, 75
suspended retiree, 8, 15-16,
75
T
transfers, 11,
13, 31, 37
transportation, 36, 38,
41, 53
V
vision care, 37
vitamins, 40
W
well-baby care, 23
X
x-rays, 19, 23,
35-36, 77
NOTES
NOTES
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