2016 CARMAX MEDICAL PLAN GUIDE. Health in Your Hands

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1 2016 CARMAX MEDICAL PLAN GUIDE Health in Your Hands

2 2 1 WELCOME TO YOUR 2016 CARMAX MEDICAL PLAN You don t have to strive for better health alone. We re pleased to offer benefits that include personalized programs, online tools and 24/7 support to help you on your journey to health and well-being. We hope you will refer to this guide throughout your journey. And we invite you and your covered family members to read about the programs, services and resources designed to support you and to use them to live your healthiest, happiest life. YOUR TOOLS FOR TOTAL HEALTH Here you ll find a full list of your medical plan s programs, resources, online tools and mobile apps available to help you with everything from saving money on surgery to finding the right day care. Be your own health manager 2 Aetna Navigator Aetna Mobile DocFind Quest Diagnostics Member Payment Estimator Personal Health Record (PHR) Health at your fingertips 6 Mobile Apps Health care is a call or click away 8 Teladoc itriage Informed Health Line Aetna In Touch Care CVS/Caremark prescription drug plan Help yourself live healthier 14 Simple Steps To A Healthier Life Compass Health Assessment Online wellness programs Healthy Lifestyle Coaching Beginning Right maternity program Fitness and wellness discounts Aetna Resources For Living Employee Assistance Program YOUR AETNA HEALTH CONCIERGE IS STANDING BY Have a specific benefits question? Don t know where to start? Call your Aetna Health Concierge. Whether you need help with a claim or understanding your medical benefits, your Aetna Health Concierge has the answers. Call , Monday Friday, 8 a.m. to 6 p.m. You can also log in to your secure Aetna Navigator member website at and send an through the Contact Us link. Know who to call and where to go 21 Where to go when

3 2 3 BE YOUR OWN HEALTH MANAGER With your secure Aetna Navigator member website Connecting with the right care at a price you re prepared for, having your health history at your fingertips, getting treatment that supports your well-being as well as your health this is health care today. And it starts with you being proactive. If you haven t already, register for Aetna Navigator, and get to know this powerful health care resource. YOUR ONLINE COMMAND STATION With Aetna Navigator When it comes to managing your health, Aetna Navigator is your best friend. Your online Aetna Navigator Dashboard is personal and adaptive. The more you use it, the more it changes to fit your profile and needs. With Aetna Navigator, you can: Use self-service features View and print a digital copy of your ID card Send and receive messages with your Aetna health team Access and print your Personal Health Record (PHR) Find the right care Search and compare in-network providers with the DocFind tool Locate the nearest walk-in clinic or urgent care center Get help with a healthier lifestyle Take a Health Assessment Join an online wellness program through Simple Steps To A Healthier Life Manage costs See what your plan covers Track your health care spending Compare and estimate costs with Member Payment Estimator Find health answers Learn about symptoms or a specific diagnosis Monitor your health activity score in your PHR REGISTER TODAY Once you complete your registration, you can log in to your Aetna Navigator home page anytime. And stay in touch on the go with the free Aetna Mobile app. Have your Aetna member ID card handy when you register! 1. Go to 2. Click on the Log In/Register link 3. Follow the prompts. Remember to update your and agree to electronic communications so you can get your Explanation of Benefits (EOBs) and claims notices quickly. Your health on the go We all depend on convenience and accessibility while we re on the go. Your Aetna Mobile app gives you the power to manage your health whenever, from wherever you are. With Aetna Mobile, you can: Search for a doctor, hospital or pharmacy Check your coverage and view claims Access your Personal Health Record, and more

4 4 5 BE YOUR OWN HEALTH MANAGER With your secure Aetna Navigator member website CONNECT TO CARE THAT S RIGHT FOR YOU With the DocFind search tool With Aetna s DocFind search tool, finding the right in-network doctor, dentist or facility is fast and easy. And you can personalize your search by city, state, specialty and gender. 1. Log in to Aetna Navigator at 2. Click on Find a Doctor, Dentist or Facility in the left menu bar 3. Customize your search for a provider CHOOSE AN IN-NETWORK PROVIDER AND SAVE MONEY! Look for the Aexcel specialists are labeled with a and meet national standards for outstanding clinical performance and lower costs they are a network within a network. Get your lab work with Quest Diagnostics Don t pay extra for tests you need. Quest Diagnostics is the preferred in-network provider for lab work. They have special rates for Aetna members, so you ll save money when you use Quest. Be sure to choose Quest Diagnostics or another network provider when you need lab work. When it s time to get your biometric screening, visit You can schedule your appointment, check your results and more. Download the MyQuest app from Google Play or the App Store, or visit and click on MyQuest. 1. Log in to Aetna Navigator at 2. Select Your health care costs > Member Payment Estimator *Estimated costs not available in all markets or for all procedures. Actual costs may differ for a number of reasons, including if other or different services are performed by the doctor or facility at the time of your visit, and/or additional claims/member payments are processed before the actual claim for the estimated service is processed. KNOW BEFORE YOU GO With the Member Payment Estimator tool Your plan allows you to choose where you get care. But the costs for the same procedures and treatments can vary widely between providers and facilities. With Aetna s Member Payment Estimator tool, you can search and compare actual costs for common procedures, treatments and doctor s services before your next visit or procedure.* When you use Member Payment Estimator, you may be surprised at how much costs differ from facility to facility in your area. The type of facility matters, too. An MRI often costs much less at an imaging center or other freestanding facility than at a hospital. Lower back MRI (no contrast) Imaging center Hospital Los Angeles, California $461 $1,787 Houston, Texas $515 $1,226 You can be a smarter health care consumer. Don t pay more than you have to. Take your health and your costs in your hands by knowing before you go. ACCESS YOUR HEALTH HISTORY WHENEVER, WHEREVER With the Aetna Personal Health Record (PHR) Accessing your health history details and dates is easy and fast with the Aetna PHR. Your PHR stores family health history, immunization records, prescription and over-the-counter medications, tests and procedures, and more. Use your PHR to review your medical history, complete health forms and share information with your provider. Whenever you visit the doctor, Aetna automatically updates your PHR. And you can also add information at your convenience. 1. Log in to Aetna Navigator at 2. Look in the I want to menu 3. Click on View Personal Health Record

5 6 7 HEALTH AT YOUR FINGERTIPS With free mobile apps Manage your health from your smartphone or tablet with free mobile apps. All of these apps are available from the App Store and Google Play. HELP IS JUST A TAP AWAY Aetna Mobile Use Aetna Mobile to access health information, check coverage, search for a provider, view claims and more. CVS/pharmacy Refill a prescription, check drug costs and find a nearby MinuteClinic. Teladoc Talk to a board-certified doctor, anytime, anywhere. Use the Teladoc mobile app to request a consult on the go. MyQuest Quest Diagnostics is Aetna s preferred in-network lab provider. Use the app to schedule appointments, check results, share information and more. itriage Use the itriage app for quick, easy access to plain language medical information. Search symptoms, conditions, medications and procedures. And find the right doctor and facilities to get care. Aetna Resources For Living SM Employee Assistance Program (EAP) The Aetna Resources For Living app gives you access to support and resources to help you manage issues that impact your work, life and well-being.

6 8 9 HEALTH CARE IS A CALL OR CLICK AWAY With these tools and resources Taking care of yourself doesn t have to be overwhelming. Get to know the health care assistance programs available to you and your covered dependents many are free and available 24/7/365. So when you re sick and need care, you ll remember you don t need to struggle alone. Call TELADOC ( ). Talk to a board-certified doctor, anytime, anywhere. Use the Teladoc mobile app to request a consult on the go. TALK TO A DOCTOR ANYTIME, ANYWHERE With Teladoc Teladoc gives you 24/7/365 access to board-certified doctors and pediatricians, licensed in your state, in about ten minutes.* You and your covered dependents can use Teladoc for many non-emergency medical issues, anytime, anywhere. Teladoc consults can be via phone or online video chat. There is no time limit and it costs about the same as a visit with your regular doctor. Teladoc doctors can also write prescriptions and help coordinate with your regular health care provider. Register with Teladoc today Doing paperwork when you re sick is a hard pill to swallow. Be efficient with your time and register ahead. 1. Go to 2. Create separate profiles for yourself and each covered family member 3. Download the Teladoc mobile app from the App Store or Google Play to use Teladoc on the go *Teladoc may not be available in all states. CHECK SYMPTOMS, FIND CARE With itriage itriage helps you learn what could be wrong and where to go for care. Check symptoms Research tests, treatments, procedures and diseases Learn which treatment path may be right for you Three ways to get itriage 1. Download the free app from Google Play or the App Store 2. Text itriage to to receive a download link (standard text messaging rates may apply) 3. Register at Use the itriage app for quick, easy access to plain language medical information about symptoms, conditions, medications and procedures.

7 10 11 HEALTH CARE IS A CALL OR CLICK AWAY With these tools and resources TALK WITH A NURSE, DAY OR NIGHT With the Aetna Informed Health Line Your plan includes the Aetna Informed Health Line, a 24-hour Nurse Line, to help you anytime day or night. Informed Health Line nurses can help you: Learn about medical procedures and treatment options Prepare for a conversation with your doctor Determine if you need urgent or emergency care or if you should see your doctor Call and select the option to speak with a nurse. GET A NURSE ON YOUR CARE TEAM With the Aetna In Touch Care SM program If your records show an upcoming hospital stay or a chronic condition, like diabetes, high blood pressure or asthma, an Aetna In Touch Care nurse or consultant will call to offer support. An In Touch Care nurse doesn t replace your regular doctor, but he or she can become your dedicated, trusted advocate someone you can confide in and get help navigating the health care system. You can work with your nurse one-on-one, use the online programs that your nurse suggests, or both. Even if you use online programs, you can still connect with your nurse whenever you need to. One nurse, one member You ll work with the same nurse every time you need help. That way, you ll build a relationship as your nurse gets to know your unique health history. If any other covered family members have health risks, they can work with the same nurse if they prefer. A call from an Aetna In Touch Nurse is one you should take! And if you ve been diagnosed with a chronic condition, you don t need to wait for the phone to ring. Call your Aetna Health Concierge at and ask to sign up for the Aetna In Touch Care program. An Aetna In Touch Care nurse can: Provide education and information about all your health issues Direct you to the most appropriate health care Better coordinate multiple layers of care, and more

8 12 13 HEALTH CARE IS A CALL OR CLICK AWAY With these tools and resources KEEP UP WITH YOUR HEALTH With your CVS/Caremark prescription drug plan Your prescription drug benefits are administered by CVS/Caremark. You can fill prescriptions at any of the nearly 67,000 licensed pharmacies in the CVS network, including: 9,500+ CVS/pharmacy stores Other major pharmacy chains, including Walgreens and Rite Aid Pharmacies located in large retail stores and grocery chains Local and independent pharmacies in your area MinuteClinic MinuteClinic is a walk-in medical clinic located inside select CVS/pharmacy stores nationwide. MinuteClinic offers non-emergency family care from nurse practitioners and physician assistants.* You can also get many wellness exams and routine physicals. *MinuteClinic employs physician assistants in select states. Maintenance Choice If you take medications to manage conditions like arthritis, asthma, diabetes or high cholesterol, Maintenance Choice saves you time and money. Use Maintenance Choice to fill your maintenance medication prescriptions through mail order or at your local CVS/pharmacy. Either way, you ll get a 90-day supply for the same cost as a 60-day supply at a retail pharmacy. Register for Maintenance Choice at QUESTIONS? Call CVS Caremark Customer Care at or visit Which drugs are covered? Your plan covers drugs at different benefit levels depending on whether they are generic, preferred brand-name drugs or non-preferred brand-name drugs. Check the Performance Drug List to see which drugs are covered at what level. View the list at or at benefits.carmax.com. Save with generic drugs Generics are the same as brand-name drugs in dose, use and form, but cost less. They are FDA approved and safe to use. Not every drug is available as a generic, but many are. Ask your doctor or pharmacist about the drugs you and your family use. You may have to try one drug before you can try another This year we are updating our coverage to include a Generics First program. This program promotes the use of generic prescription drugs to address specific conditions (when generic options have a track record of success). If you are affected by this change, you and your doctor will be notified by CVS/Caremark. Save 20% on CVS-brand health products CVS automatically sends plan members an ExtraCare Health Card for a 20% discount on all CVS-brand health-related purchases. If you already have a CVS ExtraCare Rewards Card, you can link it to your ExtraCare Health Card to combine your points and savings. CVS/pharmacy app Use the free app to refill a prescription, track your rewards, or find a CVS/pharmacy or MinuteClinic. Download from Google Play or the App Store.

9 14 15 HELP YOURSELF LIVE HEALTHIER With wellness programs Whether it s eating healthier, sleeping better, quitting smoking or stressing less, your benefits include personalized online programs and one-on-one coaching for the healthy life you want. HEALTHIER STARTS HERE With Simple Steps To A Healthier Life No matter what your journey to health looks like, the Simple Steps To A Healthier Life program helps you to take that first step and then keep on going. From losing weight to putting out your final cigarette, Simple Steps offers self-guided online health and wellness programs that provide structure and simple steps for achieving your goals. Start with an online Compass Health Assessment Your online Health Assessment takes about 15 minutes. It s also part of your Commitment to Health requirement as a CarMax Associate. After completing the Health Assessment, you ll get a Personal Health Report to help you understand where you are today and how to make improvements for tomorrow. Find your Direction Based on your Health Assessment, you ll get a recommendation for online wellness programs called Directions. With Directions, you set the pace, so you can achieve your health goals on your own time. Directions include: Be Tobacco Free Heart-Healthy Cholesterol Blood Pressure Check Live Well with Asthma Diabetes Life Sleep Well Eat Healthier Stress Less Get Active Weigh Less Healthy Back Healthy in a Hurry 1. Log in to Aetna Navigator at 2. Scroll over Health Records and click Take the Health Assessment. Use the results from your biometric screening to complete your Health Assessment.

10 16 17 HELP YOURSELF LIVE HEALTHIER With wellness programs GET POWERFUL SUPPORT With Healthy Lifestyle Coaching Eat better, stress less, sleep more whatever your health goal, don t go it alone. Get one-on-one help from a Healthy Lifestyle Coach. A Healthy Lifestyle Coach is there to keep you focused and motivated daytime, nighttime and even those not today times. The best part? Your personal coach is absolutely free! Remember, Healthy Lifestyle Coaching is also an important part of the CarMax Commitment to Health Program. If your biometric screening indicates that you are at risk for metabolic syndrome or if you use tobacco, you need to complete two coaching sessions by October 14 in order to keep your medical plan credit. THE BEST TIME TO START IS RIGHT NOW Contact a coach at , Monday Friday, 8 a.m. to 8 p.m. local time If your Health Assessment shows you might benefit from Healthy Lifestyle Coaching, a coach may call you directly. Don t miss it! Your single-point-of-contact coach Like any great coach, your Healthy Lifestyle Coach stays with you through thick and thin. Together, you ll craft a personalized plan, help keep you on track and celebrate your wins. Examples of coaching programs include: Weight Management Find your motivation to get to and maintain a healthy weight. Learning that it s not about just eating, but eating well, will help change your relationship with food. Tobacco Cessation Get help recognizing and managing your tobacco triggers. Discover alternatives to replace tobacco and make a day-by-day plan to quit. For good. Stress Management Don t let stress run you or run you down. A coach can help you cope better and learn mindfulness techniques to improve communication, sleep better and be more present in your life. Nutritional Counseling Address particular dietary needs. If your biometric screening results suggest a specialized diet might help, this is a great place to start. From lowering your sodium intake to managing diabetes, work with a registered dietitian to learn about your diet, dietary needs, eating behaviors, caloric needs and meal planning. You ll also learn shopping tips and strategies for improving nutrition.

11 18 19 HELP YOURSELF LIVE HEALTHIER With wellness programs MAKE IT A HEALTHY START With the Beginning Right maternity program Finding out what you re having. Sharing your news. Choosing a name. Pregnancy comes with many big decisions. But deciding to get great prenatal care is a no brainer! The Beginning Right maternity program is free and included in your Aetna medical plan. You get: Nurse support Talk with specially trained nurse by phone to learn about early labor symptoms, what to expect before and after delivery, caring for your newborn and more. Helpful s Get useful info about prenatal care, labor and delivery, and vaccines. Smoke-Free Moms-To-Be program You ve never had a better reason or more support to quit for good. Free copy of The Mayo Clinic Guide to a Healthy Pregnancy Sign up and complete a pregnancy risk survey by 16 weeks to get a free copy of this awesome book covering everything from nutrition to newborns. Extra support for high-risk pregnancies Beginning Right can help you find out if you re at risk for pregnancy-related conditions. And if you re eligible, an Aetna nurse will help manage your prenatal care. If you have a child in the neonatal intensive care unit (NICU) for three days or longer, you can get help from the NeoCare Solutions SM program. The program offers a full year of one-on-one help from a NeoCoach as well as digital support tools from NeoCare mobile. Register for Beginning Right as soon as you or your spouse is pregnant! Call CRADLE-1 ( ), weekdays from 8 a.m. to 7 p.m. ET. EARN INCENTIVES FOR PARTICIPATING Bump up your care and earn incentives* to help with those extra bottles, bibs and blankies after baby arrives. Earn: $50 when you join by your 16th week of pregnancy $100 when you participate and complete a postpartum survey *Incentives will be paid to the Associate whose coverage includes the Beginning Right participant. Payment(s) will be included in the Associate s paycheck after completion of the incentive requirements. The Associate must be an Active Associate to receive the incentive. If the Associate terminates employment, any remaining incentive will not be paid. Incentive payments are subject to ordinary income taxes. Allow up to eight weeks for processing depending on when the incentive requirement was completed. SPEND LESS ON BETTER HEALTH With fitness and wellness discounts Your Aetna plan includes special discounts on health-related products and services. There are no claims, referrals or limits on how often you can use your discounts. And they are available to your covered family members, too! Some of these discounts include: Extra pairs of glasses or contact lenses Hearing aids and batteries Fitness club memberships Home exercise equipment Weight-loss programs like Jenny Craig and Nutrisystem Massage therapy Aromatherapy, and more DISCOVER YOUR DISCOUNTS TODAY 1. Log in to Aetna Navigator at 2. Scroll over the Health Programs tab 3. Click on See the discounts under the Get discounts section

12 20 21 HELP YOURSELF LIVE HEALTHIER With wellness programs KNOW WHO TO CALL AND WHERE TO GO For health care from anywhere REAL HELP FOR REAL LIFE With the Aetna Resources For Living Employee Assistance Program (EAP) From balancing your professional demands and your home life to struggling with substance abuse, Aetna Resources For Living can help. Aetna Resources For Living is a free, confidential support and counseling EAP service available to you and everyone in your home, even if they are not covered dependents under your Aetna plan. When you call Aetna Resources For Living, you ll get connected with a psychologist, marriage and family therapist, or substance abuse counselor, or get a referral for local help if you request one. Aetna Resources For Living also helps with financial, legal and family issues like estate planning or finding elder care. Aetna Resources For Living helps with: Mental health and well-being Personal and professional relationships Substance abuse Family life Daily stress Financial and legal support Free confidential consultation with a lawyer or financial adviser Free will kits and other legal documents Referrals to community resources, such as credit counseling or career coaching Free materials and audio recordings on a wide variety of topics Family support Finding a day care center Locating an elder care provider Searching for a college Estate planning AVAILABLE 24/7 Put this number in your phone: Go to and enter the Company ID and Password: MYKMXEAP Use this guide to know who to call and where to go to get help, get care and get better. Start with an in-network provider, including physicians and hospitals that participate in the Aetna Choice POS II (Open Access) network. Choosing in-network providers gives you the most value from your benefits. Using an out-of-network provider increases out-of-pocket costs through deductibles, coinsurance amounts and a higher out-of-pocket maximum. FIND A DOCTOR Call your Aetna Health Concierge at Go to Click Find a Doctor and select Aetna Choice POS II (Open Access)

13 22 23 KNOW WHO TO CALL AND WHERE TO GO For health care from anywhere Where to go How to contact Your in-network cost Talk with a nurse 24-Hour Aetna Nurse Line The free 24-Hour Nurse Line (Informed Health Line) can help you: Learn about medical procedures and treatment options Prepare for a conversation with your doctor Determine if you need immediate care, or if you can wait to see your doctor Locate a retail walk-in clinic Retail walk-in clinics are a good choice when you need immediate but not urgent care. Consider a walk-in clinic for: Cold and flu symptoms Coughs and sore throat Fevers You can also get wellness exams and routine physicals. And CVS, Target and Walgreens clinics are all in the Aetna network. Teladoc 24/7/365 access to board-certified doctors that you and covered family members can use for non-urgent medical issues. Register ahead of time so you ll be ready when: Your regular doctor is unavailable You re considering the ER for a non-emergency issue You re away from home on vacation, a business trip, etc. Teladoc is a great option for: Cold and flu symptoms Allergies Rashes Basic infections Respiratory infections Sinus problems, and more Primary care physician (PCP) office visit Always talk with your PCP first. Go to your PCP for: Annual physicals Coordinating treatment plans Any health concerns Call and select the option to speak with a nurse Log in to Aetna Navigator at Call TELADOC ( ) Visit Free download from Google Play or the App Store Call your Aetna Health Concierge at Use the DocFind search tool Log in to Aetna Navigator at You pay nothing Core 60: 40% after deductible Select 70: $30 copay Premium 80: $20 copay Core 60: $40 per visit Select 70: $30 copay Premium 80: $20 copay Core 60: 40% after deductible Select 70: $30 copay Premium 80: $20 copay Where to go How to contact Your in-network cost Specialist office visit Call your Aetna Health Concierge at Core 60: 40% after deductible Referrals are not required by your plan, but before going to a specialist, talk with your Select 70: 30% after deductible PCP to make sure you re heading to the right provider. Use the DocFind search tool Premium 80: $50 copay Look for the Aexcel Network on your DocFind search tool. Log in to Aetna Navigator at Urgent care center Use when you need immediate care, but are unable to see your regular doctor. Many urgent care centers have onsite labs and perform X-rays. Consider urgent care for: Fractures or sprains Cuts and minor lacerations Allergic reactions Infections Minor burns or rashes Flu symptoms Emergency room (ER) Go in the event of life-threatening medical situation. ERs are open 24/7/365 and equipped to treat any medical situation. If you go to the ER for a non-life-threatening issue, you will likely wait a long time to be treated and pay much more than urgent care. Consider the ER for: Allergic reactions to food, animal or bug bites Broken bones Chest pain Constant vomiting Continuous bleeding Severe shortness of breath Deep wounds Weakness or pain in a leg or arm Head injuries Unconsciousness Severe burns Acute asthma Knife/Gunshot wound Life threatening mental or substance abuse situations Log in to Aetna Navigator at Call 911 Log in to Aetna Navigator at Emergency room visits will vary widely in cost, based on the services rendered. Important: If you get care in an emergency room and your symptoms did not indicate an emergency, no benefits will be paid. If you are admitted to the hospital or surgery is performed, you must notify Aetna of an emergency admission within 48 hours or you will be subject to a Precertification Penalty. Using out-of-network providers costs more than using in-network providers. Log in to to find in-network providers in your area. Core 60: 40% after deductible Select 70: $60 copay Premium 80: $40 copay Core 60: 40% after deductible Select 70: $250 copay + 30% after deductible Premium 80: $150 copay + 20% after deductible

14 YOUR HEALTH IS IN YOUR HANDS This year, take control of your health. Learn about your current health and future risks. Set health goals and get help to meet them. Keep up with your health on the go. Get the health care you need at the lowest cost. It s all up to you.

15 12800 Tuckahoe Creek Parkway Richmond, VA INDICIA FPO TAKE YOUR HEALTH IN YOUR HANDS Live healthy, live happy Google Play is a trademark of Google, Inc. The App Store is a trademark of Apple, Inc. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). CCG CARMAX-0056 (2/16)