Health Plan - Aetna
Centers of Excellence (COE) – Orthopedic
Providers with COE Admitting Privileges
Aetna Online Provider Search Instructions
The following services are covered under the State of Delaware Group Health Insurance Program (GHIP). Costs noted are for an inpatient stay.
Aetna HMO Plan
Note: Requires a prior authorization
| Type of Procedure | Site of Care | Your Cost Per Visit |
|---|---|---|
| Orthopedic (hip replacement / knee replacement) |
COE Facility (Preferred) |
$100 copay per day; $200 copay max per admission |
| Orthopedic (hip replacement / knee replacement) |
Non-COE Facility | $500 copay per admission |
Aetna CDH Gold Plan
Note: Requires a prior authorization
| Type of Procedure | Site of Care | Your Cost Per Visit |
|---|---|---|
| Orthopedic (hip replacement / knee replacement) |
COE Facility (Preferred) |
10% coinsurance (after plan year deductible is met) |
| Orthopedic (hip replacement / knee replacement) |
Non-COE Facility | 10% coinsurance (after plan year deductible is met) |
Note: Aetna refers to COE facilities as Institutes of Quality and Institutes of Excellence.
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