Stanford Health Care Alliance
The Patient Protection and Affordable Care Act (also known as the Health Care Reform law) requires that you receive a Summary of Benefits and Coverage (SBC). The SBC is designed to help you understand and evaluate your health plan choices. Digital copies provided in the Resource section on this page. Paper copies are also available, free of charge, from the Postdoc Benefits Office by calling 650-724-9490.
- No deductible
- No claims to file
- Fixed copay for office visits, emergency room visits, and hospital stays
- Greatest savings when your provider is in the SHCA network of doctors and facilities
- When accessing care within SHCA's 5 core counties, and your provider is in the SHCA network, covered services are paid at 100% after the applicable copay
- You may see an out of network provider within the 5 core counties, but your costs will be much higher. For example, Sutter Health providers, including Palo Alto Medical Foundation, UCSF providers, and John Muir providers are out of network
- When accessing care outside the 5 core counties, use the Aetna Choice POS II network, and covered services are paid at 100% after applicable copay. Sutter health providers are excluded from the Aetna Choice POS II network nationwide
- Pre-authorizations for elective and radiology imaging services required
- Prescription drug coverage
- World-wide emergency care at in-network costs
Please Note: Carefully review the OON cost structure provided on the Summary of Benefits and Coverages and within the Benefits Guide, both available in the Resources section at the bottom of this page.
Additional detail of plan structure
- Medical Expenses Claim Form - For when you had to pay out of pocket for medical services received due to out of area Urgent and Emergency Care, including international care
- Pharmacy Expenses Claim Form - For when you had to pay out of pocket for Rxs received from an Out-of-Network Pharmacy, including international pharmacies