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DEPARTMENT of DEFENSE NONAPPROPRIATED FUND HEALTH BENEFITS PROGRAM Aetna Traditional Choice® Indemnity Medical Plan Summary of Benefits effective January 1, 2015 New
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Company

Aetna / /

Currency

USD / /

Facility

Participating Pharmacy Non-Participating Pharmacy / Convalescent facility / Hospital Services / /

IndustryTerm

retail copays / dental network / hospital services / ancillary services / /

MedicalCondition

Spinal disorder / Temporomandibular Joint Dysfunction / injury / illness / Anesthesia Allergy / heart disease / diabetes / /

MedicalTreatment

Voluntary sterilization / chiropractic / surgery / immunizations / bariatric surgery / /

Organization

DEPARTMENT of DEFENSE NONAPPROPRIATED FUND HEALTH BENEFITS PROGRAM Aetna Passive PPO Dental Plan Summary of Benefits / Physician hospital / FDA / Department of Defense / DEPARTMENT of DEFENSE NONAPPROPRIATED FUND HEALTH BENEFITS PROGRAM Aetna Traditional Choice / /

Person

Orthodontia / /

/

Position

Choice Plan Plan Provisions Physician Services / dentist / non-participating dentist / /

Product

Nicotine / /

Technology

X-ray / /

URL

www.aetna.com/products/rxnonmedicare/data/2014/MISC/antiobesity.html / www.nafhealthplans.com / /

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