Important Information You Should Know About the LM HealthWorks Cost Estimator Tool

 

The LM HealthWorks Cost Estimator Tool has been designed to help manage your expectations in understanding how your medical costs might work under the LM HealthWorks Plan.

To carefully input the data in order to obtain an accurate comparison, you will need to allow about 20-30 minutes. If you don’t have that time now, it is recommended that you come back when you have more time to spend in the modeler.

You will have the option of modeling your costs under the LM HealthWorks Plan only.

This Cost Estimator Tool includes prescription drug coverage. The costs provided in the tool are based on Aetna’s-negotiated pharmacy cost data for Aetna-sponsored pharmacy plans. Your prescription drug coverage is through CVS Caremark, so costs shown in this tool will be approximations. You can obtain detailed information specific to your prescriptions by visiting the CVS Caremark website and selecting LMPlan1 in the Check drug costs section to identify your prescription drug coverage and costs. You can override the pharmacy cost and enter the cost obtained from the CVS Caremark tool if you choose. In the footnotes section of the final results page of Cost Estimator Tool, you will see the following:

1 This estimate assumes you will not incur any additional claims for the year.

This footnote reflects the fact that not all of your medical services are predictable and that you could experience claims that you have not anticipated. If this happens, your costs will be different than those you chose to model.

3This cost does not include premium contributions or administrative fees that may be paid by your employer, or unanticipated large claims incurred by plan participants. This estimate represents only the employer costs associated with those health care services you defined and included in the calculation.

This footnote reflects the fact that this cost estimator tool is an online tool that lets you enter current information about how you use health care services and receive a summary showing your estimated out-of-pocket responsibility and the plan’s share of costs. This can help you anticipate and plan for your out-of-pocket health care costs for the coming year. is designed to be used across a broad spectrum of Aetna’s health plan offerings. For the LM HealthWorks Plan, the costs of your services shown in this model are not impacted by any administrative fees or contributions, nor will they be modified by unanticipated large claims.

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