MMC Benefits Handbook
Musculoskeletal Surgery – Knee, Hip, Spine
Aetna's Centers of Excellence, known as Institutes of Quality (IOQ) for Orthopedic is a special network of hospitals and other facilities known for quality care. Aetna's IOQ facilities specialize in:
  • Spine surgery - (laminectomy, primary fusion, fusion revision, discectomy (w/out decompression), decompression (w/out fusion)
  • Total joint replacement (knee/hip)
If you utilize an IOQ, your surgery will be covered at 100% after the plan's in-network deductible. Prior authorization is required.
 
$400 Deductible Plan
$1,500 Deductible Plan
$2,850 Deductible Plan
Tier 1: Center of Excellence (IOQ)
Covered at 100% after deductible
Covered at 100% after deductible
Covered at 100% after deductible
Tier 2: In-Network
You pay 20% after deductible
You pay 20% after deductible
You pay 30% after deductible
Tier 3:
Out-of-Network
You pay 40% after deductible
You pay 40% after deductible
You pay 50% after deductible
See "Travel and Lodging" for information about reimbursement for travel and lodging expenses related to musculoskeletal surgery.