What's Changing for 2026

Vendor Change: Aetna as new medical plan and prescription benefit provider for 2026

Beginning January 1, 2026, the GW Postdoc PPO including both medical and prescription benefits will be provided by Aetna. This means that the plan design and benefit coverage as well as the plan administration (i.e. provider network, service experience and support tools) will be provided by Aetna replacing our current providers, UnitedHealthcare/OptumRx.

Note: If you do not take action during open enrollment, your current medical election, i.e. GW Postdoc PPO will automatically roll forward— if you currently participate in the GW Postdoc PPO and make no election you will continue in that plan administered by Aetna; if you currently waive coverage and make no election, you will waive coverage for 2026.

As part of the transition to Aetna, beginning January 1, 2026, you can expect several enhancements designed to improve the overall healthcare experience. These service improvements aim to make it easier for you to access care, navigate your benefits, and receive personalized support, while maintaining the quality and coverage you rely on.

Enhanced Member Support: Dedicated customer service line for GW plan participants, offering personalized assistance
Improved Digital Tools: Access to Aetna’s enhanced member portal and mobile app for easier navigation of benefits, claims, and provider searches
Expanded Provider Network: Broad national network that maintains access to most current providers while offering additional in-network options
Simplified Navigation: Streamlined coordination for claims, referrals, and pre-authorizations
Focused Health Resources and Communications: Access to timely wellness communications and care management programs tailored to chronic conditions, preventive care, and mental health support

For more information, please explore the Discover the Aetna Healthcare Experience session - On Demand.

Tip! Want to check if your preferred provider is in-network before the transition?

Visit www.Aetna.com and follow these steps:

Click “Find a doctor” at the top of the page.
Under the “Don’t have a member account?”, Select “Plan from an Employer”.
Under "Continue as a Guest", Enter your ZIP code.
On the next screen, under "Select a Plan", scroll to “Aetna Open Access Plans" and select "Managed Choice® POS (Open Access)” as your plan and click "Continue".

This will help you confirm whether your provider is part of Aetna’s network.

*If by chance, a preferred doctor is not in Aetna’s network, please reach out to GW Benefits. Although in network status is not guaranteed, Aetna’s network team will reach out to the provider to explore network status.

2026 Medical Plan and Contribution Overview

Beginning January 1, 2026, the GW Postdoc PPO will include the following changes and expanded coverage:

Walk-in Clinic In-network (e.g. CVS Minute Clinic): increased coverage to 100% no deductible
Acupuncture: added coverage for 10 visits per year, 100% after $30 copay in-network, 60% out-of-network
Allergy Injections: increased in-network coverage to 100%, no deductible, no copay
Outpatient Mental and Substance Abuse Therapy Visits: increased coverage to 100% in-network, no deductible, no copay; 80% after deductible out-of-network
Durable Medical Equipment: out-of-network coverage added at 60% after deductible

The Postdoc Medical Plan contributions will increase for 2026. The monthly full-time postdoc contribution increase will range from approximately $10 to $51, depending on your coverage level.

2026 Pharmacy Overview

Beginning January 1, 2026, when you elect the GW Postdoc PPO, your accompanying prescription drug coverage will include the following programs/features:

Maintenance Choice with Opt-Out: This program allows members to fill 90-day supplies of long-term (maintenance) medications at the lowest cost either by mail or via an in-network participating pharmacy including CVS Pharmacy. This program is mandatory for all 90-day fills unless the member opts out.
Transition Fill Program: This program allows a one-time fill within the first 90-days of eligibility for a non-specialty drug that has prior authorization, step therapy, or is a non-formulary drug.
Choose Generics Program: This program encourages members to use generic medications instead of brand-name drugs when available. Generics contain the same active ingredients, strength, and dosage as their brand-name counterparts but typically cost significantly less. Note: If you do choose the brand name drug when a generic equivalent is available, you will be responsible for both the generic drug copay and the the difference in cost between the brand and generic drug.
Specialty medications: Beginning, January 1st, specialty medications must be filled through an Aetna in-network specialty pharmacy. Learn More Here: Specialty Pharmacy

Frequently Asked Questions (FAQs)

Is my medication covered by Aetna?
- To find out if your medication is covered, check the 2025 Advanced Control Plan- Aetna formulary (Note: 2026 formulary will be available starting January 1, 2026.)
Is my pharmacy in the Aetna network?
- To see if your pharmacy is in-network, check Aetna Network Pharmacies
- When prompted, use following pharmacy network name: Aetna National Pharmacy Network (most common)
Where can I find more information?
- Review additional Frequently Asked Questions (FAQs)

*A note about prior authorizations for medications: Any prior authorization from OptumRx does not carry over to Aetna. Members will need to contact their doctor to request a new pre-authorization review.

2026 Dental Contribution Overview

Dental premiums for GW’s dental plans are increasing, and Postdoc contributions will increase for all three dental plan options.Postdoc monthly contributions will increase 4% for the DMO. The Low PPO and High PPO will increase 6.8%monthly. The DMO, High PPO and Low PPO plans continue to be offered through Aetna and there will be no coverage or plan design changes for 2026.