BannerAetna Silver 6: No PCP required + Unlimited $0 MinuteClinic + free 98point6 virtual care 24/7 – HMO

Description

This plan has 94% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type	HMO
Deductible	$295 per person $295 per person
Out-of-pocket max	$745 per person $1,490 per family
Metal tier	Silver

Visit Copay

Primary care visit	$10 copay
Specialist visit	$25 copay
Preventive care visit	No charge

Urgent, Emergency Care, and Hospital Care

Urgent care	$5 copay
Emergency room	50% coinsurance after deductible
Ambulance	50% coinsurance after deductible
Hospital stay (facility)	50% coinsurance after deductible
Hospital stay (physician)	50% coinsurance after deductible
Outpatient procedure (facility)	35% coinsurance after deductible
Outpatient procedure (physician)	35% coinsurance after deductible
Physical rehabilitation	$25 copay

Maternitowny and Pregnancy

Well baby care	No charge
Labor, delivery, hospital stay	50% coinsurance after deductible

Pharmacy, Drugs, and Medication

Generic	$10 copay
Brand	$20 copay
Non-preferred Brand	45% coinsurance after deductible
Specialty	50% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays	$35 copay
Imaging (CT/PET/MRI)	35% coinsurance after deductible
Blood work	$20 copay

Mental and Psychiatric Health Care

Mental Health outpatient services	$10 copay
Psychiatric hospital stay	50% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits	https://www.banneraetna.com/en/documents/2024-IFP-769276_23435AZ0040020-06_SBC.pdf
Drug and medication plan formulary	http://aet.na/azbhaivl24
Search doctor list	https://www.myplanportal.com/dsepublic/#/contentPage?page=providerSearchLanding&site_id=banneraetnaivlexchange