Bronze 1: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 – HMO

Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: No charge
Specialist visit: $115 copay
Urgent care visit: $50 copay

Description

Health Care Plan Details

Network type HMO
Deductible $8,895 per person $8,895 per person
Out-of-pocket max $9,395 per person $18,790 per family
Metal tier Expanded Bronze

Visit Copay

Primary care visit No charge
Specialist visit $115 copay
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

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

Maternitowny and Pregnancy

Labor, delivery, hospital stay 50% after deductible

Pharmacy, Drugs, and Medication

Generic $25 copay
Brand $50 copay after deductible
Non-preferred Brand 40% after deductible
Specialty 50% after deductible

Lab Tests and Diagnostic Procedures

X-rays 50% after deductible
Imaging (CT/PET/MRI) 50% after deductible
Blood work 50% after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services No charge
Psychiatric hospital stay 50% after deductible

Health Plan Provider Information