Bronze 2 HSA: Aetna network of doctors & hospitals + MinuteClinic + Virtual Care 24/7 – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: 50% coinsurance after deductible
Specialist visit: 50% coinsurance after deductible
Urgent care visit: 50% coinsurance after deductible
Description
Health Care Plan Details
Network type | HMO |
Deductible | $6,200 per person $6,200 per person |
Out-of-pocket max | $7,500 per person $15,000 per family |
Metal tier | Expanded Bronze |
Visit Copay
Primary care visit | 50% coinsurance after deductible |
Specialist visit | 50% coinsurance after deductible |
Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
Urgent care | 50% coinsurance after deductible |
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) | 50% coinsurance after deductible |
Outpatient procedure (physician) | 50% coinsurance after deductible |
Physical rehabilitation | 50% coinsurance after deductible |
Maternitowny and Pregnancy
Well baby care | No charge |
Labor, delivery, hospital stay | 50% coinsurance after deductible |
Pharmacy, Drugs, and Medication
Generic | $25 copay after deductible |
Brand | 35% coinsurance after deductible |
Non-preferred Brand | 45% coinsurance after deductible |
Specialty | 50% coinsurance after deductible |
Lab Tests and Diagnostic Procedures
X-rays | 50% coinsurance after deductible |
Imaging (CT/PET/MRI) | 50% coinsurance after deductible |
Blood work | 50% coinsurance after deductible |
Mental and Psychiatric Health Care
Mental Health outpatient services | 50% coinsurance after deductible |
Psychiatric hospital stay | 50% coinsurance after deductible |
Health Plan Provider Information
Health Plan Benefits | https://www.aetnacvshealth.com/documents/2024-IFP-767309_84867OH0100001-01_SBC.pdf |
Drug and medication plan formulary | http://aet.na/ohivl24 |
Search doctor list | https://www.aetna.com/dsepublic/#/contentPage?page=providerSearchLanding&site_id=aetnaivlexchange |