Silver 6: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 – HMO

73% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $40 copay

SKU: 18628FL016003404 Category:

Description

This plan has 73% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type HMO
Deductible $5,995 per person $5,995 per person
Out-of-pocket max $7,145 per person $14,290 per family
Metal tier Silver

Visit Copay

Primary care visit $30 copay
Specialist visit $60 copay
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care $40 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 $50 copay

Maternitowny and Pregnancy

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

Pharmacy, Drugs, and Medication

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

Lab Tests and Diagnostic Procedures

X-rays $45 copay after deductible
Imaging (CT/PET/MRI) 35% coinsurance after deductible
Blood work $40 copay

Mental and Psychiatric Health Care

Mental Health outpatient services $30 copay
Psychiatric hospital stay 50% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits https://www.aetnacvshealth.com/documents/2024-IFP-771745_18628FL0160034-04_SBC.pdf
Drug and medication plan formulary http://aet.na/flivl24
Search doctor list https://www.aetna.com/dsepublic/#/contentPage?page=providerSearchLanding&site_id=aetnaivlexchange