Silver 6: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $35 copay
Specialist visit: $80 copay
Urgent care visit: $50 copay
Description
Health Care Plan Details
Network type | HMO |
Deductible | $7,795 per person $7,795 per person |
Out-of-pocket max | $8,445 per person $16,890 per family |
Metal tier | Silver |
Visit Copay
Primary care visit | $35 copay |
Specialist visit | $80 copay |
Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
Urgent care | $50 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 | $60 copay |
Maternitowny and Pregnancy
Well baby care | No charge |
Labor, delivery, hospital stay | 50% coinsurance after deductible |
Pharmacy, Drugs, and Medication
Generic | $25 copay |
Brand | $55 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 | $35 copay |
Psychiatric hospital stay | 50% coinsurance after deductible |
Health Plan Provider Information
Health Plan Benefits | https://www.aetnacvshealth.com/documents/2024-IFP-767734_82824GA0110022-01_SBC.pdf |
Drug and medication plan formulary | http://aet.na/gaivl24 |
Search doctor list | https://www.aetna.com/dsepublic/#/contentPage?page=providerSearchLanding&site_id=aetnaivlexchange |