Aetna HMO Bronze Options

Every ACA plan is assigned a metal tier: Platinum, Gold, Silver, or Bronze. All plans offer the same quality of care. The metal tier is based on how you and your plan split the costs. BRONZE plans will have the lowest premiums, but the highest out-of-pocket costs as well as the highest deductibles. Below you will find a comparison of Aetna’s Bronze options.

Aetna Health, Vision and Dental Insurance

Aetna BRONZE HMO Plans

Plan Info Bronze 1 Bronze 4 Bronze S
Benefits Summary Benefits Summary Benefits Summary
Deductible ? Individual/Family
 $8,995 / $17,990 $0 $7,500 / $15,000
Out of Pocket Max ? Individual/Family
 $9,395 / $18,790 $9,400 / $18,800 $9,400 / $18,800
Primary Care/Specialist
 $55 / $125 $15 / $100 $50 / $100
Emergency Room Care
 50% coinsurance $2,200 copay/visit 50% coinsurance
Urgent Care
 $60 copay $50 copay/visit $75 copay
Inpatient hospital stay
 50% coinsurance $2,500 copay/day, days 1-3 50% coinsurance
Lab services / Xray
 50% coinsurance Lab: $50 copay / visit
X-ray: $75 copay / visit		 50% coinsurance
Prescription Drugs
Preferred generic
 Tier 1A: $5 copay/ $12.50 copay
Tier 1: $40 copay/ $100 copay deductible does not apply		 Tier 1A: $5 copay/ $12.50 copay/
Tier 1: $40 copay/ $100 copay		 $25 copay/ $62.50 copay deductible does not apply (preferred and non preferred)
Preferred Brand Drugs
 $70 copay/$175 copay
deductible does not apply		 40% coinsurance for up to a 90 day supply $50 copay / $125 copay
Non-preferred generic/brand drugs
 $95 copay / $237.50 copay
deductible does not apply		 45% coinsurance for up to a 90 day supply $100 copay/ $250 copay
Preferred/non-preferred specialty drugs
 $500 copay
deductible does not apply		 50% coinsurance for up to a 30 day supply $500 copay

Every ACA plan covers 10 essential benefits:

  • Prescription drugs
  • Pregnancy, maternity and newborn care
  • Pediatric services, including oral and vision care
  • Mental health and substance use disorder services
  • Preventive and wellness services, and chronic disease management
  • Laboratory services
  • Emergency services
  • Hospitalization
  • Ambulatory services
  • Rehabilitative and habilitative services and devices

Aetna CVS Health Plans – 2024 Illinois HMO Hospital Network

Aetna HMO Bronze
Aetna HMO Bronze

Hospital Network Highlights – Hospitals include, but are not limited to:

  • Edward Hospital
  • Elmhurst Memorial Hospital
  • Holy Cross Hospital
  • Humboldt Park Health
  • Insight Chicago, Inc.
  • Jackson Park Hospital Foundation
  • John H. Stroger Hospital of Cook County
  • LaRabida Children’s Hospital
  • Loretto Hospital
  • Louis A. Weiss Memorial Hospital
  • Mercy Harvard Hospital, Inc.
  • Methodist Hospital of Chicago
  • Mount Sinai Hospital Medical Center
  • Northshore University Health System – Evanston Hospital
  • NorthShore University HealthSystem – Glenbrook Hospital
  • NorthShore University HealthSystem – Highland Park
  • NorthShore University Health System – Skokie Hospital
  • Northwest Community Hospital
  • OSF Little Company of Mary Medical Center
  • Provident Hospital of Cook County
  • Roseland Community Hospital
  • Shriners Hospital for Children-Chicago IL
  • South Shore Hospital