Aetna HMO Silver 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. Silver plans will have moderate premiums, moderate out-of-pocket-costs, and will have deductibles that are lower than Bronze plan options. Below you will find a comparison of Aetna’s Silver options.

Aetna Health, Vision and Dental Insurance

Silver HMO Options

Plan Info Silver 5 Silver 6 Silver 7 Silver S
Benefits Summary Benefits Summary Benefits Summary Benefits Summary
Deductible ? Individual/Family
 $8,395 / $16,790 $7,795 / $15,590 $7,795 / $15,590 $5,900 / $11,800
Out of Pocket Max ? Individual/Family
 $8,885 / $17,770 $8,445 / $16,890 $8,845 / $17,690 $9,100 / $18,200
Primary Care/Specialist
 $50 / $80 $35 / $80 $30 / $60 $40 / $80
Emergency Room Care
 50% coinsurance 50% coinsurance 50% coinsurance 40% coinsurance
Urgent Care
 $50 copay $50 copay $50 copay $60 copay
Inpatient hospital stay
 50% coinsurance 50% coinsurance 50% coinsurance 40% coinsurance
Lab services / Xray
 Lab: $25 copay
X-ray: $30 copay		 Lab: $40 copay
X-ray: $45 copay		 Lab: $30 copay
X-ray: $50 copay		 40% coinsurance
Prescription Drugs
Preferred generic
 Tier 1A: $5 copay/ $12.50 copay
Tier 1: $25 copay/ $62.50 copay
ded does not apply		 Tier 1A: $5 copay / $12.50 copay
Tier 1: $25 copay / $62.50 copay
ded does not apply		 Tier 1A: $5 copay / $12.50 copay
Tier 1: $25 copay / $62.50 copay
ded does not apply		 $20 copay / $50 copay
ded does not apply
Preferred Brand Drugs
 40% coinsurance ded does not apply $60 copay / $150 copay
ded does not apply		 $60 copay / $150 copay
ded does not apply		 $40 copay / $100 copay
ded does not apply
Non-preferred generic/brand drugs
 $125 copay / $312.50 copay
ded does not apply		 $125 copay /
$312.50 copay
ded does not apply		 $125 copay / $312.50 copay
ded does not apply		 $80 copay/ $200 copay
Preferred/non-preferred specialty drugs
 $400 copay
ded does not apply		 $400 copay
ded does not apply		 $400 copay
ded does not apply		 $350 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 Silver HMO
Aetna Silver HMO

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