Aetna CVS Health Insurance Plans
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Bronze Plans
| Plan Info | Bronze | Bronze HDHP |
|---|---|---|
|
Deductible ? Individual/Family
|
$8,800 / $17,600 | $6,000 / $12,000 |
|
Out of Pocket Max ? Individual/Family
|
$9,100 / $18,200 | $7,100 / $14,200 |
|
Coinsurance
|
50% | 50% |
|
Primary Care/Specialist
|
$45 DW / $100 DW | 50% after ded. |
|
MinuteClinic Virtual Care / walk-in visit
|
Covered in full | 100% after ded. |
|
Other walk-in clinic
|
$45 DW | 50% after ded. |
|
Urgent Care / Emergency Care Visit
|
50% after ded. | 50% after ded. |
|
Inpatient hospital stay
|
50% after ded. | 50% after ded. |
|
Lab services / Xray
|
50% after ded. | 50% after ded. |
|
Preferred Prescription Drugs ? Generic/Brand
|
$30 DW / $65 DW | 50% after ded. |
|
Non-Preferred Prescription Drugs ? Generic/Brand
|
$90 DW | 50% after ded. |
|
Specialty Prescription Drugs ? Preferred/Non-Preferred
|
$500 DW | 50% after ded. |
DW = deductible waived || after ded = after deductible
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Silver Plans
| Plan Info | Silver 1 | Silver 2 | Silver 3 |
|---|---|---|---|
|
Deductible ? Individual/Family
|
$4,550 / $9,100 | $5,000 / $10,000 | $7,000 / $14,000 |
|
Out of Pocket Max ?
Individual/Family |
$9,100 / $18,200 | $9,100/ $18,200 | $8,850 / $17,700 |
|
Coinsurance
|
40% | 40% | 40% |
|
Primary Care/Specialist
|
$30 DW / $60 DW | $35 DW / $50 DW | $35 DW / $70 DW |
|
MinuteClinic Virtual Care / walk-in
|
Covered in full / Covered in full |
Covered in full / Covered in full |
Covered in full / Covered in full |
|
Other walk-in clinic
|
$30 DW | $35 DW | $35 DW |
|
Urgent Care / Emergency Care Visit
|
$60 DW / 40% after ded. | $50 DW / 40% after ded. | $70 DW / $750 DW |
|
Inpatient hospital stay
|
40% after ded. | 40% after ded. | 40% after ded. |
|
Lab services / Xray
|
40% after ded. | 40% after ded. | $35 DW / $100 DW |
|
Preferred Prescription Drugs ?
Generic/Brand |
$15 DW/$60 DW | $15 DW/$60 DW | $15 DW/$60 DW |
|
Non-Preferred Prescription Drugs ? Generic/Brand
|
$85 DW | $85 DW | $85 DW |
|
Specialty Prescription Drugs ?
Preferred & Non-Preferred |
$300 DW | $300 DW | $300 DW |
DW = deductible waived || after ded = after deductible
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Gold Plans
| Plan Info | Gold |
|---|---|
| Deductible ? Individual/Family | $1,500 / $3,000 |
| Out of Pocket Max ? Individual/Family |
$7,000 / $14,000 |
| Coinsurance | 20% |
| Primary Care/Specialist | $20 DW / $40 DW |
| MinuteClinic Virtual Care / walk-in | Covered in full / Covered in full |
| Other walk-in clinic | $20 DW |
| Urgent Care / Emergency Care Visit | $40 DW / $750 DW |
| Inpatient hospital stay | 20% after ded. |
| Lab services / Xray | 20% after ded. |
| Preferred Prescription Drugs ? Generic/Brand |
$15 DW / $45 DW |
| Non-Preferred Prescription Drugs ? Generic/Brand | $70 DW |
| Specialty Prescription Drugs ? Preferred & Non-Preferred |
$250 DW |
DW = deductible waived || after ded = after deductible
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