Aetna Health Insurance Coverage

Aetna has long been a leading provider of group health insurance, but more recently expanded into the individual and family markets in several states. Offering a large selection of plans to choose from including traditional coverage, first dollar PPO plans, high deductible health savings accounts, and hospital care only policies, Aetna is now a prominent player in these new markets.

Benefit Options

All of their health insurance plans offer preventive care benefits that are not subject to the deductible. The copay amount owed by the insured for preventive care will vary depending on the plan selected. Preventive care overage includes annual OBGYN exams, well child care, and physical exams every two years.

Most policies offer prescription drug coverage with a small pharmacy specific deductible. Deductibles can range from the $250 - $500 in most cases. Generic, preferred, non-preferred, and oral contraceptives are included. Additionally an affordable dental insurance rider can be added to all polices.

Maternity coverage is not yet an option with individual or family coverage. Complications due to pregnancy are covered, but expenses associated with delivery and office visits are not covered.

Out of Pocket Expenses

The lifetime maximum is five million dollars per insured. If this amount is reached, the insured would no longer have coverage. The out of pocket maximum will vary depending on the plan selected. Out of pocket maximum includes the deductible and/or co-insurance amounts combined. The insured will be responsible for the deductible and co-insurance with traditional plans, only the co-insurance with first dollar PPO plans, or a set deductible for a health savings account qualified plan.

Competitive Niche

Typically, Aetna coverage is competitively priced for singles in most age groups and for some family plans. Females applying alone will find the plans to be priced reasonably when compared to other insurers. The Aetna network is extensive and covers a large portion of the nation. If the insured moves, he or she will most likely be able to take their policy with them to the new service area.

In summary, consumers have several choices when it comes to purchasing individual or family health insurance. Aetna is one carrier that offers competitive plans with attractive first dollar benefits and an extensive nationwide network of doctors and hospitals.