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Home   >  Health Insurance Companies   >   Aetna Plans   >   Aetna MC Open Access 7500 w/ PC Visits + Dental
 
 

Aetna - California Plans

Managed Choice Open Access 7500 with Unlimited Primary Care Visits Health Insurance Plan with Dental

A plan summary of the Aetna California Managed Choice Open Access 7500 with Unlimited Primary Care Visits Plan with Dental is detailed out below for both In Network and Out of Network coverage.

                                                In Network Out of Network

  Copay

30%

50% or Not Covered

  Office Visits

 Non-Specialist: $40 (Deductible Waived); Specialist: 20% after Deductible 50% after Deductible

  Annual Deductible

Individual: $7,500 Family: $15,000

Individual: $10,000 Family: $20,000

  Annual Out-Of-Pocket  Limit

Individual: $10,000 Family: $20,000

Individual: $12,500 Family: $25,000

  Lifetime Maximum

Not Applicable Not Applicable

  Prescription Drugs

Generic: $15)

50% plus Generic: $15

  Laboratory & X-Ray

20% after Deductible (Non-Preventive) 50% after Deductible (Non-Preventive)

  Annual Physical Exam

No Charge 50% after Deductible

  Annual OB-GYN Exam

No Charge 50% after Deductible

  Well Baby Care

No Charge (Age and frequency limits apply) 50% after Deductible (Age and frequency limits apply)

  Outpatient Surgery

20% after Deductible 50% after Deductible

  Emergency Room

$150 (waived if admitted) after Deductible $150 (waived if admitted) after Deductible

  Inpatient Hospital

20% after Deductible 50% after Deductible

  Ambulance

20% after Deductible 20% after Deductible

  Home Health Care

20% after Deductible (30 visits/calendar year; In and Out-of-Network combined) 50% after Deductible (30 visits/calendar year; In and Out-of-Network combined)

  Mental Health - Outpatient

Not Covered Not Covered

  Chiropractic Care

20% (24 visit max; $25 per visit max) 50% (24 visit max; $25 per visit max)

  Acupuncture

See Brochure See Brochure

  Mental Health - Inpatient

Not Covered Not Covered

  Chemical Dependency

20% 50%

  Maternity Care

Not Covered (except for pregnancy complications) Not Covered (except for pregnancy complications)

                                                              


To learn more about your individual and family California health insurance options, the price of each plan and/or a detailed benefit summary of the plans, visit us here.

NOTICE! Final rates and benefits are based on actual plan selection (including plan riders you may request) and the assignment of any rate adjustment factors due to the health plan's underwriting guidelines.

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