Aetna CA Managed Choice Open Access High Deductible 5500 (HSA Compatible) with Dental – California Health Insurance Plan
A detailed comparison of the Aetna CA Managed Choice Open Access High Deductible 5500 (HSA Compatible) with Dental health insurance plan as offered in California is listed below for both Network and Non-Network coverage. This is a review of the coverage for this specific Aetna plan. However, GoHealthInsurance offers a large variety of health insurance options to fit your needs. If you wish, get a new Aetna health insurance quote for California now or view all of our Aetna health insurance quotes.
| Network | Non-Network | |
|---|---|---|
| Copay | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 0% after deductible (Unlimited visits); Specialist Visit: 0% after deductible (Unlimited visits) | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits) |
| OfficeVisit | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 0% after deductible (Unlimited visits); Specialist Visit: 0% after deductible (Unlimited visits) | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits) |
| Deductible true | Individual: $5,500, Family: $11,000 | Individual: $10,000, Family: $20,000 |
| Coinsurance | 0% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied,Members responsibility) | 50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied,Members responsibility) |
| Coinsurance Limit | Individual: $0, Family: $0 | Individual: $2,500, Family: $5,000 |
| Out-of-Pocket Maximum | N/A | N/A |
| Lifetime Maximum | Unlimited | Unlimited |
| Prescription Drugs | Pharmacy Deductible (per individual): Integrated Medical/Rx Deductible; Generic (Oral Contraceptives Included): 0% after Medical/Rx Deductible; Preferred Brand (Oral Contraceptives Included): 0% after Medical/Rx Deductible; Non-Preferred Brand (Oral Contr | Pharmacy Deductible (per individual): Integrated Medical/Rx Deductible; Generic (Oral Contraceptives Included): 50% after Medical/Rx Deductible; Preferred Brand (Oral Contraceptives Included): 50% after Medical/Rx Deductible; Non-Preferred Brand (Oral Con |
| Emergency Room | $0 after deductible | $0 after deductible |
| Adult Preventative Care | Annual Routine Gyn Exam (No waiting period, Annual Pap/Mammogram): $0 copay, deductible waived; Preventive Health - Routine Physical: $0 copay, deductible waived (Includes lab work and X-rays) | Annual Routine Gyn Exam (No waiting period, Annual Pap/Mammogram): 50% after deductible; Preventive Health - Routine Physical: 50% after deductible (Includes lab work and X-rays) |
| Child Preventative Care | $0 (Age and frequency limits apply); No charge for immunizations up to the age of 18 | 50% (Age and frequency limits apply); No charge for immunizations up to the age of 18 |
| Lab / X-Ray | 0% after deductible (Non-Preventive) | 50% after deductible (Non-Preventive) |
| Maternity | Treated the same as any other medical condition | Treated the same as any other medical condition |
| Physical Therapy | Physical/Occupational Therapy (24 visits per calendar year): 0% after deductible | Physical/Occupational Therapy (24 visits per calendar year): 50% after deductible |
| Home Health Care | 0% after deductible (instead of hospital, 30 visits per calendar year) | 50% after deductible (instead of hospital, 30 visits per calendar year) |
| Mental Health | Inpatient and Outpatient: coverage is only provided for severe mental or nervous disorders. Deductible and co-insurance/copay apply. | Inpatient and Outpatient: coverage is only provided for severe mental or nervous disorders. Deductible and co-insurance/copay apply. |
| Hospital Care | Hospital Admission: 0% after deductible; Outpatient Surgery: 0% after deductible; Urgent Care Facility: 0% after deductible | Hospital Admission: 50% after deductible; Outpatient Surgery: 50% after deductible; Urgent Care Facility: 50% after deductible |
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