Aetna Managed Choice Open Access Value 10000 – Texas Health Insurance Plan

A detailed comparison of the Aetna Managed Choice Open Access Value 10000 health insurance plan as offered in Texas 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 Texas 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): Visit 1-2 $30 copay, deductible waived, thereafter 30% consinurance after deductible (Specialist and Primary share visits, Unlimited visits); Specialist Visit Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 30% after deductible (Unlimited visits); Specialist Visit: 30% after deductible (Unlimited visits)
OfficeVisit Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visit 1-2 $30 copay, deductible waived, thereafter 30% consinurance after deductible (Specialist and Primary share visits, Unlimited visits); Specialist Visit Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 30% after deductible (Unlimited visits); Specialist Visit: 30% after deductible (Unlimited visits)
Deductible false Individual: $10,000, Family: $20,000 Individual: $10,000, Family: $20,000
Coinsurance 30% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied) 50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Coinsurance Limit Individual: $2,500, Family: $5,000 Individual: $2,500, Family: $5,000
Out-of-Pocket Maximum N/A N/A
Lifetime Maximum Unlimited Unlimited
Prescription Drugs Pharmacy Deductible (per individual): $500 (Does not apply to generic); Generic (Oral Contraceptives Included): $20 copay, deductible waived; Preferred Brand (Oral Contraceptives Included): $45 copay after deductible; Non-Preferred Brand (Oral Contracepti Pharmacy Deductible (per individual): $500 (Does not apply to generic); Generic (Oral Contraceptives Included): $20 copay plus 30%, deductible waived; Preferred Brand (Oral Contraceptives Included): $45 copay plus 30% after deductible; Non-Preferred Brand
Emergency Room $500 copay (waived if admitted) $500 copay (waived if admitted)
Adult Preventative Care Annual Routine Gyn Exam (No waiting period, no calendar year max., Annual Pap/Mammogram): $0 copay, deductible waived; Preventive Health - Routine Physical (No waiting period): $0 copay, deductible waived (Includes lab work and X-rays) Annual Routine Gyn Exam (No waiting period, no calendar year max., Annual Pap/Mammogram): 30% after deductible; Preventive Health - Routine Physical (No waiting period): 30% after deductible (Includes lab work and X-rays)
Child Preventative Care $0 Copay (Age and frequency schedule apply); No charge for immunizations up to the age of 18 30% after deductible (Age and frequency schedule apply); No charge for immunizations up to the age of 18
Lab / X-Ray 30% after deductible (Non-Preventive) 50% after deductible (Non-Preventive)
Maternity Not covered (Except for pregnancy complications) Not covered (Except for pregnancy complications)
Physical Therapy Physical/Occupational Therapy (24 visits per calendar year, maximum applies to combined in and out-of-network benefits): 30% after deductible Physical/Occupational Therapy (24 visits per calendar year, maximum applies to combined in and out-of-network benefits): 50% after deductible
Home Health Care 30% after deductible (instead of hospital, 30 visits per calendar year, Maximum applies to combined in and out-of-network benefits) 50% after deductible (instead of hospital, 30 visits per calendar year, Maximum applies to combined in and out-of-network benefits)
Mental Health Not covered Not covered
Hospital Care Hospital Admission: 30% after deductible; Outpatient Surgery: 30% after deductible; Urgent Care Facility: $75 copay, deductible waived Hospital Admission: 50% after deductible; Outpatient Surgery: 50% after deductible; Urgent Care Facility: 50% after deductible
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