Aetna Managed Choice Open Access 7500 with Unlimited Primary Care Visits plus Dental – Georgia Health Insurance Plan
A detailed comparison of the Aetna Managed Choice Open Access 7500 with Unlimited Primary Care Visits plus Dental health insurance plan as offered in Georgia 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 Georgia 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): $30 copay, deductible waived (Unlimited visits); Specialist Visit: 20% after deductible (Unlimited visits) | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 30% after deductible (Unlimited visits); Specialist Visit: 40% after deductible (Unlimited visits) |
| OfficeVisit | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: 20% after deductible (Unlimited visits) | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 30% after deductible (Unlimited visits); Specialist Visit: 40% after deductible (Unlimited visits) |
| Deductible true | Individual: $7,500, Family: $15,000 | Individual: $10,000, Family: $20,000 |
| Coinsurance | 20% after deductible up to out of pocket max. ($0 once out of pocket max. is satisfied) | 40% 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): Not Applicable; Generic (Oral Contraceptives Included): $15 copay; Preferred Brand (Oral Contraceptives Included): Not covered (Aetna Discount Applies); Non-Preferred Brand (Oral Contraceptives Included): Not covered; | Pharmacy Deductible (per individual): Not Applicable; Generic (Oral Contraceptives Included): $15 copay plus 30%; Preferred Brand (Oral Contraceptives Included): Not covered (Aetna Discount Applies); Non-Preferred Brand (Oral Contraceptives Included): Not |
| Emergency Room | $350 copay (waived if admitted) | $350 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 (Age and frequency limits apply); No charge for immunizations up to age 18 | 30% (Age and frequency limits apply); No charge for immunizations up to age 18 |
| Lab / X-Ray | 20% after deductible (Non-Preventive) | 40% after deductible (Non-Preventive) |
| Maternity | Not covered | Not covered |
| Physical Therapy | Physical/Occupational Therapy (24 visits per calendar year, Maximum applies to combined in and out-of-network benefits): 20% after deductible | Physical/Occupational Therapy (24 visits per calendar year, Maximum applies to combined in and out-of-network benefits): 40% after deductible |
| Home Health Care | 20% after deductible (instead of hospital, 30 visits per calendar year, maximum applies to combined in and out-of-network benefits) | 40% after deductible (instead of hospital, 30 visits per calendar year, maximum applies to combined in and out-of-network benefits) |
| Mental Health | Inpatient and Outpatient: Coverage provided for mental illness (Deductible and coinsurance/copay apply - Day and/or visit limits apply) | Inpatient and Outpatient: Coverage provided for mental illness (Deductible and coinsurance/copay apply - Day and/or visit limits apply) |
| Hospital Care | Hospital Admission: 20% after deductible; Outpatient Surgery: 20% after deductible; Urgent Care Facility: $50 copay, deductible waived | Hospital Admission: 40% after deductible; Outpatient Surgery: 40% after deductible; Urgent Care Facility: 30% after deductible |
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