Aetna


Please wait...

aetna
FREE Online Quote

Aetna has more than 37 million members that include individuals, families, students, companies and retirees and has been named the most admired health insurance company by Fortune magazine.

The biggest advantage Aetna has over other insurance companies in Illinois is that their individual policies are issued without waivers or riders. Instead, Aetna offers various risk categories based on each applicant. This allows applicants to receive benefits for health conditions that other insurance companies normally exclude by charging an increased premium and ensures applicants with minimal health risk do not have to subsidize the cost of members with a higher health risk.

All Aetna individual plans in Illinois (Managed Choice Open Access, PPO Plans, Managed Choice, PPO High Deductible Plans, and PPO First Dollar Plans) allow you to go directly to any recognized health care provider, including specialists, for covered expenses, but costs will be higher if you choose out-of-network health care providers. The following are standard benefits included in all Aetna individual plans:

  • Unlimited office visits to your primary care physician and specialists
  • No referrals required
  • No waiting periods to access preventive health and routine physicals
  • Lab work and x-rays included in routine physicals
  • 100% annual routine GYN exam coverage – no waiting period, copay, or deductible
  • 100% coverage on in-network childhood immunizations
  • Prescription drug coverage

Managed Choice Open Access First Dollar 30 Plan

Our Rating:

The Managed Choice Open Access PPO First Dollar 30 Plan is the most expensive individual plan Aetna offers in Illinois. It features the lowest annual deductible options, low annual out-of-pocket maximums, an office visit copays for office visits and prescription drug coverage. In-network plan highlights include:

  • No deductible
  • $30 office visit copay (unlimited)
  • $40 copay for specialists (unlimited)
  • 70% coinsurance (30% member responsibility)
  • $15 copay for generic prescriptions (no deductible)
  • $7500 individual out-of-pocket maximum
  • Prescription drug card benefits
    • Generic drugs – $15 copay
    • Preferred brands – $40 copay*
    • Non-preferred brands – $60 copay*

(*There is a $500 calendar year deductible for brand and non-preferred brand drugs)

Managed Choice Open Access First Dollar 40 Plan

Our Rating:

The Managed Choice Open Access PPO First Dollar 40 Plan is a watered-down version of Managed Choice Open Access First Dollar 30. The differences are:

  • $40 office visit copayment (compared to $30)
  • $50 copay for specialists (compared to $50)
  • 60% coinsurance (40% member responsibility)
  • $12,500 individual out-of-pocket maximum (compared to $7500)
  • $20 copay for generic prescriptions (compared to $15)
  • Preferred brand and non-preferred are not covered with a drug copayment, but the Aetna prescription discount applies

Managed Choice Open Access 2500 Plan

Our Rating:

Managed Choice Open Access 2500 Plan gives you the comprehensive benefits in the Managed Care Open Access First Dollar 30 Plan at a reduced premium cost by having a $2500 deductible. In-network plan highlights include:

  • $2500 deductible
  • $30 office visit copay (unlimited)
  • $40 copay for specialists (unlimited)
  • 80% coinsurance (20% member responsibility)
  • 5000 individual out-of-pocket maximum
  • Prescription drug card benefits
    • Generic drugs – $15 copay
    • Preferred brands – $35 copay*
    • Non-preferred brands – $50 copay*

(*There is a $500 calendar year deductible for brand and non-preferred brand drugs)

Managed Choice Open Access High Deductible 3000 Plan

Our Rating:

The Managed Choice Open Access 3000 Plan is designed to work in conjunction with contributions to a Health Savings Account (HSA). An HSA allows you to pay for qualified medical expenses on a tax-advantaged basis. This plan will keep your premiums low because there is no copay benefit and you will are responsible for more out-of-pocket costs before the plan coverage kicks in. In-network plan highlights include:

  • $3,000 deductible
  • 100% coinsurance (0% member responsibility after deductible)
  • $25 copay for preventive health, deductible waived
  • Deductible waived for preventive health, routine physicals, and annal routine GYN exam
  • Prescription benefit – prescription costs count towards $3000 deductible. Once deductible is met, all prescription drugs are covered at 100% for remainder of calendar year.

Preventive and Hospital Care 1250 Plan

Our Rating:

The Preventive and Hospital Care 1250 Plan provides basic coverage at the lowest price. It provides coverage for hospitalization, surgery, and emergency services. It also covers routine physicals and annual OBGYN exams but does not cover any additional office visits. In-network benefits include:

  • $1,250 deductible
  • 80% coinsurance (20% member responsibility after deductible)
  • Deductible waived for preventive health, routine physicals, and annal routine GYN exam
  • $15 copay for generic prescriptions
  • Preferred brand and non-preferred are not covered with a drug copayment, but the Aetna prescription discount applies