Aetna HMO – Bronze Plan Options
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BRONZE HMO Options
Every ACA plan is assigned a metal tier: Platinum, Gold, Silver, or Bronze. All plans offer the same quality of care. The metal tier is based on how you and your plan split the costs. BRONZE plans will have the lowest premiums, but the highest out-of-pocket costs as well as the highest deductibles. Below you will find a comparison of Aetna’s Bronze options.
Aetna BRONZE HMO Plans
| Plan Info | Bronze 1 | Bronze 4 | Bronze S |
|---|---|---|---|
| Benefits Summary | Benefits Summary | Benefits Summary | |
| Deductible – Individual/Family | $8,995 / $17,990 | $0 | $7,500 / $15,000 |
| Out of Pocket Max – Individual/Family | $9,395 / $18,790 | $9,400 / $18,800 | $9,400 / $18,800 |
| Primary Care/Specialist | $55 / $125 | $15 / $100 | $50 / $100 |
| Emergency Room Care | 50% coinsurance | $2,200 copay/visit | 50% coinsurance |
| Urgent Care | $60 copay | $50 copay/visit | $75 copay |
| Inpatient hospital stay | 50% coinsurance | $2,500 copay/day, days 1-3 | 50% coinsurance |
| Lab services / Xray | 50% coinsurance | Lab: $50 copay / visit X-ray: $75 copay / visit | 50% coinsurance |
| Prescription Drugs | |||
| Preferred generic | Tier 1A: $5 copay/ $12.50 copay Tier 1: $40 copay/ $100 copay deductible does not apply | Tier 1A: $5 copay/ $12.50 copay/ Tier 1: $40 copay/ $100 copay | $25 copay/ $62.50 copay deductible does not apply (preferred and non preferred) |
| Preferred Brand Drugs | $70 copay/$175 copay deductible does not apply | 40% coinsurance for up to a 90 day supply | $50 copay / $125 copay |
| Non-preferred generic/brand drugs | $95 copay / $237.50 copay deductible does not apply | 45% coinsurance for up to a 90 day supply | $100 copay/ $250 copay |
| Preferred/non-preferred specialty drugs | $500 copay deductible does not apply | 50% coinsurance for up to a 30 day supply | $500 copay |
Every ACA plan covers 10 essential benefits:
- Prescription drugs
- Pregnancy, maternity and newborn care
- Pediatric services, including oral and vision care
- Mental health and substance use disorder services
- Preventive and wellness services, and chronic disease management
- Laboratory services
- Emergency services
- Hospitalization
- Ambulatory services
- Rehabilitative and habilitative services and devices
Aetna CVS Health Plans – 2024 Illinois HMO Hospital Network
Hospital Network Highlights – hospitals include, but are not limited to:
- Edward Hospital
- Elmhurst Memorial Hospital
- Holy Cross Hospital
- Humboldt Park Health
- Insight Chicago, Inc.
- Jackson Park Hospital Foundation
- John H. Stroger Hospital of Cook County
- LaRabida Children’s Hospital
- Loretto Hospital
- Louis A. Weiss Memorial Hospital
- Mercy Harvard Hospital, Inc.
- Methodist Hospital of Chicago
- Mount Sinai Hospital Medical Center
- Northshore University Health System – Evanston Hospital
- NorthShore University HealthSystem – Glenbrook Hospital
- NorthShore University HealthSystem – Highland Park
- NorthShore University Health System – Skokie Hospital
- Northwest Community Hospital
- OSF Little Company of Mary Medical Center
- Provident Hospital of Cook County
- Roseland Community Hospital
- Shriners Hospital for Children-Chicago IL
- South Shore Hospital
