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

All Aetna individual plans in Illinois allow you to go directly to any recognized health care provider, including specialists, for covered expenses. 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

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

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