Aetna CVS Health Insurance Plans
Bronze Plans
| Plan Info | Bronze | Bronze HDHP |
|---|---|---|
| Deductible – Individual/Family | $8,800 / $17,600 | $6,000 / $12,000 |
| Out of Pocket Max – Individual/Family | $9,100 / $18,200 | $7,100 / $14,200 |
| Coinsurance | 50% | 50% |
| Primary Care/Specialist | $45 DW / $100 DW | 50% after ded. |
| MinuteClinic Virtual Care / walk-in visit | Covered in full | 100% after ded. |
| Other walk-in clinic | $45 DW | 50% after ded. |
| Urgent Care / Emergency Care Visit | 50% after ded. | 50% after ded. |
| Inpatient hospital stay | 50% after ded. | 50% after ded. |
| Lab services / Xray | 50% after ded. | 50% after ded. |
| Preferred Prescription Drugs – Generic/Brand | $30 DW / $65 DW | 50% after ded. |
| Non-Preferred Prescription Drugs – Generic/Brand | $90 DW | 50% after ded. |
| Specialty Prescription Drugs – Preferred/Non-Preferred | $500 DW | 50% after ded. |
DW = deductible waived || after ded = after deductible
Silver Plans
| Plan Info | Silver 1 | Silver 2 | Silver 3 |
|---|---|---|---|
| Deductible – Individual/Family | $4,550 / $9,100 | $5,000 / $10,000 | $7,000 / $14,000 |
| Out of Pocket Max – Individual/Family |
$9,100 / $18,200 | $9,100/ $18,200 | $8,850 / $17,700 |
| Coinsurance | 40% | 40% | 40% |
| Primary Care/Specialist | $30 DW / $60 DW | $35 DW / $50 DW | $35 DW / $70 DW |
| MinuteClinic Virtual Care / walk-in | Covered in full / Covered in full |
Covered in full / Covered in full |
Covered in full / Covered in full |
| Other walk-in clinic | $30 DW | $35 DW | $35 DW |
| Urgent Care / Emergency Care Visit | $60 DW / 40% after ded. | $50 DW / 40% after ded. | $70 DW / $750 DW |
| Inpatient hospital stay | 40% after ded. | 40% after ded. | 40% after ded. |
| Lab services / Xray | 40% after ded. | 40% after ded. | $35 DW / $100 DW |
| Preferred Prescription Drugs – Generic/Brand |
$15 DW/$60 DW | $15 DW/$60 DW | $15 DW/$60 DW |
| Non-Preferred Prescription Drugs – Generic/Brand | $85 DW | $85 DW | $85 DW |
| Specialty Prescription Drugs – Preferred & Non-Preferred |
$300 DW | $300 DW | $300 DW |
DW = deductible waived || after ded = after deductible
Gold Plans
| Plan Info | Gold |
|---|---|
| Deductible – Individual/Family | $1,500 / $3,000 |
| Out of Pocket Max – Individual/Family |
$7,000 / $14,000 |
| Coinsurance | 20% |
| Primary Care/Specialist | $20 DW / $40 DW |
| MinuteClinic Virtual Care / walk-in | Covered in full / Covered in full |
| Other walk-in clinic | $20 DW |
| Urgent Care / Emergency Care Visit | $40 DW / $750 DW |
| Inpatient hospital stay | 20% after ded. |
| Lab services / Xray | 20% after ded. |
| Preferred Prescription Drugs – Generic/Brand |
$15 DW / $45 DW |
| Non-Preferred Prescription Drugs – Generic/Brand | $70 DW |
| Specialty Prescription Drugs – Preferred & Non-Preferred |
$250 DW |
DW = deductible waived || after ded = after deductible
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