What is the extent of Aetna coverage under its health insurance plans?

Aetna coverage under its health insurance plans has been expanded to include individual and family coverage, in addition to group health insurance coverage. Aetna provides a range of insurance plans and coverage including first dollar PPO plans, traditional coverage, hospital care only policies, and high-deductible health savings accounts, among others.

In general, Aetna coverage provides preventive care benefits that are not subject to deductibles. Copays owed by the insured for preventive care tend to vary depending on the type of insurance plan selected. Preventive care coverage usually includes annual OBGYN exams, physical exams every two years, and well child care. In most cases, deductibles may range from $250 to $500. An affordable dental insurance rider can be included to all policies. Individual or family coverage does not include maternity coverage but may include coverage for pregnancy complications. Medical expenses that are associated with delivery and office visits are not covered.

Out-of-pocket expenses for Aetna insurance plans include the deductible and/or co-insurance amounts. The lifetime maximum is usually at five million dollars per insured.

If the five-million-dollar amount is reached, the insured would no longer have coverage. The out-of-pocket amount varies depending on the insurance plan selected. In general, the insured shall pay for the deductible and co-insurance with traditional plans. The insured shall only pay for co-insurance amounts in first dollar PPO plans and in a set deductible for a health savings account qualified plan.

Aetna coverage is usually competitively priced for singles and individuals in most age groups and for select family plans. Such coverage is said to be extensive and allows the insured to benefit from coverage wherever he/she goes across the country.

Answer by general public — June 26, 2009 @ 2:01 pm

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