One of the nation’s strongest, largest, and oldest health insurance companies, Aetna is known for their lenient underwriting which has allowed many individuals with flawed medical pasts to get a health plan. Aetna has 18 million medical members, 13.6 million dental members, and 8.8 million pharmacy members throughout the country, giving the broad customer base access to over 1 million health care providers and over 5,400 hospitals. The company began in 1850, and continues to sell life and health insurance products to a vast number of Americans. By providing employers, individuals, seniors, and public health plan members with coverage, Aetna reaches a broad span of those who need care.
Accredited by the NCQA in Illinois for maintaining a sufficient level of access and service, good providers, and effective care, Aetna is a reliable health plan in the state. Aetna individual and family coverage in Illinois is divided into two networks: Open Access Managed Choice, and Preferred Provider Organization. With many more options available in the OAMC network, members can choose from standard comprehensive, high deductible HSA, and several budget-friendly plans. The PPO option is a value plan, with one deductible and lower monthly premiums. Most deductibles are relatively high in Illinois, starting at $2500 for Open Access traditional plans.
Aetna Individual Plans in Illinois
Open Access Managed Choice & PPO
A hybrid of managed care and broad selection, these plans give members the ability to use an HMO and choose a primary care physician (optional), or go with a PPO network. Involving a PCP to facilitate your care gives you a guide through the network, and is suggested by the plan. Available with copays for instant access to low cost office visits and prescriptions, you can choose from a range of deductibles for traditional service. With a high deductible format, you can connect your plan to an HSA and pay out-of-pocket until reaching your deductible. Value plans lower your monthly premium and offer a limited range of services for those with fewer health concerns.
High Deductible Plans
Open Access Managed Choice Savings Plus
Connected to the Open Access Managed Choice (HMO) network,these plans offer low monthly rates and your choice of a $3000 or $6500 deductible. While able to use the HMO network, these plans also allow members to use any non-network provider of their preference. Prescriptions are covered at $15 for generics, and your first three office visits are covered for a copay. Coinsurance range from 20 to 40 percent after deductible based on the type of service received. For those on a budget and less need to see the doctor, these plans are a viable option.
A deductible of $3000 gives members access to lower premiums and a network of preferred providers, such as family doctors, specialists and hospitals. This plan includes preventive care covered in full with in-network providers, specialty care, prescription drugs, hospital and emergency care, and outpatient surgery. Though a bit more limited, these plans give members the freedom to choose their providers within the PPO network or out-of-network. Unlike OAMC plans, you cannot choose between HMO or PPO coverage, and do not need referrals for any services.
Get Aetna plan rates and a side-by-side comparison of all Illinois plans in your area with a free health insurance quote. To consult an agent about plan details and options, call us at 888 803 5917.