This is the section of our Texas health insurance website where we examine the health insurance companies that are available in Texas. Let take a look at some of the Aetna plans.
Plans at a Glance in Texas:
Aetna* Managed Choice® Open Access and PPO High Deductible Health Insurance Plans
- Lower premiums
- High deductible, then 20% for most visits and services
- Allows you to open a tax-advantaged HSA
The Aetna Advantage Managed Choice Open Access and PPO High Deductible 3000 Plan is designed to work in conjunction with contributions to a Health Savings Account (HSA).** An HSA allows you to pay for qualified medical expenses on a tax-advantaged basis. Your premium payments will be quite low. The “high-deductible” part means that you’ll pay more out of pocket than with most other plans before coverage kicks in.
| Features of the Managed Choice Open Access and PPO High Deductible Plan s(in-network rates) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Premiums | Lower | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Annual deductible | $3,000 individual; $6,000 family | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Out-of-pocket maximum | $3,000 individual; $6,000 family | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Office visit fees | 0% after deductible*** | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Prescription drug copay | 0% after deductible**** | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Hospitalization | 0% after deductible*** | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Aetna* Managed Choice® Open Access and PPO 7500 Health Insurance Plan
The Aetna Advantage Managed Choice Open Access and PPO 7500 Plan may be your choice if you are looking for the lowest monthly payments you can find. In return, you will pay a higher annual deductible, out-of-pocket maximum and office visit copays.
Like other Aetna Managed Choice and PPO health insurance plans, the Managed Choice Open Access and PPO 7500 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses. The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers. With the state of the current economy, it is important for you to lower your costs wherever you can. However, one of the things you cannot afford to go without is health insurance for you and your family. At Aetna, we know how difficult it is for you to meet your family budget on a monthly basis. With that in mind, we have created a plan that has the best of both – it includes the medical, dental and eye care savings that you need, at a reasonable cost that won’t break the bank Aetna* Managed Choice® Open Access and PPO First Dollar 30 Health Insurance Plan
The Aetna Advantage Managed Choice Open Access and PPO First Dollar 30 Plan features our lowest annual deductibles, annual out-of-pocket outlays and copays for office visits, plus prescription drug coverage. It also has the highest premiums of our individual plans.
Like other Aetna PPO health insurance plans, the First Dollar Managed Choice Open Access and PPO 30 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses. The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers. Aetna* Managed Choice® Open Access and PPO 2500 Health Insurance Plan
If you’re willing to pay a little more in premiums than you would for some other plans, the Aetna Advantage Managed Choice Open Access and PPO 2500 Plan may be for you. In return for moderately higher premiums, you’ll enjoy quality prescription drug coverage, plus lower annual deductibles, annual out-of-pocket expenses and office visit copays.
Like other Aetna Managed Choice Open Access and PPO health insurance plans, the Managed Choice Open Access and PPO 2500 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses. The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers. Aetna* Managed Choice® Open Access and PPO Value 5000 Health Insurance Plan
The Aetna Advantage Managed Choice Open Access and PPO Value 5000 Plan may be a good choice if you’re looking for a health insurance plan that offers an attractive balance of plan features and affordable premiums.
Like other Aetna Managed Choice Open Access and PPO Value health insurance plans, the Managed Choice Open Access and PPO Value 2500 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses.The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers. Aetna* Preventive and Hospital Care 1250 Health Insurance Plan
The Aetna Advantage Preventive and Hospital Care 1250 Plan may be your choice if you are looking for lower monthly payments and are willing to pay a higher out-of-pocket maximum.
Like other Aetna Preventive and Hospital Care plans, the Preventive and Hospital Care 1250 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses. The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers. |
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Company: East Coast Health Insurance
Here is the full benefit details of one of our favorite Aetna health insurance plans in Texas the Managed Choice Open Access 2500 w/Dental.
Phone: 888-803-5917
Fax: 954.571.4143
Plan Detail
Insurance Plan Detail
Apply For the Aetna Plan in Texas see Managed Choice Open Access 2500 with Dental Aetna Texas Health Insurance brochure |
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| Estimated Monthly Premium | $176.00 |
| Plan Type | PPO |
| Networks | |
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Detail |
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| In-Network | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits) |
| Out-of-Network | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits) |
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Detail |
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| In-Network | Individual: $2,500, Family: $5,000 |
| Out-of-Network | Individual: $5,000, Family: $10,000 |
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Detail |
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| In-Network | 80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied) |
| Out-of-Network | 50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied) |
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Detail |
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| In-Network | Individual: $2,500, Family: $5,000 |
| Out-of-Network | Individual: $5,000, Family: $10,000 |
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Detail |
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| In-Network | Individual: $5,000, Family: $10,000 (Includes deductible) |
| Out-of-Network | Individual: $10,000, Family: $20,000 (Includes deductible) |
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Detail |
$5,000,000 per insured (Maximum applies to combined in and out-of-network benefits) |
| In-Network | |
| Out-of-Network | |
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Detail |
N/A |
| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits) |
| Out-of-Network | Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits) |
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Detail |
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| In-Network | Pharmacy Deductible: $500 per insured (Does not apply to generic); Generic (Oral Contraceptives Included): $15 copay, deductible waived; Preferred Brand (Oral Contraceptives Included): $35 copay after deductible; Non-Preferred Brand (Oral Contraceptives Included): $60 copay after deductible; Calendar Year Maximum (Maximum applies to combined in and out-of-network benefits): $2,500 per insured |
| Out-of-Network | Pharmacy Deductible: $500 per insured (Does not apply to generic); Generic (Oral Contraceptives Included): $15 copay plus 70%, deductible waived; Preferred Brand (Oral Contraceptives Included): $35 copay plus 70% after deductible; Non-Preferred Brand (Oral Contraceptives Included): $60 copay plus 70% after deductible; Calendar Year Maximum (Maximum applies to combined in and out-of-network benefits): $2,500 per insured |
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Detail |
$100 copay (waived if admitted), 80% coinsurance after deductible |
| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | Annual Routine Gyn Exam (No waiting period, no calendar year max., Annual Pap/Mammogram): $0 copay, deductible waived; Preventive Health – Routine Physical (Aetna will pay up to $200 per exam, Maximum applies to combined in and out-of-network benefits, no waiting period): $30 copay deductible waived (Includes lab work and X-rays) |
| Out-of-Network | Annual Routine Gyn Exam (No waiting period, no calendar year max., Annual Pap/Mammogram): 70% after deductible; Preventive Health – Routine Physical (Aetna will pay up to $200 per exam, Maximum applies to combined in and out-of-network benefits, no waiting period): 70% after deductible (Includes lab work and X-rays) |
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Detail |
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| In-Network | $30 copay (Age and frequency schedule apply). |
| Out-of-Network | 70% after deductible (Age and frequency schedule apply). |
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Detail |
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| In-Network | 80% after deductible |
| Out-of-Network | 50% after deductible |
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Detail |
Not covered (Except for pregnancy complications) |
| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | Physical/Occupational Therapy and Chiropractic Care (24 visits per calendar year, Maximum applies to combined in and out-of-network benefits): 80% after deductible (Aetna will pay up to $25 per visit max.) |
| Out-of-Network | Physical/Occupational Therapy and Chiropractic Care (24 visits per calendar year, Maximum applies to combined in and out-of-network benefits): 50% after deductible (Aetna will pay up to $25 per visit max.) |
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Detail |
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| In-Network | 80% after deductible (in lieu of hospital, 30 days per calendar year, Maximum applies to combined in and out-of-network benefits) |
| Out-of-Network | 50% after deductible (in lieu of hospital, 30 days per calendar year, Maximum applies to combined in and out-of-network benefits) |
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Detail |
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| In-Network | 80% after deductible (in lieu of hospital, 30 days per calendar year, Maximum applies to combined in and out-of-network benefits) |
| Out-of-Network | 50% after deductible (in lieu of hospital, 30 days per calendar year, Maximum applies to combined in and out-of-network benefits) |
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Detail |
Not covered except for severe, biologically based mental or nervous disorders and associated treatment of drug and alcohol dependencies |
| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | Hospital Admission: 80% after deductible; Outpatient Surgery: 80% after deductible; Urgent Care Facility: $50 copay, deductible waived |
| Out-of-Network | Hospital Admission: 50% after deductible; Outpatient Surgery: 50% after deductible; Urgent Care Facility: 50% after deductible |
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Detail |
see Aetna Texas Health Insurance brochure |
| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | |
| Out-of-Network | |
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Detail |
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| In-Network | Dental PPO Max Plan: Annual Deductible per Member (Does not apply to Diagnostic and Preventive Services): $25, $75 family maximum Annual Maximum Benefit: Unlimited Diagnostic Services: Oral Exams – Periodic Oral Exam: 100% deductible waived Comprehensive Oral Exam: 100% after deductible waived Problem-focused Oral Exam: 100% after deductible X-rays – Bitewing – single film: 100% after deductible Complete Series: 100% after deductible Preventive Services: Adult Cleaning: 100% deductible waived Child Cleaning: 100% deductible waived Sealants – per tooth: Discount Flouride Application – with cleaning: 100% deductible waived Space Maintainers: Discount Basic Services: Amalgam Filling – 2 Surfaces: 100% after deductible Resin Filling – 2 Surfaces Anterior: Discount Oral Surgery – Extraction-exposed Root or Erupted Tooth: Discount Extraction of Impacted Tooth – Soft Tissue: Discount Major Services: Complete Upper Denture: Discount Partial Upper Denture (resin base): Discount Crown – Porcelain with Noble Metal: Discount Pontic – Porcelain with Noble Metal: Discount Inlay – Metallic (3 or more surfaces): Discount Oral Surgery: Removal of Impacted Tooth-partially bony: Discount Endodontic Services: Bicuspid Root Canal Therapy: Discount Molar Root Canal Therapy: Discount Periodontic Services: Scaling & Root Planing – per Quadrant: Discount Osseous Surgery – per Quadrant: Discount Orthodontic Services: Discount Individual Dental PPO Max plan: Member Benefits – Annual Deductible per Member (Does not apply to Diagnostic and Preventive Services): $25; $75 family maximum; Annual Maximum Benefit: Unlimited; Diagnostic Services – Oral Exams – Periodic oral exam: 100% deductible waived, Comprehensive oral exam: 100% deductible waived, Problem-focused oral exam: 100% deductible waived; X-rays – Bitewing-single film: 100% deductible waived, Complete series: 100% deductible waived; Preventive Services – Adult cleaning: 100% deductible waived, Child cleaning: 100% deductible waived, Sealants-per tooth: Discount, Fluoride application-with cleaning: 100% deductible waived, Space maintainers: Discount; Basic Services – Amalgam fillings-2 surfaces: 100% after deductible, Resin fillings-2 surfaces: Discount; Oral Surgery – Extraction-exposed root or erupted tooth: Discount, Extraction of impacted tooth-soft tissue: Discount; Major Services – Complete upper denture: Discount, Partial upper denture (resin based): Discount, Crown-Porcelain with noble metal: Discount, Pontic-Porcelain with noble metal: Discount, Inlay-Metallic (3 or more surfaces): Discount; Oral Surgery – Removal of impacted tooth-partially bony: Discount; Endodontic Services – Bicuspid root canal therapy: Discount, Molar root canal therapy: Discount; Periodontic Services – Scaling and root planning-per quadrant: Discount, Osseous surgery-per quadrant: Discount; Orthodontic Services: Discount |
| Out-of-Network | Individual Dental PPO Max plan: Member Benefits – Annual Deductible per Member (Does not apply to Diagnostic and Preventive Services): $25; $75 family maximum; Annual Maximum Benefit: Unlimited; Diagnostic Services – Oral Exams – Periodic oral exam: 100% deductible waived, Comprehensive oral exam: 100% deductible waived, Problem-focused oral exam: 100% deductible waived; X-rays – Bitewing-single film: 100% deductible waived, Complete series: 100% deductible waived; Preventive Services – Adult cleaning: 100% deductible waived, Child cleaning: 100% deductible waived, Sealants-per tooth: Not covered, Fluoride application-with cleaning: 100% deductible waived, Space maintainers: Not covered; Basic Services – Amalgam fillings-2 surfaces: 100% after deductible, Resin fillings-2 surfaces: Not covered; Oral Surgery – Extraction-exposed root or erupted tooth: Not covered, Extraction of impacted tooth-soft tissue: Not covered; Major Services – Complete upper denture: Not covered, Partial upper denture (resin based): Not covered, Crown-Porcelain with noble metal: Not covered, Pontic-Porcelain with noble metal: Not covered, Inlay-Metallic (3 or more surfaces): Not covered; Oral Surgery – Removal of impacted tooth-partially bony: Not covered; Endodontic Services – Bicuspid root canal therapy: Not covered, Molar root canal therapy: Not covered; Periodontic Services – Scaling and root planning-per quadrant: Not covered, Osseous surgery-per quadrant: Not covered; Orthodontic Services: Not covered |
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Detail |
see Aetna Texas Health Insurance brochure |
| In-Network | |
| Out-of-Network | |
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Included Riders |
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Product Brochure |
see Aetna Texas Health Insurance brochure |
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