The third largest insurer in the nation offers great plans to the country’s second largest state. Aetna has stood the test of time, with the same brand name offering insurance products for over 160 years. In Texas, they provide individuals and families with Open Access Managed Choice and PPO plans, giving access to two great networks and several plan designs. Aetna is also one of the most accepting insurers when it comes to conditions, as their underwriting guidelines are much more lenient than the competition in every state. While you may experience a rate increase for a condition, it is somewhat within reason with Aetna, and certain minor conditions will not be declined.
Aetna rounds off its Texas coverage with a Commendable status accreditation from the NCQA for commercial (individual and group) HMO/POS, and PPO plans. The Open Access Managed Choice network is the HMO, which provides the cost saving options of managed care with the freedom of a PPO. Their Texas PPO network is separate, though the plans are identical. It just depends which network and plan type you prefer. Aetna is a highly trusted Texas insurer, and is always growing and changing to fit the needs of its members and potential members. Their provider network consists of over 1 million health care professionals nationally, and 5,400 hospitals to offer in-network options whether in or out of the coverage area.
Aetna Individual Plans in Texas
Open Access Managed Choice & PPO
Choose a traditional, high deductible, or value plan with the same coverage options on either the Open Access Managed Choice network or the PPO network. With Open Access Managed Choice plans, you can opt to select a primary care doctor and treat your plan like an HMO, or lean more towards the liberties of a PPO. Using in-network doctors and services is the most rewarding, however, with copays on office visits and generic drugs. Coverage is 80 percent after deductible on all medical services.
Open Access Managed Choice & PPO High Deductible
These plans offer the lowest premiums due to the larger amount of member cost sharing. Pay out-of-pocket for all services until your deductible is met, and then your plan covers everything from physicians to emergency care at 90 percent. For those who are interested in funding a Health Savings Account to receive income tax breaks and use tax-free money to pay for medical care, OAMC high deductibles are HSA-qualified. Select the OAMC or PPO network depending on your preference for delivery of care.
Open Access Managed Choice & PPO Value
Value plans offer three covered office visits for a copay before deductible, and cover generic prescriptions also. These plans are designed for cost savings, with lower premiums, and higher deductibles. With certain elements of the standard OAMC plans, these provide a limited sampling of those benefits, including hospital and emergency care, and brand name drugs with a separate deductible. All services are covered at 70 percent after deductible.
Open Access Managed Choice Savings Plus
Only available through the OAMC network, these plans provide low cost POS coverage. Select one of two deductibles, and use the various providers in the Open Access Managed Choice HMO network for care, or go out-of-network without a referral. After deductible, member coinsurance is 20 to 40 percent, depending on the service.
Preventive & Hospital Care
A deductible of $2750 provides HSA-compatible coverage for those who want a bare-bones policy. These plans cover preventive services at any time for free with an in-network provider, and hospital care at 80 percent when the calendar year deductible is met. Prescriptions and physician visits are not covered, but there is a basic level of care provided for those who want something minimal.
Find out how much these plans will cost in your area by getting a free, no obligation health insurance quote for research, or to apply instantly. Contact us at 888 803 5917 to speak directly with an agent about Aetna or other plans.