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Aetna
is a publicly traded insurance company listed on the New York stock
exchange under the ticker symbol AET. Aetna is one of the nation's
leaders in health care, dental, pharmacy, group life, and disability
insurance, and employee benefits. Dedicated to helping people
achieve health and financial security, Aetna puts information and
helpful resources to work for its members to help them make
better-informed decisions about their health care. As of September
30, 2008 Aetna has over 17 million medical members. Aetna also
offer PPO memberships with some of the largest PPO networks in the
country with over 874,000 health care professionals. 506,000
primary care doctors and specialists, and 4,987 hospitals
participating.
Aetna offers a variety of individual health plans depending on the
State you live in. The most popular are the Aetna Advantage plans
for individuals, families and the self employed. This series of
individual health plans include the Managed Choice Open Access and
PPO $2,500 and $5,000 Deductible plans. The Managed Choice and PPO
HSA
qualified HDHPs
with $6,000 and $10,000 annual family deductibles to choose from.
The PPO Preventative & Hospital Care Plan with $1,250 (individual)
and $2,500 (family) annual deductibles to choose from. These plans
vary by State and may include more or less coverage depending on
your specific State health insurance mandates.
Aetna
plans
now include the new mandates under the PPACA (Patient
Protection & Affordable Care Act) that went in to effect on
September 23rd, 2010. They are as follows:
No lifetime limits on overall plan benefits, and
no lifetime limit on the dollar value of specific
"essential benefits."
Annual limits on essential benefits, only until
1/1/14.
Rescission only for fraud or intentional
misrepresentation of material facts.
(This was law before the PPACA)
Coverage of preventive health services and
immunizations without cost sharing. Including the
following
Covered
Preventive Services for Adults:
Abdominal Aortic Aneurysm one-time screening
for men of specified ages who have ever smoked
Alcohol Misuse screening and counseling
Aspirin use for men and women of certain
ages
Blood Pressure screening for all adults
Cholesterol screening for adults of certain
ages or at higher risk
Colorectal Cancer screening for adults over
50
Depression screening for adults
Type 2 Diabetes screening for adults with
high blood pressure
Diet counseling for adults at higher risk
for chronic disease
HIV screening for all adults at higher risk
Immunization vaccines for adults--doses,
recommended ages, and recommended populations
vary:
Hepatitis A
Hepatitis B
Herpes Zoster
Human Papillomavirus
Influenza
Measles, Mumps, Rubella
Meningococcal
Pneumococcal
Tetanus, Diphtheria, Pertussis
Varicella
Obesity screening and counseling for all
adults
Sexually Transmitted Infection (STI)
prevention counseling for adults at higher risk
Tobacco Use screening for all adults and
cessation interventions for tobacco users
Syphilis screening for all adults at higher
risk
Covered
Preventive Services for Women, Including Pregnant
Women:
Anemia screening on a routine basis for
pregnant women
Bacteriuria urinary tract or other infection
screening for pregnant women
BRCA counseling about genetic testing for
women at higher risk
Breast Cancer Mammography screenings every 1
to 2 years for women over 40
Breast Cancer Chemoprevention counseling for
women at higher risk
Breast Feeding interventions to support and
promote breast feeding
Cervical Cancer screening for sexually
active women
Chlamydia Infection screening for younger
women and other women at higher risk
Folic Acid supplements for women who may
become pregnant
Gonorrhea screening for all women at higher
risk
Hepatitis B screening for pregnant women at
their first prenatal visit
Osteoporosis screening for women over age 60
depending on risk factors
Rh Incompatibility screening for all
pregnant women and follow-up testing for women
at higher risk
Tobacco Use screening and interventions for
all women, and expanded counseling for pregnant
tobacco users
Syphilis screening for all pregnant women or
other women at increased risk
Covered
Preventive Services for Children:
Alcohol and Drug Use assessments for
adolescents
Autism screening for children at 18 and 24
months
Behavioral assessments for children of all
ages
Cervical Dysplasia screening for sexually
active females
Congenital Hypothyroidism screening for
newborns
Developmental screening for children under
age 3, and surveillance throughout childhood
Dyslipidemia screening for children at
higher risk of lipid disorders
Fluoride Chemoprevention supplements for
children without fluoride in their water source
Gonorrhea preventive medication for the eyes
of all newborns
Hearing screening for all newborns
Height, Weight and Body Mass Index
measurements for children
Hematocrit or Hemoglobin screening for
children
Hemoglobinopathies or sickle cell screening
for newborns
HIV screening for adolescents at higher risk
Immunization vaccines for children from
birth - age 18 doses, recommended ages, and
recommended populations vary:
Diphtheria, Tetanus, Pertussis
Haemophilus influenzae type b
Hepatitis A
Hepatitis B
Human Papillomavirus
Inactivated Poliovirus
Influenza
Measles, Mumps, Rubella
Meningococcal
Pneumococcal
Rotavirus
Varicella
Iron supplements for children ages 6 to 12
months at risk for anemia
Lead screening for children at risk of
exposure
Medical History for all children throughout
development
Obesity screening and counseling
Oral Health risk assessment for young
children
Phenylketonuria (PKU) screening for this
genetic disorder in newborns
Sexually Transmitted Infection (STI)
prevention counseling for adolescents at higher
risk
Tuberculin testing for children at higher
risk of tuberculosis
Vision screening for all children
Dependent coverage extended to adult children to
age 26.
Prohibition of pre-existing exclusions for
individuals under 19.
Multiple Individual Traditional & HSA qualified Health Insurance
Plans to choose from.
4
tier outpatient R/X card included with the Managed Choice PPO &
Open Access Plans and the Managed Choice & PPO First Dollar
plans.
Please Note: Before Brand name outpatient prescriptions are
covered on the Managed Choice PPO & Open Access plans and the
Managed Choice & PPO First Dollar plans, each insured family
member must satisfy a separate $500 outpatient prescription card
deductible before they may use their Brand name prescription
drug co pay. Generic drugs require no deductible on these plans.
The
PPO Preventative & Hospital Care plan includes only a discount
prescription card.
Unlimited $30 "first dollar" (no deductible
required) outpatient primary care doctor office visit co pays
included with the Managed Choice PPO & Open
Access Plans. Specialty outpatient doctor office visits will
require a $50 co pay per visit.
Unlimited $40 "first dollar" (no deductible
required) outpatient primary care doctor office visit co pays
included with the Managed Choice PPO & Open Access Plans.
The
PPO Preventative & Hospital Care plan does not include coverage
for outpatient primary care or specialist doctor office visits.
A
$2,500 individual and $5,000 family calendar year deductible is
the only option with the Managed Choice PPO & Open Access plans.
A
$1,250 individual and $2,500 family calendar deductible is the
only option with the Preventative and Hospital Care 1250 plan.
The
Managed Choice & PPO First Dollar Plan has a $0 deductible.
There is NO calendar year deductible with this plan.
100%, 80/20 & 70/30 co-insurance options to choose from with
stop loss numbers ranging from $12,500 (with 80/20 option) to
$25,000 (with 70/30 option).
Largest Nationwide P.P.O. network in the
country. Are your doctors in the network?Find out
here:
www.phcs.com
Lifetime Maximum coverage amounts are unlimited with all of the
aforementioned plans.
All
of the aforementioned PPACA Preventative Care mandates now
included.
HSA
qualified HDHP also available. Details for this plan are
outlined in the Aetna brochure below.
Optional "first dollar" A.M.E. plan providing up
to $5,000 of "first dollar" coverage per accident
(see V.B.A. brochure below) only $29.95 per family.
Optional Dental Insurance plan available as well. See World
Advantage Dental plan brochure below.
Aetna Advantage Individual Health Insurance Plans Brochure 2011
(
PDF)
Click below for FREE side by side comparison quotes for Permanent
Health Insurance coverage from multiple carriers.
World Care Individual Dental Insurance Plan Brochure (
PDF format)
World Care Individual Dental Insurance Plan Brochure (
PDF format)