Pennsylvania Aetna HMO (Health Maintenance Organization) plans provide some of the most comprehensive health care coverage available to Pennsylvania residents. As Pennsylvania's leading trusted source for HMO coverage, we specialize in finding the policies that fit within your budget and offer the coverage you want.
Individuals who join an Aetna HMO are considered its members. When you join a Pennsylvania HMO, a primary care physician is selected from a large Network list. Your physician will coordinate all of your medical care. There are no claim forms when you visit a network provider and no waiting period for routine physical exams.
Aetna’s “HMO 30” is one of the most popular, yet affordable health insurance plans in Pennsylvania. Since there is no major medical deductible to meet, out-of-pocket expenses tend to be lower when compared to a typical PPO plan. Also, lifetime benefits are unlimited instead of the more common $1-5 million cap. Covered office visits are subject to low $30 copay while specialist visits are subject to a $50 copay. There is no limit to the number of covered office visits that an individual or family can use.
Preventive coverage is also included and actually emphasized in the Pennsylvania Aetna HMO plans. Routine physicals are subject to a copay $30 while annual routine GYN exams, paps and mammograms are subject to a $40 copay. Typically, you do not have to meet a deductible to use the preventive services.
Lab tests and X-Rays are also covered by a low $50 copay. And although home health care and outpatient therapy are not commonly used, they are covered by copays and are not subject to a deductible. After a $500 deductible, prescriptions are covered by copays of either $15, $40 or $60. For many generic versions, you may be able to pay a lower amount at retail pharmacies such as Wal-Mart or Giant Eagle.
Hospital visits (including maternity) are not subject to a deductible. Instead, a $600 copay per day is charged (maximum of five days of copays). Aetna’s Pennsylvania HMO plans also offer alternative copay charges to reduce the premium. Outpatient surgery is subject to just a $550 copay and the emergency room copay is just $250.
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Pennsylvania Aetna HMO 30 Health Insurance Plan Details
