Aetna of Alaska PPO Value 2500 Plan Information
Deductible
Individual: $2,500
Family: $5,000
Coinsurance
30% after deductible up to out-of-pocket max.
Coinsurance Maximum
Individual: $2,500
Family: $5,000
Out-of-Pocket Maximum
Individual: $5,000
Family: $10,000
*Includes deductible
Lifetime Maximum per Insured
$5,000,000
Non-Specialist Office Visit
Visit 1-2 $30 Copay deductible waived. Visit 3+ 30% after deductible. Specialist and Non Specialist share visit max.
Specialist Visit
Visit 1-2 $30 Copay deductible waived. Visit 3+ 30% after deductible. Specialist and Non Specialist share visit max.
Hospital Admission
30% After deductible
Outpatient Surgery
30% After deductible
Urgent Care Facility
$50 Copay deductible waived
Emergency Room
$100 Copay (waived if admitted) 30% coinsurance after deductible
Annual Routine Gyn Exam
$0 copay deductible waived
Maternity
Not Covered except for pregnancy complications
Preventive Health-Routine Physical
$50 Copay deductible waived
Lab/X-Ray
30% After deductible
Skilled Nursing
30% After deductible
Physical/Occupational Therapy and Chiropractic Care
30% After deductible
Home Health Care
30% After deductible
Durable Medical Equipment
30% After deductible
Pharmacy Deductible
Not Applicable
Generic
$20 Copay deductible waived
Preferred Brand
Not Covered
Aetna Discount Applies
Non-Preferred Brand
Not Covered
Aetna Discount Applies
Calendar Year Maximum
$5,000
Other Aetna of Alaska health insurance plans:
