14/07/2024

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Aetna Health Insurance Company of Arizona Review

Aetna Health Insurance Company of Arizona Review

Aetna Health Insurance Company of Arizona is a top notch choice for Arizona health insurance. Of course, no one insurance company is the best fit for everyone’s needs so let’s take a closer look at some of the Arizona health insurance plans offered by Aetna and see if they may be a good fit for your medical insurance needs.

Aetna has been in the picture of the American consumer since 1850. In that year it was founded in the state of Connecticut to sell life insurance. Nowadays this insurance company is one of the nation’s leaders in health care, dental, group plan and disability insurance. It is because of their continual growth within the United States that the company now has an estimated 15.8 million medical members, 13 million dental members and 10.6 million pharmacy members. They serve in all 50 states of the nation including the state of Arizona and it is in this state that just recently in 2005, the company introduced Medicare advantage plans.

The state of Arizona with approximately 6,166,318 million inhabitants is one of the fastest growing states in the nation with a 20% increase in population from 2000 to 2006. What the company does to accommodate their members in the state of Arizona is split the counties in which it offers coverage into two areas. The rate of your health plan and your providers will change according to the area in which you live in.

The areas will also determine which network of specialists they will be using when is time for them to receive health coverage. Area one includes the following counties: Apache, Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Mohave, Navajo, Pinal, Santa Cruz, Yavapai and Yuma. These counties are all under the Preferred Provider Organization Network or PPO, meaning that their in-network coverage will include all the PPO network providers. In case that they use someone that is not included under the PPO network, they will have to pay out of network costs.

The second area is very different than the first one in that it only covers the counties of Maricopa and Pina. These two counties fall under what Aetna calls the Aexcel Network. This type of network is very different than any other one simply because is a network exclusively for specialists. These specialists are classified by Aetna because they have demonstrated cost-effective coverage and excelled in medical coverage efficiency. Members of this network can choose to select specialists within twelve areas. Those twelve areas involve cardiology, cardiothoracic surgery, gastroenterology, otolaryngology, neurology, neurosurgery, general surgery, obstetrics and gynecology, plastic surgery, urology and vascular surgery.

It is also important to highlight that Aetna members that chose any specialist within this network will not be charged more because of it. They are covered under their plan and they can choose to attend anyone in the network of specialists at any time.

The first insurance company to offer consumer directed health plans, Aetna receives a rating of A by A.M. Best making it an excellent choice for anyone looking to purchase health care coverage. They have over 793,000 health care professionals affiliated to them, 462,000 primary care doctors and physicians and 4,716 hospitals within the United States and they continue to grow. In the state of Arizona, they have established themselves are one of he biggest health insurance companies and at the moment they offer 8 plans that people looking for health coverage can choose from. Below you will see each plan listed and a brief description of what it offers.

PPO 1000: With this plan you will have a $1000 deductible per individual and $2000 per family. All members of this plan will use the PPO network and their out-of-pocket maximum would be $2500 for individual and $5000 for family. You will be paying a $20 for office visits ($35 if the visit involves a specialist) and prescription coverage is divided into three tiers (generic, brand name and specialty) with prices of $15, $25 and $40 respectively. The last thing worth mentioning about this plan is that for hospitalization you will pay 20% after you meet your deductible.

PPO 1500: The premiums in this plan are moderately high and they offer a $1500 deductible for individuals and $3000 for family. The coverage is almost the same as the first plan described because they shared the same copayments when for doctor visits, specialists and hospitalization. Some different things are the prescription coverage which would range from $15 to $40 and that the maximum out of pocket would be a little more expensive, $3000 for individual and $6000 for family.

PPO 2500: As expressed in its name the deductible for this coverage is much higher with $2500 for individual and $5000 for a family. The copay for hospitalization is the same as the other two plans discussed before, however the doctor copay varies with $25 for office visits and $45 for specialists. Out-of-pocket maximum is $5000 for individual and $10000 per family, and prescription drug coverage ranges from $15 to $40 dollars.

PPO 5000: Premiums for this plan are much lower than all the other ones simply because it has a high deductible in case of using the services. If you choose this plan you will have a deductible of $5000 for individual and $10000 for family. Your office visits will also be $25 with a higher cost of $40 for specialists. Hospitalization is also 20% after the deductible and prescription coverage also ranges from $15 to $40. The out-of-pocket maximum is much higher however, with $7500 individual and $15,000 per family accordingly.

PPO Value 2500: This plan offers you moderately high out of pocket expenses and copays, but the moderate monthly premiums balance it out. The office visits vary because for your 1st and 2nd visit you will only pay $30, however after the 3rd visit you will be charged 30% after you pay your deductible. The deductible is $2500 for individual and $5000 for family, while the out-of-pocket maximum is $5000 for individual and $1000 for family respectively. Once again we see the prescription coverage divided into three tiers with the copays of $15, $35 and $50 respectively.

First Dollar PPO 35: With moderate premiums, moderate monthly payments and excellent prescription coverage this plan is one of the most famous within the state. You do not have a deductible and your out-of-pocket maximum is $3500 for individual and $7000 for family. Your office visits are $35 and $45 for specialists, while your prescription drug coverage is $15, $25 and $40 divided into the three tiers. The only thing that is a little bit more expensive is hospitalization for which you will have to pay a 35% co-insurance.

Preventive and Hospital Care 1250: This plan gives you the freedom to go to any recognized health care professional for treatment. Premiums are low simply because out-of-pocket expenses are a little bit higher. You have a deductible of $1250 for individual and $2500 for family the same amount of out-of-pocket maximum ($1250 and $25000). You are not covered for doctor visits and prescription coverage because it’s only a preventive care plan and for hospitalizations you will have to pay 20% after meeting your deductible.

Preventive and Hospital Care 3000: Like the other preventive plan discussed above, you can go anywhere if you are covered under this plan. Aetna offers this plan as a Health Savings Account compatible coverage, which means that you can pay for medical expenses on tax-advantage basis. With these plan you will have a $3000 deductible for individual and $6000 for family with an out-of-pocket maximum of $5000 for individual and $10000 for family. You will not be covered for doctor visits and prescription medication and you will have to pay a 20% co-insurance for hospitalizations after your deductible.