How 57 People Used
With his 20 percent coinsurance, he’ll end up paying a few hundred dollars for the hospital visit. His health plan will pay the remaining portion: In Ben’s case, 80 percent. Find out how hospital plans can help you cover costs before you meet your medical deductible. Copay What is copay? Copays are flat fees for certain visits.
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Aetna 33 People Used
Aetna coinsurance limit. 000 annually for dental services, Your health plan pays the rest up to any benefit or lifetime maximum, they offer more extensive benefits to meet the needs of seniors, limit reached ; Effective 01-01-2016 GR-11613-03-OOC -OH 18.02.312.1-OH L (12/15) Aetna Health and Life Insurance Co offers it some areas (see above) because it helps seniors fill the …
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Health 52 People Used
Coinsurance is when you pay a specific percentage of the cost of a specific service. The limit is based on data Aetna receives. The data is based on what doctors charge for the health care service. We receive the data from Fair Health, an independent organization. Check your plan documents for more details: Your health plan documents will tell you how we pay for out-of …
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Summary 56 People Used
common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, or other underlined terms see the Glossary. You can get the FEHB Plan brochure at www.AetnaFeds.com, and view the Glossary at www.cciio.cms.gov. You can call 1-888-238-6240 to request a copy of either document. Important Questions Answers Why This Matters: What is …
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Summary 56 People Used
Facility fee (e.g., hospital room) 15% coinsurance 25% coinsurance Penalty of $400 for failure to obtain pre-authorization for out-of-network care. Physician/surgeon fees 15% coinsurance 25% coinsurance None If you need mental health, behavioral health, or substance abuse services Outpatient services Office: $5 copay/visit, deductible doesn't
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Summary 58 People Used
Rehabilitation services 20% coinsurance Not covered Coverage is limited to 35 visits for Physical Therapy, Occupational Therapy, Speech Therapy and Chiropractic care combined. Habilitation services 20% coinsurance Not covered None Skilled nursing care 20% coinsurance Not covered Coverage is limited to 25 days.
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Summary 59 People Used
40% coinsurance 50% coinsurance for non-urgent use. If you have a hospital stay Facility fee (e.g., hospital room) 20% coinsurance 40% coinsurance Penalty of $400 for failure to obtain pre-authorization for out-of-network care. Physician/surgeon fees 20% coinsurance 40% coinsurance None If you need mental health, behavioral health, or
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Summary 58 People Used
Aetna: Individual $2,000 / Family $4,000. Out-of-Network: Individual $4,000 / Family $8,000. The out–of–pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out–of–pocket limits until the overall family out–of–pocket limit has been met.
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MTA 57 People Used
Up to a calendar year maximum of $240 per family. Combined with medical deductible Member Coinsurance Covered 100% Allowance Schedule Coinsurance Limit Not applicable Not applicable Lifetime Maximum Unlimited Unlimited Maximum Out of Pocket (copayment/coinsurance) Not applicable Not applicable PCP/ Referral Requirement None None
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Summary 59 People Used
Home health care 0% coinsurance Not covered Coverage is limited to 60 visits. Rehabilitation services 0% coinsurance Not covered Coverage is limited to 35 visits for Physical Therapy, Occupational Therapy, Speech Therapy & Chiropractic care combined.
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Summary 59 People Used
50% coinsurance 50% coinsurance for non-urgent use. If you have a hospital stay Facility fee (e.g., hospital room) 30% coinsurance 50% coinsurance Penalty of $400 for failure to obtain pre-authorization for out-of-network care. Physician/surgeon fees 30% coinsurance 50% coinsurance None If you need mental health, behavioral health, or
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PLAN 56 People Used
Aetna Open Access ® Aetna SelectSM PLAN DESIGN & BENEFITS $500 Family Member Coinsurance 10% coinsurance Applies to all expenses unless otherwise stated. Payment Limit (per calendar year) $2,000 Individual $4,000 Family Certain member cost sharing elements may not apply toward the Payment Limit. Pharmacy expenses do not apply towards the Payment …
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Aetna 56 People Used
Member Coinsurance Covered 100% Applies to all expenses unless otherwise stated. Limit (per calendar year) $8,700 IndividualPayment $17,400 Family Certain member cost sharing elements may not apply toward the Payment Limit. Only those out-of-pocket expenses resulting from the application of coinsurance percentage, copays, and deductibles
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