Vimo Editorial: Health Plan Profile
Editorial review written by Erik Espe, Vimo Research Group
Source: Aetna brochure
Last Updated: 07/27/2007
Aetna 's MC 5000 plan already has a high, high deductible of $5,000. But watch out for the out-of-pocket maximum (OOPM), which reaches $8,000. You'll pay 30 percent of health care expenditures after the deductible until you've reached the $8,000 OOPM amount.
There are some preventative care benefits, including annual OB/GYN exams and an annual physical, which aren't affected by the deductible. In short, you can enjoy these benefits even before you've spent $5,000. There's a small copay for generic drugs and a separate $500 deductible for brand-name drugs.
BEST FOR: Healthy young people looking for coverage of medical emergencies. With a high deductible and high OOPM, you won't see significant benefits from this plan unless you have an emergency.
PROS: The very low premiums and
Aetna 's excellent network.
CONS: The sky high deductible and coinsurance maximum means you will spend a huge sum before covered services are paid completely by the insurance company. There also is no maternity coverage.