Health Insurance Product Reviews (BETA)
Major Carriers and High Deductible Health Plans

Vimo Editorial: Health Plan Profile

Aetna ’s PPO 2500 plan offers excellent coverage for a high-deductible plan, even delivering benefits for non-specialist doctor visits beforeyou’ve spent more than your deductible. In other words, after your plan goes into effect, you can have a standard doctor visit for a small copay.

Granted, the deductible is high. At $2,500, it would take a serious medical emergency for you to burn through it. The plan also offers a pre-deductible $40 copay for an annual OB/GYN exam, and $15 copays for generic prescription drugs. In other words, if you don’t become seriously sick during the year, you still gain some benefits from the plan when you go on routine doctor visits.

BEST FOR: Someone looking for low monthly payments  who is willing to pay a high deductible, out-of-pocket maximum (OOPM), and office visit copays in return. The OOPM of the plan is $5,000.

PROS: The low premiums and Aetna, which has a great network in Texas. Aetna plans for individuals and their families are available in 189 counties in Texas. Aetna members in Texas have access to a network of 265 hospitals, 7,459 primary care physicians and 18,164 specialists.

CONS: A lack of maternity coverage may mean that the plan won’t appeal to many young women. The deductible is high as well. The plan also isn’t compatible with Health Savings Accounts (HSAs).