Aetna Health Insurance
Aetna is an insurance company that strives to give its customers the best healthcare options possible. With its wide range of medical, dental, vision, and behavioral health care, Aetna is considered to be one of the most widely known health insurance companies in the United States. Some other payment options available to the patients are APS Healthcare, Alliance, Beech Street, CIGNA, Guardian, Pacificare, etc.
States That Accept Aetna Insurance
- Washington DC
- North Carolina
- South Carolina
The Traditional Choice indemnity insurance of Aetna makes it a point to give all of their employees freedom. There is complete absence of network, referrals, or even primary care doctors. Here, employees are open to go to any licensed healthcare facility or professional for seeking help. There is a deductable and a coinsurance facility that apply. The amount any employee pays for covered services before the health plan begins is deductable at Aetna. The coinsurance offered is the percentage of health care expenses which the employee pays after the deductible amount. The employees also send in claim forms for any form of care they receive. Additionally, several programs on wellness and prevention are available here.
Certain additional features include discounted rates for employees through the National Advantage Program. Such facility applies to covered services from many doctors, hospitals, and other facilities. There are discounts on eyewear, gym memberships, and such health and wellness services and products without any additional costs.
Individuals and Families
Aetna offers addiction benefits to family members which vary depending on the situation. It keeps in mind that life can take any turn at any point of time. With such sudden incidents, what crops up simultaneously, are the expenses. Therefore it is important to have an insurance which can meet the unexpected costs. Some of the products that they offer to help people in need are:
- Aetna Fixed Benefits Plan
- Aetna Hospital Plan
- Group Critical Illness Insurance
- Group Accident Insurance
- Dental and vision insurance
- Life and disability insurance
- Vital Savings by Aetna discount program
Hospital insurance is known as Medicare Part A. After deductions of uncovered items it pays the inpatient hospital stay for 60 days of benefit period. Part A also includes health and hospital care. Both Parts A and B are original Medicare. Confirm from doctor about the treatments and if Medicare will cover them.
The Part B of medicare is medical insurance. It covers for the medical services like pathological diagnosis to treat a medical condition. Preventive services are also covered. Part B of medicare covers 80% of covered costs post deductions. 20% is bourne by the insured. Doctor services in hospital are also covered in Part B. Both Parts A and B are called Original Medicare.
Part A Covers
- Hospital stays
- Critical access hospitals
- Rehabilitation facilities for inpatient
- Non-medical health care
- Nursing facilities for in patient
- Nursing home care (Non-custodial care)
- Hospice care
- Home health service
- Pathological and radiation treatment received for the inpatient
- Operations, implants and other surgeries.
What’s Not Covered
- Most doctor services received as an inpatient are not covered. They are under Part B.
- Personal services like the usage of laundry facilities, telephone, television and others in the hospital.
- Custodial care like help in eating, bathing and dressing.
Part B Covers
What's Not Covered
There is a supplement premium in addition to Part A and Part B. If there is a Medicare Advantage Plan one can apply for Medicare Supplement policy but it is mandatory to leave the Medicare Avantage Plan before the new plan begins.
It is illegal to sell Medicare Supplement plan while retaining Medicare Medical Savings plan.
- Doctor services
- Outpatient care
- Home health services
- Durable medical equipment
- Clinical research
- Ambulance services
- Mental health services
- Second opinions before surgery
- Preventive services such as physical exams, screenings and flu shots
- Some physical and occupational therapy to prevent or lessen complications from an existing medical problem
- Dental, vision or hearing care, except in very limited situations
- Care received outside the United States, except in very limited situations
- Custodial care such as help with eating, bathing or dressing