Aetna High Deductible 3000 (HSA Compatible) California Health Insurance Plan Details

Insurance Plan Summary
Company
Aetna
Plan Name
High Deductible 3000 (HSA Compatible)
Plan Type
PPO
Primary Care Physician Required
No 
Specialist Referrals Required
No 
HSA Eligible
Yes 
Out-of-Network Coverage
Yes
In-Network Coverage
Coinsurance
No Charge after deductible 
Office Visit
 
Primary Doctor
No Charge after deductible 
Specialist
No Charge after deductible 
Periodic Health Exam
$20 Copay 
Periodic OB-GYN Exam
No Charge 
Well Baby Care
$20 copay; Age and frequency schedule apply 
Chiropractic
No Charge after deductible. Aetna will pay $25 Max. Per Visit/ 24 Visits Per Year. 
Mental Health
Not covered except for severe biologically based mental and nervous disorders with associated treatment of drug and alcohol dependencies 
Prescription Drugs
 
Generic
No Charge after deductible 
Brand
No Charge after deductible 
Non-Formulary
No Charge after deductible 
Separate Rx Deductible
Integrated Medical/Rx Deductible 
Mail Order
Available
Outpatient Lab/X-Ray
No Charge after deductible 
Emergency Room
No Charge after deductible 
Outpatient Surgery
No Charge after deductible 
Hospitalization
No Charge after deductible 
Maternity
 
Pre & Postnatal Office Visit
Not Covered 
Labor & Delivery Hospital Stay
Not Covered 
Additional Information
Will insurance company obtain and pay for medical records?
Yes
eSign
(electronic signature)
Yes
A.M. Best Rating
A
as of 06/11/2007
More Insurance Plan Details
More Details
Exclusions and Limitations
Exclusions and Limitations
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Company
Aetna
Plan Name
High Deductible 3000 (HSA Compatible)
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