Aetna Ohio health insurance coverage is available in most parts of the state and is very competitively priced. Group individual and family policies are among the most popular plans offered, along with Medigap plans for applicants that have reached age 65. Also offered are specific plans for students and the self-employed. Policies can be easily customized, and flexible billing options are always available, including "direct bill at home."
This giant carrier issued its first insurance policy in 1850. But, many Ohioans are truly happy they “met” Aetna, especially considering their large network of doctors and specialists. Their PPO coverage is recognized and respected by more than 21,000 doctors and hospitals, making it one of the most popular forms of medical coverage. More than 23 million persons are covered by health benefits, and an additional 14 million persons for dental benefits. Employer-sponsored benefits continue to cover large and small companies.
In addition to individual and Senior coverage, other lines of business include dental, vision, disability, Group life, pharmacy, Medicaid services, and worker's compensation administration. The network of providers is large for both young and older applicants. Currently, Aetna does not market subsidized Marketplace plans or "off-Exchange" contracts in the Buckeye State. It is possible, with new healthcare legislation, they may begin offering coverage in 2019 in selected counties.
Aetna Senior Medicare Coverage In Ohio (For Persons Age 65 And Older)
Medicare Supplement Plans
Medicare Supplement plans pay for many of the out-of-pocket expenses not covered by basic coverage. The standardized plans that are available are A, B, F, F (HD), G, and N. Options not offered by Aetna are generally available through one of many other carriers, including Anthem Blue Cross, Humana, Transamerica, UnitedHealthcare, and many additional carriers.
Plan F is the most comprehensive and expensive option, since Part A and B deductibles, 100% Part B coinsurance, Part B excess, foreign travel emergency, and skilled nursing facility coinsurance are covered. Plan A is one of the least expensive options, since "Basic" benefits and the Part B coinsurance are the main features. Parts A and B deductibles are not covered. Plan F (HD) is the least expensive option, since a single deductible must be met before benefits are paid (100%).
Shown below are estimated monthly preferred rates for all available plans in selected areas. Three rating territories are utilized: Zip codes 436 and 440-445 consist of one area. 450-454, and 459 consist of another area. The remainder of the state is the third area.
Hamilton, Clermont, Clinton, Brown, Warren, Highland, Preble, Greene, Shelby, Darke, Miami, Montgomery, Mercer, Clark, and Adams Counties Male Age 65
Plan A - $111
Plan B - $117
Plan F - $151
Plan F (HD) - $60
Plan G - $127
Plan N - $123
Hamilton, Clermont, Clinton, Brown, Warren, Highland, Preble, Greene, Shelby, Darke, Miami, Montgomery, Mercer, Clark, and Adams Counties Female Age 65
Plan A - $96
Plan B - $102
Plan F - $131
Plan F (HD) - $52
Plan G - $110
Plan N - $99
Zip Codes 436 and 440-445 Male Age 65
Plan A - $124
Plan B - $131
Plan F - $168
Plan F (HD) - $67
Plan G - $141
Plan N - $114
Zip Codes 436 and 440-445 Female Age 65
Plan A - $107
Plan B - $114
Plan F - $146
Plan F (HD) - $58
Plan G - $123
Plan N - $99
Remainder Of State Male Age 65
Plan A - $105
Plan B - $112
Plan F - $143
Plan F (HD) - $57
Plan G - $121
Plan N - $98
Remainder Of State Female Age 65
Plan A - $92
Plan B - $97
Plan F - $125
Plan F (HD) - $50
Plan G - $105
Plan N - $85
Medicare Advantage Plans (Rates And Benefits Often Vary Depending On County)
Aetna Medicare Value Plan (PPO) - $0 monthly premium with $0 deductible and maximum out-of-pocket expenses of $4,900. Office visit copays are $15 and $45, with ER copay of $80. Inpatient hospital copay is $360 per day for first five days, and $0 days 5-90. Lab and diagnostic copays are $20 and 20%. Imaging copays are x-ray ($50), and CT-scan and radiology ($235). The ambulance copay is $300 with a $280 copay for an ambulatory surgical center. Dental, hearing, and eyewear benefits can be added as riders. Preferred pharmacy 30-day copays are $2 (Tier1), $5 (Tier 2), $42 (Tier 3), $100 (Tier 4), and 30% (Tier 5). 90-day mail-order copays are $0 (Tier1), $10 (Tier 2), $121 (Tier 3), and $300 (Tier 4).
Aetna Medicare Value Plan (HMO) - $0 deductible and maximum out-of-pocket expenses of $4,900. Office visit copays are $15 and $45, with ER copay of $80. Inpatient hospital copay is $400 per day for first four days, and $0 days 5-90. Lab and diagnostic copays are $15 and 20%. Imaging copays are x-ray ($50), and CT-scan and radiology ($150). The ambulance copay is $320 with a $250 copay for an ambulatory surgical center. Dental, hearing, and eyewear benefits can be added as riders. Preferred pharmacy 30-day copays are $0 (Tier1), $5 (Tier 2), $42 (Tier 3), $100 (Tier 4), and 31% (Tier 5). 90-day mail-order copays are $0 (Tier1), $10 (Tier 2), $121 (Tier 3), and $300 (Tier 4).
Aetna Medicare Choice Plan (PPO) - $0 deductible and maximum out-of-pocket expenses of $4,100. Office visit copays are $10 and $30, with ER copay of $80. Inpatient hospital copay is $220 per day for first six days, and $0 days 7-90. Lab and diagnostic copays are $0 and $25. Imaging copays are x-ray ($20), and CT-scan and radiology ($140). The ambulance copay is $300 with a $130 copay for an ambulatory surgical center. Dental, hearing, and eyewear benefits can be added as riders. Preferred pharmacy 30-day copays are $2 (Tier1), $5 (Tier 2), $42 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day mail-order copays are $0 (Tier1), $10 (Tier 2), $121 (Tier 3), and $300 (Tier 4).
Previous Year Pricing (Under Age 65)
Their rates are not always the lowest, when compared to other companies, but their PPO plans are usually a "good buy." We expect to see Aetna continue to participate in the Ohio Exchange and Marketplace again by 2019, which will guarantee approval for all consumers that purchase a policy. You can apply directly through our website.
Although they have not offered individual medical plans as long as a few other companies, such as UnitedHealthOne, Medical Mutual or Anthem, a wide variety of quality policies are available, including comprehensive, catastrophic and HSA plans. Short-term coverage is not available although customers can cancel their policy at any time. Thus, if you only needed to purchase benefits for a few months, that would be acceptable. (Note: At this time, Aetna does not offer short-term plans).
Popular Marketplace Plans In Ohio
Bronze $20 Copay - The least expensive Bronze-tier policy that offers copays on office visits ($20) and generic prescriptions ($15). As a Point-Of-Service (POS) option, this plan combines HMO and PPO features, including substantial discounts if stay "in-network."
Specialist visits are subject to a $50 copay and also must meet the policy deductible of $5,750. Hospital visits have a $250 per stay charge plus applicable deductibles and copays.
Silver $10 Copay - Another POS plan that features a very low $10 copay on office visits but no deductible on specialist visits. Since the cost of a specialist can easily be more than $150, this is a major money-saver. The deductible of $3,750 is also very reasonable.
Cost-sharing applies (to all Silver-tier plans), so depending upon household income, deductible and out-of-pocket expenses can drastically reduce.
Gold $5 Copay - "Cadillac" of Ohio Marketplace policies. $5 and $40 copays on primary-care-physician and specialist visits. Add a low $1,400 deductible and you have a very attractive option if you're willing to spend a few extra dollars. Maximum out-of-pocket maximum is $5,000.
Grandfathered plans (policies issued in April of 2010 or earlier) remain active for many households. Although benefits do not reflect new mandates and guidelines, unless they are terminated by the original carrier, you may keep the contract.
These options have become very popular in recent years. And although their rates are extremely competitive, it is still important to properly compare their policy to the other Ohio health companies. And that’s what we do best! Although we will consider all policies when researching your options, we feel it is most important to recommend the options that best fits your specific needs...regardless of which company that might be.
The quotes you view on our website are always free! When applying for coverage, we can help you every step of the way, including researching and comparing policies. You can also "apply direct" with the links we provide.