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What is an out-of-pocket maximum Aetna?

Definitions: Out-of-pocket (OOP) max: The highest amount you could pay in a given year for services (excludes premium). Copay/coinsurance: The amount you pay per visit or prescription to treat an injury or illness. It typically counts toward your OOP max.

What is the difference between Tier 1 and Tier 2 Aetna?

Tier 1 Aetna Premier Care Network Plus Multi-Tier providers. Utilizing a provider from this tier results in maximum savings for Aetna members. Tier 2 Aetna Health broad network providers. Utilizing a provider from this tier results in standard savings for Aetna members.

What does out network mean for health insurance?

If a doctor or facility has no contract with your health plan, theyre considered out-of-network and can charge you full price. Its usually much higher than the in-network discounted rate.

How does the Aetna deductible work?

After you meet your deductible, you pay a smaller portion of your medical costs. (This is your coinsurance.) Your plan pays the rest. Once you meet your out-of-pocket maximum (this is your deductible plus coinsurance limit), your plan pays for all covered medical services in full.