Benefits of Choosing Aetna
Aetna has more than 37 million members that include individuals, families, students, companies and retirees and has been named the most admired health insurance company by Fortune magazine.
The biggest advantage Aetna has over other insurance companies in Illinois is that their individual policies are issued without waivers or riders. Instead, Aetna offers various risk categories based on each applicant. This allows applicants to receive benefits for health conditions that other insurance companies normally exclude by charging an increased premium and ensures applicants with minimal health risk do not have to subsidize the cost of members with a higher health risk.
All essential health benefits are covered:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Pregnancy, maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (Pediatric dental care only covered through Aetna on off-exchange plans.)
Aetna offers affordable care options. You decide which plan offers the copay, deductible, and coinsurance amounts that are right for you. And all Aetna’s plans offer these $0 benefits:
- Preventive care, including routine screenings
- Virtual Care*
- MinuteClinic visits at CVS**
*Members may be required to pay a cost-share based on what medical services were received and the type of a provider a member visits. Please consult benefit documents for more details. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates.
**For a complete list of participating walk-in clinics, log in to Aetna.com and use our provider search tool. Includes select MinuteClinic services. Not allMinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states. Access to walk-in clinics varies by geography. Walk-in appointments are based on availability and not guaranteed. Online scheduling is recommended.
Aetna CVS Health Plans – Illinois Hospital Network
Hospital Network Highlights – hospitals include, but are not limited to:
Chicago:
- Jackson Park Hospital Foundation
- Holy Cross Hospital
- Humbolt Park Health
- John H. Stroger Hospital of Cook County
- La Rabida Children’s Hospital
- Loretto Hospital
- Louis Weiss Memorial Hospital
- Mercy Harvard Hospital
- Insight Chicago
- Methodist Hospital of Chicago
- Mount Sinai Hospital and Medical Center
Northshore University Health System:
- Northshore University Health System – Glenbrook
- Northshore University Health System – Highland Park
- Northshore University Health System – Evanston
- Northshore University Health System – Skokie
- Edward Hospital
- Elmhurst Memorial Hospital
- Northwest Community Hospital
- Swedish Covenant Hospital
- OSF Little Company of Mary Hospital
- Provident Hospital of Cook County
- Roseland Community Hospital
- Schwab Rehabilitation Hospital
- South Shore Hospital
- St. Anthony Hospital
- St. Bernard Hospital
- Swedish Covenant Hospital
- Thorek Hospital and Medical Center
- Vista Medical Center East
- Vista Medical Center West
- University of Illinois at Chicago Medical Center
All Aetna individual plans in Illinois allow you to go directly to any recognized health care provider, including specialists, for covered expenses. The following are standard benefits included in all Aetna individual plans:
- Unlimited office visits to your primary care physician and specialists
- No referrals required
- No waiting periods to access preventive health and routine physicals
- Lab work and x-rays included in routine physicals
- 100% annual routine GYN exam coverage – no waiting period, copay, or deductible
- 100% coverage on in-network childhood immunizations
- Prescription drug coverage