Gold Savings Plus OAEPO 1000 90 70 by Aetna Inc.
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Plan Information
- Plan Name
- Gold Savings Plus OAEPO 1000 90 70
- Insurance Company
- Aetna Inc.
In Network Benefits
- Office Co-pay
- $30
- Specialist Co-pay
- $50
- Hospital Co-pay
- 10% after deductible
- Emergency Room
- $750
- Referrals Needed
- No
- Rx: Generic/Brand/High Brand
- $15/$65/50%
- In-Network Deductible (single/family)
- $1,000/$2,000
- In-Network Co-Insurance
- 10%
- Max Out of Pocket (single/family)
- $3,500/$7,000
Out Of Network Benefits
- Deductible (single/family)
- N/A
- Co-Insurance
- N/A
- Out of Pocket Max (single/family)
- N/A
Other Benefits
- Vision/Dental
- Pediatric Vision and Dental
- HSA Eligible
- No
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