Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta

82824GA0110002
Expanded Bronze
HMO

Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta is an Expanded Bronze HMO plan by Aetna CVS Health.

Locations

Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta is offered in the following counties.

Plan Overview

This is a plan overview for 2022 version of Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta 82824GA0110002.
Insurer: Aetna CVS Health
Network Type: HMO
Metal Type: Expanded Bronze
HSA Eligible?: Yes
Plan ID: 82824GA0110002

Cost-Sharing Overview

Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta offers the following cost-sharing.

Notes:

  • Some plans have separate cost-sharing for medical and drugs, while other plans offer combined cost-sharing. The cost-sharing amounts above are combined medical and drug costs unless otherwise noted.
  • You are viewing the standard version of this plan. Your costs may be lower depending on your income. Use the “get a quote” button below to see your estimated premium and out-of-pocket costs after assistance.
Ready to sign up for Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

Plan Features

Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta offers the following features and referral requirements.

Wellness Program: Yes
Disease Program: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Notice Pregnancy: No
Referral Specialist: No
Specialist Requiring Referral:
Plan Exclusions:
Child Only Option?: Allows Adult and Child-Only

Network Details

The following network details will help you understand what Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta covers when you are out of the service area or out of the country.

Out of Country Coverage: No
Out of Country Coverage Description:
Out of Service Area Coverage: No
Out of Service Area Coverage Description: Except for Emergencies
National Network: No

Additional Benefits and Cost-Sharing

Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta includes the following benefits at the cost sharing rates listed below.

Service In-Network
Copay / Coinsurance
Out-of-Network
Copay / Coinsurance
Limits and Explanation
Primary Care Visit to Treat an Injury or Illness
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Specialist Visit
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Other Practitioner Office Visit (Nurse, Physician Assistant)
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Outpatient Surgery Physician/Surgical Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Hospice Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Routine Dental Services (Adult)
Not Covered
/ /
Infertility Treatment
Not Covered
/ /
Long-Term/Custodial Nursing Home Care
Not Covered
/ /
Private-Duty Nursing
Not Covered
/ /
Routine Eye Exam (Adult)
Not Covered
/ /
Urgent Care Centers or Facilities
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Home Health Care Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 120 Visit(s) per Year
Emergency Room Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Emergency Transportation/Ambulance
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Inpatient Hospital Services (e.g., Hospital Stay)
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Inpatient Physician and Surgical Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Bariatric Surgery
Not Covered
/ /
Cosmetic Surgery
Not Covered
/ /
Skilled Nursing Facility
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 60 Days per Year
Prenatal and Postnatal Care
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Delivery and All Inpatient Services for Maternity Care
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Mental/Behavioral Health Outpatient Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Mental/Behavioral Health Inpatient Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Substance Abuse Disorder Outpatient Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Substance Abuse Disorder Inpatient Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Generic Drugs
Covered
$25.00 Copay after deductible / No Charge after deductible /
Preferred Brand Drugs
Covered
No Charge after deductible / 35.00% Coinsurance after deductible /
Non-Preferred Brand Drugs
Covered
No Charge after deductible / 45.00% Coinsurance after deductible /
Specialty Drugs
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Outpatient Rehabilitation Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 40 Visit(s) per Year
Habilitation Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Chiropractic Care
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 20 Visit(s) per Year
Durable Medical Equipment
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Hearing Aids
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Imaging (CT/PET Scans, MRIs)
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Preventive Care/Screening/Immunization
Covered
No Charge / No Charge /
Routine Foot Care
Not Covered
/ /
Acupuncture
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 10 Visit(s) per Year
Weight Loss Programs
Not Covered
/ /
Routine Eye Exam for Children
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 1 Exam(s) per Year
Eye Glasses for Children
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 1 Item(s) per Year
Dental Check-Up for Children
Not Covered
/ /
Rehabilitative Speech Therapy
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 40 Visit(s) per Year
Rehabilitative Occupational and Rehabilitative Physical Therapy
Covered
No Charge after deductible / 50.00% Coinsurance after deductible / 40 Visit(s) per Year
Well Baby Visits and Care
Covered
No Charge / No Charge /
Laboratory Outpatient and Professional Services
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
X-rays and Diagnostic Imaging
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Basic Dental Care – Child
Not Covered
/ /
Orthodontia – Child
Not Covered
/ /
Major Dental Care – Child
Not Covered
/ /
Basic Dental Care – Adult
Not Covered
/ /
Orthodontia – Adult
Not Covered
/ /
Major Dental Care – Adult
Not Covered
/ /
Abortion for Which Public Funding is Prohibited
Not Covered
/ /
Transplant
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Accidental Dental
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Dialysis
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Allergy Testing
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Chemotherapy
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Radiation
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Diabetes Education
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Prosthetic Devices
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Infusion Therapy
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Treatment for Temporomandibular Joint Disorders
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Nutritional Counseling
Covered
No Charge / No Charge /
Reconstructive Surgery
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Applied Behavior Analysis Based Therapies
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Bone Marrow Transplant
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Clinical Trials
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Dental Anesthesia
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Diabetes Care Management
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Heart Transplant
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Mental Health Other
Covered
No Charge after deductible / 50.00% Coinsurance after deductible /
Morbid Obesity Treatment
Not Covered
/ /
Off Label Prescription Drugs
Covered
No Charge after deductible / 45.00% Coinsurance after deductible /
Prescription Drugs Other
Covered
No Charge after deductible / 45.00% Coinsurance after deductible /
Well Child Care
Covered
No Charge / No Charge /

Free Preventive Services

There is no copayment or coinsurance for any of the following Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta preventive services. This is true even if you haven’t met your yearly deductible.

Please note, these services are free only when delivered by a doctor or other provider in your plan’s network.

Additional Resources

Below are additional resources for Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta including the Summary of Benefits & Coverage (SBC), plan brochure, formulary link, and a link to the website to pay your monthly premium after you enroll.

Summary of Benefits: Summary of Benefits Link
Plan Brochure: Plan Brochure Link
Formulary: Formulary Link
Premium Payment Website: Premium Payment Link
Ready to sign up for Aetna CVS Bronze: Low-Cost Walk-in Clinic Visits, Telehealth, Atlanta?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

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