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Home arrow Resources arrow Articles arrow Aetna PPO Plans for Healthcare in California

Aetna PPO Plans for Healthcare in California

Patients who are seeking California health insurance with many health care options may find that the Aetna Preferred Provider Organization (better known as simply PPO) plans for health insurance coverage in California are ideal for them.

The Aetna PPO plans offer clients access to a wide range of plan types and sizes, but all are focused on providing flexible medical care both in and out of the PPO network, according to patient choice.

How Aetna PPO Plans Work

Aetna PPO plans work differently than an HMO plan because they offer users an additional range of choice. While HMO plan users will only be able to receive medical care and services from physicians and care providers in a specific network, the Aetna PPO plan users can choose their coverage level: in-network or out of network. Both choices do provide some coverage, but seeing in-network providers gives the most possible medical coverage. PPO plans from Aetna provide wide-ranging medical care that includes preventive care (regular exams, yearly check ups, some wellness care), hospital stays, out patient surgeries, prescription drug coverage, and visits with and to medical specialists.

The PPO plans from Aetna

The PPO plans from Aetna include two different sets of benefits: in-network and out of network. You will have coverage for either, but the actual level of coverage will depend upon which doctors and health care providers you choose to see.

When you choose to see physicians and health care providers within the Aetna health care network, you will receive the maximum health care benefits possible. This means that after your yearly deductible is met, you will need to pay a copayment when you visit the doctor or receive your medical care. The amount of the copayment will vary by PPO plan, but it will always be less than what you would pay when seeing an out of network provider. For some plans, like the Aetna Open Access Managed Choice High Deductible, the yearly deductible is high; however, once it's met, there is no copayment at the doctor.

When you visit physicians and other health providers outside of the Aetna health care network, you will still get partial coverage. Once your yearly deductible has been met, you will then need to pay a copayment. This copayment will be higher than it would be for an in-network physician; however, you are able to see any licensed physician of your choice with this option.

There is a large variety of plans for Aetna PPO customers, with something designed to fit into nearly any budget. Some options will have a high deductible and low copayment, while others have a typical $40 to $50 dollar copayment per visit, depending on the plan. Although all of the PPO plans have a deductible, you can choose the best level for your situation.

Consider your medical history and your projected future medical needs when you are choosing the right Aetna PPO. Discuss the amount of coverage you need with your insurance agent, and make sure that you are prepared for medical emergencies.

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