Comparison of Aetna and United Healthcare Choice Plus


The following table lays out some of the differences between the Aetna National HMO and the United Healthcare in 2013. The table is illustrative, not comprehensive; refer to the summaries of benefits of each plan.

 

Comparison of 2013
Coverage
Aetna HMO

United Healthcare Choice Plus POS

ANNUAL DEDUCTIBLE

 

 

 

 

 

Annual Out-of-Pocket Maximum (excludes deductible)

NETWORK ONLY

None 

None in Network

Out-of-network

$500 per person

$1,500 per family

 

None in Network

Out-of-network

$2,100 per family

$6,300 per family

 

 

Routine and Preventive Services

(include routine physicals, gynecological exams (1 per year)

hearing exams (performed during a routine physical (1 per year)

vaccinations, inoculations, immunizations

Pap tests (1 per year)

Mammograms (1 per year age 40+)

PSA screenings (2 per year age 40+) and allrelated routine X Rays and labortaory services.

Routine sigmoidoscopy (1 every 2 years age 40+)

Routine colonoscopy (1 every 10 years, age $50+)

 

$0 copay in Network

30% Out-of-Network

Primary care physician
required 
Yes 

No

 
Referrals needed for
network care
Yes

No

Pre-certification required
for many services
YesYes
Office copay - Primary
care MD
$25

$25

After hours/ home visits$25

$25 You pay 30% for out-of-network services

Routine physicals$0$0
Office copay- specialists$25

$25

You pay 30% for out-of-network services

Outpatient Mental Health

$25 copay

 [services provided only through CIGNA Behavioral Health not through AETNA]

You pay 30% for out-of-network services [services provided only through CIGNA Behavioral Health not through AETNA]

$25

 [services provided only through CIGNA Behavioral Health not through UHC]

You pay 30% for out-of-network services [services provided only through CIGNA Behavioral Health not through UHC]

 copay

Inpatient Mental Health

Copay of $100 per day not to exceed $600 (services provided only through CIGNA Behavioral Health not through AETNA)

Copay of $100 per day not to exceed $600 (services provided only through CIGNA Behavioral Health not through UHC) 

No out of network benefit

Emergency room care
[when not admitted to
hospital]
$100 waived if admitted

$100 copay waived if admitted

Urgent care$50

$35

You pay 30% for out -of-network services 

In-patient hospital
admission
$150 per day to a maximum of $600$100 per day to a maximum of $600
Outpatient surgery$250$200
Organ transplants Hospital copay applies, then youpay 0% if an Institute of Excellence (IOE) facility is usedNo Copay

You pay 30% for out -of-network services 

Anesthesiology ServicesNo copay  

 

No copay

You pay 30% for out -of-network services 

Ambulance Services

(emergency only)

No copay

No copay

 

Maternity

Prenatal Care

$25 copay for first office visit only

$25 copay for first office visit only

Maternity

Inpatient Services

Copay of $150 per day not to exceed $600 

 Copay of $100 per day not to exceed $600  

Acunpunture 

 $20 copay $25 copay

Allergy Testing (injections) 

 $20 copay AETNA

$25 copay UHC

 

Durable Medical Equipment (DME)

 

No copay  $25 copay for diabetic supplies only
Outpatient Therapy$20 copay (includes hearing/speech, physical and occupational) (60 visits per year per each type of therapy)$25 copay (includes hearing/speech, physical and occupational) (60 visits per year per each type of therapy)
Smoking Cessation Prograr ($200 per person per year max.)

 

No Copay

Surgical Treatment of Morbid Obesity AETNA $150 copay per  day not to exceed $600 
 Surgical Treatment of Morbid Obesity UHC Same as inpatient hospital benefit - in network 
Home Health Care AETNA No copay (210 visits per year) 
 Home Health Care 

UHC $25 copay (210 visits per year)  in network

You pay 30% for out-of-network service

  

 

 

See Also: