Hello, I recently got a new job and plan on being here in the long term and was just wondering if I would be able to get some assistance on the coverage options of the different plans. Which plan seems better for what reason? I’m sorry this is my first time applying for health coverage through work.

Provider Aetna 1500/3000 Plan Aetna PPO 450/900 Plan Kaiser HMO CA

Deductible (Family) $3,000.00 $900.00 $0.00

Out-of-Pocket Maximum (Individual) $3000 in network / $6000 out of network $2000 (in network) / $4000 (out of network) $1,500.00

Out-of-Pocket Maximum (Family) $4500 in network / $9000 out of network $4000 (in network) / $8000 (out of network) $3,000.00

Preventive care/screening/immunization No Charge No Charge No Charge

Specialist visit 15% coinsurance 15% coinsurance $15 copayment/visit

Generic drugs 20% copay (retail) , $10 copay (mail order) 20% coinsurance (retail), $10 copay (mail order) Retail: $10 copay/prescription for 1 to 30 day(s). Mail Order: Usually two times the retail cost sharing for up to a 100 day supply

Deductible (Individual) $1,500.00 $450.00 $0.00

Urgent care 15% coinsurance 15% coinsurance $15 copayment/visit

Emergency room services 15% coinsurance 15% coinsurance $50 copayment/visit

Preferred brand drugs 20% copay (retail), $30 copay (mail order) 20% coinsurance (retail), $30 copay (mail order) Retail: $25 copay/prescription for 1 to 30 day(s). Mail Order: Usually two times the retail cost sharing for up to a 100 day supply

Primary care visit to treat an injury or illness 15% coinsurance 15% coinsurance $15 copayment/visit

Do I need a referral to see a specialist? No No Yes

Is there an overall annual limit on what the plan pays? No No No

Does this plan use a network of providers? Yes Yes Yes

submitted by /u/6uzy
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