Aetna Emergency Room Copay

Posted : admin On 1/3/2022

Save money by staying in network

Aetna Urgent Care Copay


Maybe you’ve read that one of the best ways to save on health care costs is to “stay in network.” But you’re not sure what that means.

You’re not alone. Many people find the term confusing. We’re here to help you understand.

  • Emergency Room copay: $150 per visit; Urgent Care copay: $25 per visit; Annual Preferred Care Out of Pocket Maximum: $7,000 individual/ Family $14,000; Insurance Waiver Verification – Administered by Aetna Student Health; Waiver deadline extended to September 15th (Appeals process no longer available).
  • Protecting you from scams At times like this, there’s a higher risk of scams and price gouging. So if someone calls you to sell you an insurance policy or change your current policy — even if the person says they represent Aetna ® — call us first at the number on your ID card or 1-800-872-3862 (TTY: 711). Even if the person gives you a different number, do not call it.
  • Health Plan - Aetna Emergency Care. Use the Emergency Room (ER) only for emergencies. For example, when you have chest pain; severe shortness of breath; fainting, sudden dizziness, weakness; sudden confusion; and uncontrolled bleeding. Not sure if you should go to the ER? Contact the 24/7 Nurse Line.

You are also eligible to use Aetna ® vision discounts. 100%, no copay, up to a $150 maximum benefit per person per calendar year 100%, no copay, up to a $150. Hospital emergency room 90% after $350 emergency room copay (waived if admitted); no calendar-year deductible 90% after separate $350 emergency. Emergency Room $500 copay; deductible waived Copay waived if admitted Non-Emergency Care in an Emergency Room Not Covered. Retail Up to a 30 day supply from Aetna Standard National Network Mandatory Mail Order After one retail fill, members are required to fill a 90-day supply of.

A network is a group of health care providers. It includes doctors, specialists, dentists, hospitals, surgical centers and other facilities. These health care providers have a contract with us.

Aetna Emergency Room Payment Policy

As part of the contract, they provide services to our members at a certain rate. This rate is usually much lower than what they would charge if you were not an Aetna member. And they agree to accept the contract rate as full payment. You pay your coinsurance or copay along with your deductible.

Some plans do not offer any out-of-network benefits. For those plans, out-of-network care is covered only in an emergency. Otherwise, you are responsible for the full cost of any care you receive out of network.

The information on this page is for plans that offer both network and out-of-network coverage.