Sign In

Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7

Field Data
Health Insurance Plan ID58840TX0110035
Health Insurance Plan Year2023
StateTexas
Health Insurance IssuerAetna Health Inc. (a TX corp.)
Plan Formulary Description URLFormulary URL
Plan Marketing Materials URLMarketing URL
Last Plan Update DateFri, 25 Nov 2022 00:00 GMT
Last Import DateSat, 10 Dec 2022 05:07 GMT
 
Available Variants of the Health Plan

58840TX0110035-00

58840TX0110035-01

58840TX0110035-02

58840TX0110035-03

Copay & Coinsurance of Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7 Health Insurance Plan, 58840TX0110035

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order
Non preferred brand 31 90 days $150.0 No charge 0% No charge YES
Non preferred brand Up to 90 days supply. 30 day supply= retail cost share; 31 90 day supply= mod cost share. $60.0 No charge 0% No charge YES
Preferred brand 31 90 days $75.0 No charge 0% No charge YES
Preferred brand Up to 90 days supply. 30 day supply= retail cost share; 31 90 day supply= mod cost share. $30.0 No charge 0% No charge YES
Preferred non preferred generic 31 90 days $37.5 No charge 0% No charge YES
Preferred non preferred generic Up to 90 days supply. 30 day supply= retail cost share; 31 90 day supply= mod cost share. $15.0 No charge 0% No charge YES
Preferred non preferred specialty 31 90 days $0 No charge 100.0% No charge NO
Preferred non preferred specialty Up to 90 days supply. 30 day supply= retail cost share; 31 90 day supply= mod cost share. $250.0 No charge 0% No charge NO

Frequently Asked Questions(FAQ) about Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7, 58840TX0110035 Health Insurance Plan, 58840TX0110035

Does Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7 Health Insurance Plan, 58840TX0110035 support Mail Ordering?

Yes, Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7 Health Insurance Plan, 58840TX0110035 supports mail ordering for the next drug tiers: Non preferred brand, Preferred brand, Preferred non preferred generic

What are the copay and coinsurance options for Brand Drugs with Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7 Health Insurance Plan (58840TX0110035)?

For non preferred brand drug tier copay (No charge) is $150.0 and coinsurance (No charge) is 0.0%, non preferred brand drug tier copay (No charge) is $60.0 and coinsurance (No charge) is 0.0%, preferred brand drug tier copay (No charge) is $75.0 and coinsurance (No charge) is 0.0%, preferred brand drug tier copay (No charge) is $30.0 and coinsurance (No charge) is 0.0%

What are the copay and coinsurance options for Brand Drugs with Gold S: Aetna network of doctors & hospitals + $0 Walk-in clinic + $0 Telehealth 24/7 Health Insurance Plan (58840TX0110035)?

, non preferred brand drug tier copay (No charge) is $150.0 and coinsurance (No charge) is 0.0%, non preferred brand drug tier copay (No charge) is $60.0 and coinsurance (No charge) is 0.0%, preferred brand drug tier copay (No charge) is $75.0 and coinsurance (No charge) is 0.0%, preferred brand drug tier copay (No charge) is $30.0 and coinsurance (No charge) is 0.0%

 

Disclaimer: This is based on the import(Date: Sat, 10 Dec 2022 05:07 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API