One of the finer choices of health coverage in the Lone Star State is an Aetna Texas plan. Due to their low prices and quality plans, they are amongst the top in the marketplace.
In this article, you will learn everything about Aetna CVS Health like the many plans, costs, availability, benefits, and much more! That way you are ready to make the right decision.
Why should you choose Aetna? Are they any good? What are the benefits? We know you have a lot of questions, and we are here to answer them all. Let’s dive in!
Is there Aetna in Texas?
Yes, Aetna offers many health insurance plans in the state of Texas like the Affordable Care Act (Obamacare) and Medicare. Not only do they have these, but they are also one of the leading providers in the state. They also have plans for employers and offer dental products as well. This article will be focused on the individual and family plans that Aetna offers in the state of Texas.
The Aetna Texas plans for 2024
In the state of Texas, Aetna offers individuals and families with many options when it comes to health coverage inside Obamacare. While they only offer HMO plans, they have the option of choosing different tiers. Let’s break it down.
HMO plans
While there are 4 types of plans in the marketplace, HMO, EPO, EPO, and POS, in the state of Texas, Aetna only offers HMO plans. Health Maintenance Organizations (HMOs) are the cheapest option out of the 4 and have the “least” flexibility. Their most notable feature is that members need a referral from their PCP to see a specialist. Also, you can only get care inside the plans network.
Bronze tier
Plans:
– Aetna CVS Bronze: $0 Walk-In Clinic Visits, Telehealth, Store Discounts
The bronze tier is the cheapest out of all and has the lowest monthly premiums but will have the highest cost when it comes time to receive medical care. This is best for those who don’t expect to use their plan frequently and want something for worst case scenarios.
Silver Tier
Plans:
– Aetna CVS Silver 1: $0 Walk-In Clinic Visits, Telehealth, Store Discounts
– Aetna CVS Silver 2: $0 Walk-In Clinic Visits, Telehealth, Store Discounts
– Silver 5: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
– Silver S: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
– Silver 7: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
– Silver 6: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
The silver plans are the most balanced tier in the marketplace because they have a nice mix of medical care costs and monthly premiums. They also include extra cost savings options which makes it the most popular in Obamacare. If you want normal out-of-pocket costs while not breaking your wallet monthly, they are the best choice.
Gold tier
Plans:
– Aetna CVS Gold: $0 Walk-In Clinic Visits, Telehealth, Store Discounts
– Gold 3: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
– Gold S: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
– Gold 4: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7
The gold tier is best for those who expect frequent medical care and do not mind paying a little extra for the low medical costs. They will be the most expensive plan behind the platinum tier (which Aetna does not offer) in the marketplace.
What do Aetna plans cover in Texas?
Just like any other company, they are legally required to offer the 10 essential health benefits. In Texas, Aetna will cover the following services:
Emergencies
Ambulatory patient services
Maternity/newborn care
Hospitalization
Mental health services
Prescription drugs
Pediatrics
Laboratory services
Preventive care
Rehab/habilitative care
However, what sets Aetna apart is that they have their own unique benefits which some other companies do not. But what exactly are they? Let’s dive in
Aetna plan benefits
The most popular features of Aetna plans are their $0 cares like the following:
– $0 Virtual Care
– $0 Preventative Care
– $0 In-network walk-in clinics
On top of this they offer the best prices on prescription drugs with many plans having a $5 copay or less for medicine. Aetna members will also get $100 yearly allowance to use for over-the-counter health and wellness items at CVS stores.
One of the most notable features is Aetna’s CVS MinuteClinic care. You can get same-day care through it because many are open 24/7. These will usually include the $0 care. Below are some of the services that MinuteClinic includes:
- Allergy treatments
- Vaccines
- Illness & infections
- Women’s health and more
As you can see, they have a lot of extra benefits that are unique to Aetna only which is why it is one of the most popular health plans in the state. So, are they available in your area? Let’s find out more.
Aetna Texas provider map 2024
In the Affordable Care Act, companies offer plans based on counties. While Aetna is in the state of Texas, they may not be in your specific county. Below are the locations of coverage.
As of 2024, Aetna is in the following 41 counties in the state of Texas:
Andrews
Aransas
Bee
Bexar
Brazoria
Cameron
Collin
Comal
Crane
Dallas
Denton
Duval
Ector
Ellis
El Paso
Fort Bend
Galveston
Glasscock
Guadalupe
Harris
Hays
Howard
Hunt
Jim Wells
Johnson
Kaufman
Kendall
Kleberg
Martin
Midland
Montgomery
Nueces
Parker
Rockwall
San Patricio
Tarrant
Travis
Upton
Willacy
Williamson
Wise
If you see your county, that means Aetna is available to you and your family, if not, try and find another company. Also, depending on the county there will be different tiers available and different coverage.
What hospitals accept Aetna in Texas?
Aetna has a strong reach of providers across the state. Below is a list of hospitals that accept Aetna based on the major cities. Based on the Aetna website directly, these are the networks that are included but not limited to:
Austin
Heart Hospital of Austin
North Austin Medical Center – HCA Affiliate
Round Rock Medical Center – HCA Affiliate
St. David’s Georgetown Hospital – HCA Affiliate
St. David’s Medical Center
St. David’s South Austin Medical Center
St. David’s Surgical Hospital
Corpus Christi
Corpus Christi Medical Center – Bay Area
Corpus Christi Medical Center – Doctors Regional
Corpus Christi Medical Center – Northwest Behavioral Health Center
Corpus Christi Medical Center – The Heart Hospital
Dallas
Medical City Hospitals (HCA)
Methodist Hospital System
El Paso
Las Palmas Del Sol Healthcare
HCA Del Sol Medical Center
Houston
Bayshore Medical Center – HCA Affiliate
Brazosport Regional Health System
CHI St. Luke’s Health Baylor College of Medicine Medical Center
Clear Lake Regional Medical Center – HCA Affiliate
Conroe Regional Medical Center – HCA Affiliate
Cypress Fairbank Medical Center Hospital
Houston Northwest Medical Center
Kindred Hospital – Houston Northwest
Kingwood Medical Center – HCA Affiliate
North Cypress Medical Center
A Campus of Kingwood Medical Center
Park Plaza Hospital
Pearland Medical Center – HCA Affiliate
St. Luke’s Hospital at the Vintage
St. Luke’s Lakeside Hospital, LLC
St. Luke’s Patients Medical Center
St. Luke’s Sugar Land Hospital
St. Luke’s The Woodlands Hospital
Sugar Land Cancer Center
Sugar Land Medical Center
Texas Orthopedic Hospital – HCA Affiliate
Tomball Regional Medical Center
West Houston Medical Center – HCA Affiliate
Woman’s Hospital of Texas – HCA Affiliate
Midland/Odessa
Medical Center Hospital
Midland Memorial Hospital
Rio Grande Valley
TENET
Valley Baptist Brownsville
Valley Baptist Harlingen
San Antonio
Methodist Ambulatory Surgery Hosp NW-HCA Affiliate
Methodist Children’s Hospital of S. Texas-HCA Affiliate
Methodist Hospital – HCA Affiliate
Methodist Hospital South
Methodist Specialty and Transplant Hospital – HCA Affiliate
Methodist Stone Oak Hospital-HCA Affiliate
Methodist Texan Hospital – HCA Affiliate
Metropolitan Methodist Hospital – HCA Affiliate
Northeast Methodist Hospital – HCA Affiliate
University Health System
Pros and Cons of Aetna Texas plans
Is an Aetna plan for you? Explore the good and the bad below.
PROS
- Access to same day appointments with MinuteClinic
- High AM Best Rating of “A”
- Above average customer satisfaction
- Many $0 services
CONS
- Only HMO plans are offered
- No dental coverage included
Reviews for Aetna health insurance in Texas
Overall, Aetna is viewed in a slightly positive way. It is not uncommon for health insurance companies to get bad reviews altogether so be careful when taking reviews into mind. Below are the official 5-star ratings from different sources to Aetna:
Cuspide
ValuePenguin
Investopedia
3.5 stars
Official NCQA rating
“A”
AM Best rating
As you can see, Aetna is a solid choice for health coverage with the average rating being around 4 stars. It also received a 3.5 from the NCQA (National Committee of Quality Assurance) and an A rating from AM Best, which is the second highest rating. You can rest assured that you are safe in their hands.
How much do Aetna plans cost in Texas?
Aetna has one of the lowest rates out of any health insurance company in Texas. Investopedia gave it the award for “best premiums” and ValuePenguin has it as the cheapest option in the state of Texas at around $519 a month.
Price depends on many factors like income, household size, age, location, and more. But on average, Aetna plans cost around $513 a month without a subsidy. That is for a silver plan in the marketplace. This makes it the cheapest option on average out of every other company.
Where does Aetna rank in the Lone Star State?
According to our detailed ranking of the best health insurance companies in Texas, Aetna ranks as the 3rd best health insurance company in Texas. Checkout the rankings here. We gave them a solid 4.4 out of 5 stars. They also ranked as the “best for affordability” with many of their plans appearing as the cheapest option for Texans.
We based our rankings on many factors like availability, types of plans offered, costs, official NCQA ratings, and much more. There are over 15 different health insurance companies in the Texas marketplace, so a 3rd place ranking is great! It is a solid choice for health coverage.
Enroll in Aetna Texas plans
Explore the many Aetna plans available by calling (305) 970-8583. Save money, find doctors, make payments, and more with Cuspide!
Frequently asked questions
Don’t see your question or have a specific one? Call (305) 970-8583.
How do I contact Aetna in Texas?
There are a few ways to contact your health insurance provider. What members must know is that the contact number for their insurance will always be on their card. However, if you need to reach Aetna, you can call 1-800-213-3224. You can also reach out to us at (305) 970-8583 because we work closely with Aetna and can help with anything you may need.
Why should I choose Aetna health insurance in Texas?
There are many reasons as to why people choose an Aetna CVS Health plan in the Lone Star State. For starters, Aetna usually has the lowest cost plans in the state. On top of that they have unique benefits like same day appointments through MinuteClinic. Many $0 services for things like virtual visits, preventative care, etc. Also, they have a decent rewards program that offers cash prizes.
How do I qualify for an Aetna Texas plan?
Like any other company inside Obamacare, you must meet certain requirements to apply. For starters, health insurance plans through the marketplace are based on income. Your household needs to meet a certain minimum to qualify (depending on how many people are in your tax household). If you are a resident of the United States and meet the income requirements, you can apply for an Aetna plan in Texas. As always, give us a call and get a quote at no cost to you.
The bottom line...
While there are many health insurance companies to choose from in the Lone Star State, you now know that Aetna is amongst the top. Their low prices, large network, and plans make it a fine choice.
Before you go make a decision, it is important to speak to a licensed broker who can show you all the options in the marketplace. That way you do not miss out on a potential gold mine that was perfect for you in terms of price and coverage.
However, if an Aetna Texas plan happens to be the best choice, you can rest assured that you are in good hands because they are one of the best companies in the nation.
