Banner|Aetna Health Insurance Options in AZ
If you need individual health insurance or family health insurance in Arizona, Banner|Aetna health insurance plans offer comprehensive network coverage and Affordable Care Act (ACA) federal marketplace enrollment options. Open enrollment on the ACA Marketplace is between November 1 through January 15, so now’s good time to consider your options for health insurance in AZ.
In this guide, learn more about what Banner|Aetna health plans in the ACA Marketplace cover, unique perks this provider offers and some considerations to keep in mind.
Key Takeaways
- Banner|Aetna is a health insurance provider in Arizona that offers federal ACA Marketplace plan options. Open enrollment for the ACA Marketplace is between November 1 through January 15, but certain qualifying events may make you eligible for a special enrollment period.
- Banner|Aetna health insurance plans are contracted with the Banner Health Network of hospitals in Arizona, as well as HonorHealth hospitals and other providers, such as Sonora Quest Laboratories.
- A potential advantage of Banner|Aetna health insurance plans is that you don’t need a referral to see a specialist. You can also use Banner|Aetna health insurance at CVS MinuteClinic locations outside of Arizona, making it a good option for frequent travelers.
How Does Banner|Aetna Work for Individual & Family Insurance?
Banner|Aetna is a joint health insurance venture that combines the powers of the Aetna® health insurance company and the Banner Health system. Every ACA Marketplace plan includes coverage for essential benefits, including:
- Preventive and wellness services
- Chronic disease management
- Laboratory services
- Prescription drugs
- Pediatric services, including vision and oral care
- Mental health and substance use disorder services
- Emergency services
- Hospitalization
- Ambulatory services
- Pregnancy, newborn and maternity care
- Rehabilitative and habilitative services and devices
There are also options to add on adult vision and dental insurance coverage, including 100% preventive dental care coverage that includes two yearly cleanings, plus basic and major services. Vision coverage includes a $10 copay eye exam and a $150 allowance for eye care items at select retailers.
Banner|Aetna 2025 Plans in Arizona
Banner|Aetna offers a variety of plans for 2025, each with different coverage levels and costs. Here's a breakdown to help you compare:
- Banner Aetna Bronze 2 HSA: This Bronze plan is designed for those who want to pair their health insurance with a Health Savings Account (HSA). It features a lower deductible and out-of-pocket maximum compared to the Banner Aetna S Bronze plan..
| Banner Aetna Bronze 2 HSA |
|---|
| Deductible | OOP Max | Coinsurance | PCP Co Pay | Spec Co Pay | |
|---|---|---|---|---|---|
| Bronze | $5,695 | $7,495 | 50% | Ded | Ded |
- Banner Aetna S: This plan is available in Gold, Silver, and Bronze tiers, giving you flexibility in choosing your premium and out-of-pocket costs.
| Banner Aetna S Gold, Silver, & Bronze |
|---|
| Deductible | OOP Max | Coinsurance | PCP Co Pay | Spec Co Pay | |
|---|---|---|---|---|---|
| Gold | $1,500 | $7,800 | 25% | $30 | $60 |
| Silver | $5,000 | $8,000 | 40% | $40 | $80 |
| Bronze | $7,500 | $9,200 | 50% | $50 | $100 |
- Banner Aetna 3: This Gold plan offers a lower deductible and lower copays compared to Banner Aetna S Gold.
| Banner Aetna 3 |
|---|
| Deductible | OOP Max | Coinsurance | PCP Co Pay | Spec Co Pay | |
|---|---|---|---|---|---|
| Gold | $895 | $9,195 | 40% | $15 | $35 |
- Banner Aetna 4: This plan is available in Silver and Bronze tiers and features a $0 deductible, making it a good option if you anticipate needing more medical care.
| Banner Aetna 4 Silver & Bronze |
|---|
| Deductible | OOP Max | Coinsurance | PCP Co Pay | Spec Co Pay | |
|---|---|---|---|---|---|
| Silver | $0 | $9,195 | 50% | $40 | $125 |
| Bronze | $0 | $9,195 | 50% | No Charge | $80 |
- Banner Aetna 10: This Gold plan offers a $0 deductible and the lowest out-of-pocket maximum among the Banner|Aetna plans.
| Banner Aetna 10 |
|---|
| Deductible | OOP Max | Coinsurance | PCP Co Pay | Spec Co Pay | |
|---|---|---|---|---|---|
| Gold | $0 | $6,595 | 50% | No Charge | $25 |
**Remember:** These are just highlights. Be sure to review the full plan details and consider your individual needs and budget before making a decision.
Banner|Aetna ACA plans are assigned a specific metal tier: Gold, Silver or Bronze. These tiers determine how much a plan holder is responsible for in premiums versus cost of care, and how much the insurance plan covers. Generally, the costs you can expect from various metal tiers include the following.
- Bronze: With bronze plans, you’ll pay the lowest in monthly premiums, but you’ll owe more when you do need care. These plans have the highest deductibles of all plans.
- Silver: These plans offer a great balance between how much you’ll pay in monthly premiums and how much you’ll pay when you do need care.
- Gold: Gold plans have higher monthly premium costs than Silver plans, but you’ll pay less when you do need care.
When you’re determining the right metal tier to choose for a Banner|Aetna ACA Marketplace plan, it’s important to consider both how much you want to pay in monthly premiums, and what your anticipated healthcare needs will be over the next year. If you see the doctor regularly, a higher metal tier could help you save overall. If you anticipate only needing emergency and preventive services, a lower tier could work.
What Are the Benefits of Banner|Aetna Health Insurance Plans?
Because Banner|Aetna has major brands powering its offerings, these plans offer some unique advantages compared to other health insurers in Arizona. Some of the key considerations and advantages of Banner|Aetna health insurance plans include:
- In order to receive benefits from the plan, you must use a provider who’s covered. Coverage outside the network is limited to emergencies only.
- Banner|Aetna health insurance plans don’t require referrals in order to see a specialist.
- Plan holders do get coverage at all CVS MinuteClinic locations throughout the country. This can be a comforting benefit for plan holders who are frequent travelers.
- Plan holders also get up to a $100 yearly allowance ($25 every 3 months) to use on health and wellness over-the-counter items at CVS retail stores and online. Your member ID card also qualifies you for a 20% discount on CVS Health brand products.
- Plan holders can access free virtual care through 98point6.
- Most plans include a $3 special copay for more than 200 generic prescription drugs.
For extensive coverage in major areas in Arizona, as well as coverage at CVS MinuteClinics throughout the country, Banner|Aetna could be a cost-effective choice, depending on the benefits you’re interested in.
Who Is Eligible for Banner|Aetna Health Insurance in Arizona?
Banner|Aetna health insurance plans are available throughout Arizona at various counties, and they offer some of the most comprehensive healthcare coverage both in and out of the state. Covered counties include:
- Maricopa
- Cochise
- Coconino
- Gila
- Pima
- Pinal Yuma
In-network service providers covered under Banner|Aetna include providers within:
- Banner Health System
- Banner Children’s at Desert
- Banner Payson Medical Center
- Canyon Vista Medical Center
- Diamond Children’s Medical Center
- Tucson Medical Center
- Yuma Regional Medical Center
- Cobre Valley Regional Medical Center
- HonorHealth System
- Northern AZ Healthcare, including Flagstaff Medical Center
Before you select a Banner|Aetna health insurance plan, you may want to consider how important it is for you and your family to see specific healthcare providers. It may be helpful to check if they accept Banner|Aetna health insurance first before you decide to go with that insurer.
How to Get Banner|Aetna ACA Marketplace Insurance in AZ
If you’re interested in signing up for Banner|Aetna health insurance or another insurer on the ACA Marketplace, we can help. Use our free form to see which plans you’re eligible for and to compare costs and benefits. A personalized representative from AZ Health Insurance Brokers will be available to guide you through the signup process and answer any questions you have.
Remember that open enrollment begins November 1. If you have any questions about insurance in Arizona at all, we’re here to help. Message us online, call 602.617.4107 or email quotes@azhealthinsurancebrokers.com. We’ll be in touch.
Banner|Aetna Individual & Family Insurance FAQs
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Is Banner|Aetna the same as Aetna?
Yes, Banner|Aetna is an affiliate of Aetna Life Insurance Company and its affiliates, including Aetna.
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Does Banner|Aetna require referrals for specialists?
No, you do not need a referral in order to a see a covered specialist if you’re a Banner|Aenta individual/family health insurance plan member.
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What are Banner|Aetna out-of-network benefits?
Banner|Aetna individual and family plan holders don’t have out-of-network benefits in any state, other than in case of emergencies. However, all CVS MinuteClinics do offer covered care, since they’re not considered out-of-network, even when they’re outside of the service area.
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When is open enrollment for Banner|Aetna health insurance on the ACA Marketplace?
Open enrollment for Banner|Aetna health insurance on the ACA Marketplace is between November 1 and January 15. If you enroll by December 15, 2024, coverage will start January 1, 2025. If you enroll after December 15, 2024, and by January 15, 2025, coverage will begin February 1, 2025.
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What special enrollment periods apply to Banner|Aetna ACA Marketplace plans?
You may qualify for a special enrollment period to sign up for Banner|Aetna on the ACA Marketplace if you experience a special qualifying event, such as moving, divorce, getting married, having a baby, losing health insurance through work, adopting a child or if your household income falls below a certain amount. Typically, you have 60 days before or 60 days following the event to enroll in a Banner|Aetna ACA Marketplace plan during a special enrollment period.
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