Aetna Open Access® Managed Choice® Health Insurance Plans in Texas< Return to plan list
A Managed Choice plan is a type of health insurance that combines features of Health Maintenance Organization (HMO) benefits and Preferred Provider Organization (PPO) insurance plans.
Affordable Aetna PPO Health Insurance Plans – How They Work
Managed Choice Plans give members in Texas the freedom to go directly to any recognized health care provider, including specialists, for covered expenses.
Typically, Managed Choice Plans have a Provider Network that functions like an HMO — you choose a primary care doctor who manages and coordinates your care within the network. Like a PPO plan, you may receive care from non-network providers but with greater out-of-pocket costs. You may also be responsible for co-payments, coinsurance and an annual deductible.
As a Managed Care Plan member you are not required to use a Primary Care Physician (PCP) and you are not required to visit in-network providers. However, the plan encourages you to do so by offering more coverage for those choices.
For medical visits within the Health Plan’s Provider Network, paperwork is completed for you. If you choose to go outside the network, it is your responsibility to fill out the forms, send bills in for payment, and keep an accurate account of health care receipts.
Managed Choice Health Insurance in Texas – Is It Right For You?
Managed Choice plans offer broader coverage and lower monthly premium payments balanced with a choice of deductible levels. They can be a good choice if you anticipate frequent doctor visits and want to limit spending for those visits.
These plans offer benefits including:
- Coverage for office visits to your PCP and specialists
- No referrals required to see a specialist
- Coverage for prescription drugs
- Coverage for routine physicals including lab work and X-rays
Does that seem like the type of coverage you need?
Please keep in mind that all plan types may not be available in every state.