Aetna Open Access provides more comprehensive coverage, particularly for mental health and emergency services, and offers more flexibility with specialist referrals. Cigna HSA plans are suitable for those eligible for and seeking the benefits of a Health Savings Account, but may have higher deductibles and less coverage in certain areas.
| Attribute | Aetna Open Access | Cigna Health Savings Account (HSA) |
|---|---|---|
| Monthly premium cost | Rates vary based on plan, enrollee category, and location. Refer to rate calculator. | Varies depending on the specific plan and employer. Example: Employee Only: $76.00, Employee & Spouse/Partner: $297.00, Employee & Children: $235.00, Employee & Family: $473.00 (for one plan). |
| Deductible amount (individual/family) | Many plans have no deductible. Some have $20 annual deductible for dental PPO. Some Managed Choice plans: $2,750 individual, $5,500 family. | Minimum deductible of $1,400 for individuals and $2,800 for families in many Cigna HSA plans. Some plans have different in-network and out-of-network deductibles (e.g., $1,650/$3,300 in-network, $3,300/$6,600 out-of-network). The "Cigna Smart Plan With HSA" has a $1,650/$3,300 deductible. The "Cigna Consumer-Directed Health Plan-15/Health Savings Account" has a $1,500/$3,000 in-network and $3,000/$6,000 out-of-network deductible. |
| Out-of-pocket maximum (individual/family) | Varies by plan. Some Managed Choice plans: $7,500 individual, $15,000 family. One Aetna Select plan: $2,000 individual, $6,000 family. | For 2021, the maximum is $4,500 for individuals and $9,000 for families. The "Cigna Consumer-Directed Health Plan-15/Health Savings Account" has a $2,400/$4,800 in-network and $4,800/$9,600 out-of-network maximum. The "Cigna OAP + HSA" plan has a $4,000/$8,000 in-network and $6,000/$12,000 out-of-network maximum. For 2025, out-of-pocket maximums are listed as $8,300 for individuals and $16,600 for families. |
| Copay for primary care physician visit | Varies by plan. Some plans offer $0 copay for MinuteClinic. High Option plan: $20 copay. Other plans: $15 or $10 copay. | With the Open Access Plus HDHP + HSA, there is no copay; the visit is billed later. |
| Copay for specialist visit | Varies by plan. High Option plan: $35 copay. Another plan: $30 copay within service area. | With the Open Access Plus HDHP + HSA, there is no copay; the visit is billed later. Copays vary based on the plan. |
| Prescription drug coverage (formulary tiers and costs) | Formulary tiers: preferred generic, preferred brand-name, non-preferred. Example copays: $10 (preferred generic), $35 (preferred brand-name), $100 (non-preferred). Mail-order available. Some plans require generic use. | Prescription drug coverage is subject to the plan's annual deductible. For one plan, generic, preferred, and non-preferred brand drugs have 20% coinsurance. |
| Coverage for preventive care services | Many plans cover preventive care at 100% in-network, including exams, screenings, etc. | Preventive care is often covered at 100% in-network. Some preventive drugs are covered at 100% with no copay or deductible. |
| Availability of telehealth services | Yes, available. CVS Virtual Care may offer $0 copay visits. Teladoc may be available with $35 copay. | MDLIVE Urgent Virtual Care Services are available on some plans. |
| Network size and provider access | Large nationwide network with over a million providers. No referrals needed to see in-network specialists. | Cigna HSA plans generally provide access to a network of quality health care providers. Some plans, like the "Cigna OAP + HSA," offer two tiers of coverage. Out-of-network facilities may be covered at a lower percentage than in-network facilities. |
| Coverage for emergency room visits | Emergency room copays vary; check the specific plan details. One plan has a $125 copay, another has a $100 copay (waived if admitted). | Not available |
| Coverage for mental health services | Comprehensive coverage for therapy, counseling, and psychiatric care. Direct access to therapy without PCP referral. Telehealth options available. | Not available |
| HSA eligibility (for HSA plans) | Some plans are HSA-eligible. Requires a qualified high-deductible health plan. | Must be enrolled in a qualified high-deductible health plan (HDHP). Cannot be covered by other non-HDHP health coverage (e.g., FSA, HRA). Cannot be enrolled in Medicare or TRICARE. Cannot be claimed as a dependent on someone else's tax return. |