Aetna Health Inc. (a PA corp.) offers this marketplace health insurance plan (Plan ID 93187VA0070019) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Virginia). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Zero Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
SBC Scenario, Treatment of a Simple Fracture, Coinsurance
$0
SBC Scenario, Treatment of a Simple Fracture, Copayment
$0
SBC Scenario, Treatment of a Simple Fracture, Deductible
$0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family
per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual
Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
0.00%
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family
$0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual
$0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family
per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual
Not Applicable
Enrollment & documents
Issuer-provided metadata for this variant.
Formulary ID
VAF003
SBC Scenario, Having a Baby, Limit
$60
SBC Scenario, Having Diabetes, Limit
$20
SBC Scenario, Treatment of a Simple Fracture, Limit
$0
Additional attributes
Issuer-provided metadata for this variant.
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
No
Design Type
Design 1
Disease Management Programs Offered
Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
EHB Percent of Total Premium
100%
First Tier Utilization
100%
Import Date
1/13/2025
HSA Eligible
No
IsItANewPlan
Existing
Notice Required for Pregnancy
No
Is a Referral Required for Specialist?
No
Plan Effective Date
1/1/2025
Plan Type
HMO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
93187VA0070019
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family
per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family
$0 per person | $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual
$0
TEHBDedOutofNetFamily
per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual
Not Applicable
Unique Plan Design
No
Version Number
1
Wellness Program Offered
Yes
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Virginia?
Gold S: HMO Aetna network of doctors & hospitals (93187VA0070019) is a Gold HMO from Aetna Health Inc. (a PA corp.) in Virginia for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Gold S: HMO Aetna network of doctors & hospitals support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Gold S: HMO Aetna network of doctors & hospitals HSA-eligible and does it include dental or vision coverage?
It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.
Dental coverage is not listed for this plan.
Vision coverage is not listed for this plan.
Does Gold S: HMO Aetna network of doctors & hospitals support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Which disease management programs come with Gold S: HMO Aetna network of doctors & hospitals?
The issuer lists disease management resources for: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.
Is there out-of-country coverage for Gold S: HMO Aetna network of doctors & hospitals?
No, out-of-country services are not covered for this plan.
Does Gold S: HMO Aetna network of doctors & hospitals cover care outside the service area?
No, the issuer indicates out-of-service-area care is not covered except for emergencies. Details: Except for Emergencies
How do I enroll in or manage payments for Gold S: HMO Aetna network of doctors & hospitals?
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
