Aetna Health of California, Inc. offers this marketplace health insurance plan (Plan ID 20523CA0110015 ) 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.
Telehealth
Data pending
HSA eligible
No
Dental
Not listed
Vision
Not listed
CMS AV Calculator output: 100.00% (0.00% member share on average). Learn about AV methodology .
Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.
Office visits
Primary care
See benefits
Specialist
See benefits
HSA Not eligible
Open Enrollment window
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in California). 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.
Need more options? Browse the California directory or jump back into plan search.
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).
All providers in California
26854
PCPs in California
1495
Telehealth support
Data pending
Nationwide providers
30395
26,854 doctors statewide1,495 PCPs
58 OB/GYN
Providers
California
All US states
All
26854
30395
PCP
1495
1571
Allergy
17
17
OB/GYN
58
63
Dentists
3
4
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Tier
Covered drugs
NON-PREFERRED-GENERIC-NON-PREFERRED-BRAND
2,692
PREFERRED-BRAND-SPECIALTY-DRUGS
370
PREFERRED-BRAND
223
Prior authorization
Drugs
Required
563
Not Required
2,722
Step therapy
Drugs
Required
165
Not Required
3,120
Quantity limits
Drugs
Has Limit
929
No Limit
2,356
Aetna Health of California, Inc. · Plan ID 20523CA0110015 · 2025 filing.here .marketing repository .
Plan identifiers & tier
Issuer-provided metadata for this variant.
CSR Variation Type
Zero Cost Sharing Plan Variation
HIOS Product ID
20523CA011
Plan ID (Standard Component ID with Variant)
20523CA0110015-02
Plan Marketing Name
Gold 80 HMO
Plan Variant Marketing Name
$0 Cost Share HMO AI-AN
Issuer & service area
Issuer-provided metadata for this variant.
Market Coverage
Individual
Multiple In Network Tiers
No
Out of Country Coverage
No
Out of Service Area Coverage
No
Out of Service Area Coverage Description
Except for Emergencies
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
AV Calculator Output Number
1
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
0.00%
Medical Drug Deductibles Integrated
No
Medical Drug Maximum Out of Pocket Integrated
Yes
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance
0.00%
SBC Scenario, Having a Baby, Coinsurance
$0
SBC Scenario, Having a Baby, Copayment
$0
SBC Scenario, Having a Baby, Deductible
$0
SBC Scenario, Having Diabetes, Coinsurance
$0
SBC Scenario, Having Diabetes, Copayment
$0
SBC Scenario, Having Diabetes, Deductible
$0
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
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.
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
Drug EHB Deductible, Combined In/Out of Network, Family
per person not applicable | per group not applicable
Drug EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Drug EHB Deductible, In Network (Tier 1), Family
$0 per person | $0 per group
Drug EHB Deductible, In Network (Tier 1), Individual
$0
Drug EHB Deductible, Out of Network, Family
per person not applicable | per group not applicable
Drug EHB Deductible, Out of Network, Individual
Not Applicable
Design Type
Not Applicable
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%
Notice Required for Pregnancy
No
Is a Referral Required for Specialist?
No
Medical EHB Deductible, Combined In/Out of Network, Family
per person not applicable | per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family
$0 per person | $0 per group
Medical EHB Deductible, In Network (Tier 1), Individual
$0
Medical EHB Deductible, Out of Network, Family
per person not applicable | per group not applicable
Medical EHB Deductible, Out of Network, Individual
Not Applicable
Plan Effective Date
01/01/2025
QHP/Non QHP
On the Exchange
Wellness Program Offered
Yes
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
How do I choose the right ACA plan in California?
Plan 3 (20523CA0110015) is a Gold HMO from Aetna Health of California, Inc. in California 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 Plan 3 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 Plan 3 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 Plan 3 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 Plan 3?
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 Plan 3?
No, out-of-country services are not covered for this plan.
Does Plan 3 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 Plan 3?
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 .
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