New Jersey health plan · 2025

Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care · 89217NJ0130005

Aetna Life Insurance Company offers this marketplace health insurance plan (Plan ID 89217NJ0130005) 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.

Metal level: Silver Plan type: EPO CSR: 87% AV Level Silver Plan Issuer: Aetna Life Insurance Company
Telehealth Data pending HSA eligible No Dental Not listed Vision Not listed

Issuer actuarial value: 87.96%. Expect to pay roughly 12.04% of covered costs out of pocket, based on issuer reporting.

2025 cost summary

Key premiums & cost sharing

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.

Monthly premium

See plan search for live pricing

Before subsidies

Estimate after subsidies

Deductible

$1,000

N/A

See deductible details

Max out-of-pocket

$2,500

N/A

Review MOOP rules

Office visits

Primary care See benefits
Specialist See benefits
HSA Not eligible

Drug tiers

Generic See drug coverage
Preferred brand See drug coverage

View formulary tiers

Issuer profile See benefits
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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in New Jersey). 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.
  • 87% AV Level Silver Plan 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.

Premium snapshot

Plan identifiers & filings

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.

Plan ID 89217NJ0130005
Coverage year 2025
State New Jersey
Issuer Aetna Life Insurance Company
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 89217NJ0130005-05
Available variants

Standard On Exchange Plan · 89217NJ0130005-01

Open to Indians below 300% FPL · 89217NJ0130005-02

Open to Indians above 300% FPL · 89217NJ0130005-03

73% AV Silver Plan · 89217NJ0130005-04

87% AV Silver Plan · 89217NJ0130005-05

94% AV Silver Plan · 89217NJ0130005-06

Last plan update Fri, 28 Nov 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

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 New Jersey 33345
PCPs in New Jersey 4798
Telehealth support Data pending
Nationwide providers 44833
33,345 doctors statewide 4,798 PCPs 243 OB/GYN
Providers New Jersey All US states
All 33345 44833
PCP 4798 5238
Allergy 40 41
OB/GYN 243 293
Dentists 62 72

Drug coverage overview

3,644 drugs tracked

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 2,610
ZERO-COST-SHARE-PREVENTIVE-DRUGS 648
PREFERRED-BRAND 386
Prior authorization Drugs
Required 775
Not Required 2,869
Step therapy Drugs
Required 0
Not Required 3,644
Quantity limits Drugs
Has Limit 994
No Limit 2,650

Customer highlights

What stands out for members

  • Issuer: Aetna Life Insurance Company · Plan ID 89217NJ0130005 · 2025 filing.
  • Disease management programs available: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 89217NJ0130005-05 (87% AV Silver Plan) currently displayed.
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Variant attributes

Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care · Variant 89217NJ0130005-05

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

87% AV Level Silver Plan

HIOS Product ID

89217NJ013

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

89217NJ0130005-05

Plan Marketing Name

Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care

Plan Variant Marketing Name

Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care

Issuer & service area

Issuer-provided metadata for this variant.

Issuer Actuarial Value

87.96%

Issuer ID

89217

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

NJN001

Out of Country Coverage

No

Out of Service Area Coverage

No

Out of Service Area Coverage Description

Except for Emergencies

Service Area ID

NJS001

State Code

NJ

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$1,300

SBC Scenario, Having a Baby, Copayment

$200

SBC Scenario, Having a Baby, Deductible

$1,000

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$900

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$400

SBC Scenario, Treatment of a Simple Fracture, Copayment

$50

SBC Scenario, Treatment of a Simple Fracture, Deductible

$1,000

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

30.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family

$2500 per person | $5000 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$2,500

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

NJF002

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

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

99%

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

EPO

QHP/Non QHP

Both

Source Name

SERFF

Plan ID

89217NJ0130005

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

$1000 per person | $2000 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$1,000

TEHBDedOutofNetFamily

per person not applicable | per group not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Individual

Not Applicable

Unique Plan Design

Yes

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 New Jersey?

Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care (89217NJ0130005) is a Silver EPO from Aetna Life Insurance Company in New Jersey 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 Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care 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 Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care 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 Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care 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 Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care?

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 Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care?

No, out-of-country services are not covered for this plan.

Does Silver 2 Advanced: Aetna Whole Health network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care 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

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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