AOA
Aetna Open Access — Basic Option
FEHB Offered in 2027|Aetna Open Access (Capital Region and Saver)|Traditional|HMO
Premium
biweekly · employee paysSelf Only
$132.65biweekly · employee pays
vs 2026+$25.80 +24.1%
Lowest$61.75 (2013)
Highest$132.65 (2027)
Since 2013+114.8%
Self Plus One
$282.23biweekly · employee pays
vs 2026+$57.68 +25.7%
Lowest$152.24 (2016)
Highest$282.23 (2027)
Since 2016+85.4%
Self & Family
$299.36biweekly · employee pays
vs 2026+$54.83 +22.4%
Lowest$140.42 (2013)
Highest$299.36 (2027)
Since 2013+113.2%
Premium history
SharePeriodRate type
Year by year
follows the chart's share, period and rate-type selection| Year | Self Only | Δ | Self Plus One | Δ | Self & Family | Δ | Listed as |
|---|
Changelog
- 2012Tracked since 2012Earliest plan year in the data set.
- 2016Self Plus One enrollment addedOPM introduced the Self Plus One enrollment type government-wide in 2016.
- 2023Largest decrease: -0.4%Self Only employee share went from $96.43 to $96.00.
- 2027Largest increase: +24.1%Self Only employee share went from $106.85 to $132.65.
Full rate schedule
Plan yearIn-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | $0 | $0 | $0 |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | $0 | $0 | $0 |
| Annual out-of-pocket maximum | $7,500 | $15,000 | $15,000 |
- Type of accountNot Applicable
- Medicare Part D EGWP Prescription Drug Out-of-Pocket Maximum per enrollee$2,400
- Tier 0$0 Copayment
- Tier 1$10 Copayment
- Tier 250% Coinsurance
- Tier 350% Coinsurance
- Tier 450% Coinsurance
- Tier 550% Coinsurance
- Mail Order PharmacyNo
- Deductible waiver (with Medicare Part A as Primary)No
- Deductible waiver (with Medicare Part B as Primary)No
- Deductible Waiver with Parts A & BNo
- Out-of-Pocket Maximum with Parts A & B$7,500
- Primary Care Physician Office Visit with Medicare A & B Primary$25 Copayment
- Specialty Physician Office Visit with Parts A & B$55 Copayment
- Inpatient Hospital Services with Parts A & B20% Coinsurance
- Outpatient Hospital Services with Part A$500 Copayment
- Outpatient physician services (with Medicare Part B as Primary)$55 Copayment
- Part B Premium Reimbursement with Parts A & BNo
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- Out-of-Pocket Maximum with Part CNot applicable
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryNot applicable
- Specialty Physician Office Visit with Part CNot applicable
- Inpatient Hospital Services with Part CNot applicable
- Outpatient Hospital Services with Part CNot applicable
- Outpatient physician services (with Medicare Advantage Part C as Primary)Not applicable
- Part B Premium Reimbursement with Part CNot applicable
- Preventive CareMember Pays Nothing
- Primary Care Office Visit$25 Copayment
- Specialist Office Visit$55 Copayment
- Emergency Care$200 Copayment
- Urgent Care$50 Copayment
- Doctor Costs for Inpatient Surgery20%
- Hospital Inpatient Cost Per Admission20%
- Hospital Room Costs20% Coinsurance
- Other Inpatient Hospital Costs20%
- Doctor Costs for Outpatient SurgeryMember Pays Nothing
- Other Outpatient Surgery Costs$500 Copayment
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)$25 Copayment
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)$100 Copayment
- Enhanced Lab Network$100 Copayment
- Applied Behavioral Analysis (ABA)$55 Copayment
- Chiropractic$55 Copayment
- Occupational Therapy$55 Copayment
- Physical Therapy$55 Copayment
- Speech Therapy$55 Copayment
- Professional Services (Mental Health and Substance Use Disorder)$55 Copayment
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)20% Coinsurance
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)$55 Copayment
- Diagnosis and Treatment (Infertility Services)$500 Copayment
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)$500 Copayment
- Artificial Insemination Services (e.g. ICI, IVI, IUI)$500 Copayment
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)$500 Copayment
- Surgical Procedures$55 Copayment
- Reconstructive Surgery$55 Copayment
- Hearing Services$55 Copayment
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)Member Pays Nothing
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)20% Coinsurance
- Hospice Care$5 Copayment
- Home Health Services (Skilled Nursing Care)$90 Copayment
- Durable Medical Equipment30% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)30% Coinsurance
- Diabetes EducationMember Pays Nothing
- Nutritional CounselingMember Pays Nothing
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsCovered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesCovered
- Contact LensesCovered
- Acupuncture$25 Copayment
- Chronic Disease Management: Heart DiseaseCovered
- Chronic Disease Management: ObesityCovered
- Chronic Disease Management: HypertensionCovered
- Chronic Disease Management: AsthmaCovered
Out-of-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | Not applicable | Not applicable | Not applicable |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | Not applicable | Not applicable | Not applicable |
| Annual out-of-pocket maximum | Not applicable | Not applicable | Not applicable |
- Type of accountNot Applicable
- Tier 0100% Coinsurance
- Tier 1100% Coinsurance
- Tier 2100% Coinsurance
- Tier 3100% Coinsurance
- Tier 4100% Coinsurance
- Tier 5100% Coinsurance
- Mail Order PharmacyNo
- Deductible waiver (with Medicare Part A as Primary)Not applicable
- Deductible waiver (with Medicare Part B as Primary)Not applicable
- Deductible Waiver with Parts A & BNot applicable
- Out-of-Pocket Maximum with Parts A & BNot applicable
- Primary Care Physician Office Visit with Medicare A & B PrimaryNot applicable
- Specialty Physician Office Visit with Parts A & BNot applicable
- Inpatient Hospital Services with Parts A & BNot applicable
- Outpatient Hospital Services with Part ANot applicable
- Outpatient physician services (with Medicare Part B as Primary)Not applicable
- Part B Premium Reimbursement with Parts A & BNot applicable
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- Out-of-Pocket Maximum with Part CNot applicable
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryNot applicable
- Specialty Physician Office Visit with Part CNot applicable
- Inpatient Hospital Services with Part CNot applicable
- Outpatient Hospital Services with Part CNot applicable
- Outpatient physician services (with Medicare Advantage Part C as Primary)Not applicable
- Part B Premium Reimbursement with Part CNot applicable
- Preventive CareMember Pays All Charges
- Primary Care Office VisitMember Pays All Charges
- Specialist Office VisitMember Pays All Charges
- Emergency CareMember Pays All Charges
- Urgent CareMember Pays All Charges
- Doctor Costs for Inpatient SurgeryMember Pays All Charges
- Hospital Inpatient Cost Per AdmissionMember Pays All Charges
- Hospital Room CostsMember Pays All Charges
- Other Inpatient Hospital CostsMember Pays All Charges
- Doctor Costs for Outpatient SurgeryMember Pays All Charges
- Other Outpatient Surgery CostsMember Pays All Charges
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)Member Pays All Charges
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)Member Pays All Charges
- Enhanced Lab NetworkMember Pays All Charges
- Applied Behavioral Analysis (ABA)Member Pays All Charges
- ChiropracticMember Pays All Charges
- Occupational TherapyMember Pays All Charges
- Physical TherapyMember Pays All Charges
- Speech TherapyMember Pays All Charges
- Professional Services (Mental Health and Substance Use Disorder)Member Pays All Charges
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays All Charges
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays All Charges
- Diagnosis and Treatment (Infertility Services)Member Pays All Charges
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)Member Pays All Charges
- Artificial Insemination Services (e.g. ICI, IVI, IUI)Member Pays All Charges
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical ProceduresMember Pays All Charges
- Reconstructive SurgeryMember Pays All Charges
- Hearing ServicesMember Pays All Charges
- Hearing Aids (external)Not Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)Member Pays All Charges
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)Member Pays All Charges
- Hospice CareMember Pays All Charges
- Home Health Services (Skilled Nursing Care)Member Pays All Charges
- Durable Medical EquipmentMember Pays All Charges
- Outpatient Rehabilitation (Skilled Nursing Care Facility)Member Pays All Charges
- Diabetes EducationMember Pays All Charges
- Nutritional CounselingMember Pays All Charges
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsNot Covered
- Eye Exams for Medical Condition or Non-Surgical TreatmentNot Covered
- EyeglassesCovered
- Contact LensesCovered
- AcupunctureMember Pays All Charges
- Chronic Disease Management: Heart DiseaseNot Covered
- Chronic Disease Management: ObesityNot Covered
- Chronic Disease Management: HypertensionNot Covered
- Chronic Disease Management: AsthmaNot Covered
States
3District of ColumbiaMarylandVirginia
Counties covered
| State | Area |
|---|---|
| District of Columbia | Entire state |
| Maryland | Entire state |
| Virginia | Alexandria City, Arlington, Caroline, Clarke, Fairfax, Fairfax City, Falls Church City, Fauquier, Fredericksburg City, Greene, King George, Loudoun, Madison, Manassas City, Manassas Park City, Orange, Prince William, Rappahannock, Spotsylvania, Stafford, Westmoreland |
Service area over time
| Year | States / areas listed |
|---|---|
| 2027 | District of Columbia, Maryland, Virginia |
| 2026 | District of Columbia, Maryland, Virginia |
| 2025 | District of Columbia, Maryland, Virginia |
| 2024 | District of Columbia, Maryland, Virginia |
| 2023 | District of Columbia, Maryland, Virginia |
| 2022 | District of Columbia, Maryland, Virginia |
| 2021 | District of Columbia, Maryland, Virginia |
| 2020 | District of Columbia, Maryland, Virginia |
| 2019 | District of Columbia, Maryland, Virginia |
| 2018 | District of Columbia, Maryland, Virginia |
| 2017 | District of Columbia, Maryland, Virginia |
| 2016 | District of Columbia, Maryland, Virginia |
| 2015 | District of Columbia, Maryland, Virginia |
| 2014 | District of Columbia, Maryland, Virginia |
| 2013 | District of Columbia, Maryland, Virginia |