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ACA individual & family plan enrollment details

Important enrollment dates

Mark your calendar!

November 1*

Open Enrollment starts

This is the time to explore ACA plans, see if your doctors are in network and apply for financial help.

December 15*

Open Enrollment ends

Be sure to choose a plan by this date so you’re covered on January 1.

January 1*

Plan coverage begins

Simply make your first payment to activate your plan and access all your membership benefits.

Making insurance easier 

The top insurance terms you’ll want to know

Insurance isn’t all that complicated. It just feels that way at first. Let’s figure it out together. Here are simple definitions for common terms you might see during enrollment.

Coinsurance 

This is a percentage that you pay after you’ve met your deductible. For example, if your plan covers 80% of the cost for physical therapy, you pay 20%.

Copay 

This is a fixed amount that you typically pay at the time you get care. For example, you might pay $40 when you see your doctor.

Deductible

This is the amount you pay before your health plan starts to pay for some or all of your costs.

Network

This is a group of providers, like doctors and clinics, that have a contract with a health plan. When you see a provider in your plan's network, you get lower rates.

Out-of-pocket maximum

This is a a cap on plan costs. Once you’ve paid this amount through deductibles, copays and coinsurance, your plan pays 100% of all covered costs for the rest of the plan year.

Referral

This is an authorization from your doctor, written on paper or sent electronically, to see another doctor for a specific health service.

Big life change or one coming up? 

Great news — we’ve got plans for you through our relationship with Aetna CVS Health

That means you can sign up for ACA individual coverage through Aetna CVS Health. Visit their website to check out plan features, shop 2022 plans and see if you qualify for financial help.

Remember to stop back on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan on AetnaCVSHealth.com

Great news — we’ve got plans for you

Visit our simple shopping site to get coverage for 2022 and see if you qualify for financial help.

Remember to stop back on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan

We’re not in your area … yet

We’ve got plans to bring our ACA individual and family plans to more areas. For now, we want to make sure you’re covered.

Had a big life change? You can still get coverage for 2022. Visit the Health Insurance Marketplace® to shop for plans and see if you qualify for financial help.

Remember to visit the Marketplace on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan on HealthCare.gov

Great news — we’ve got plans for you through our relationship with Innovation Health®

That means you can sign up for ACA individual coverage through Innovation Health®. Visit their website to check out plan features, shop 2022 plans and see if you qualify for financial help.

Remember to stop back on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan on InnovationHealth.com

Notes

*FOR COVERAGE ON A PARENT’S PLAN: Your dependent child may continue coverage if your child is disabled, or in school and on a leave of absence.

*FOR $0 PLAN PREMIUM: Exclusions and limitations apply.

Transforming health care, together

Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.

Contact us

Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.

On-Demand Virtual Care with 98point6 by Transcarent

Banner|Aetna offers access to 98point6 by Transcarent, a virtual care solution that enables members to connect to care anytime, anywhere via secure in-app messaging.

Treatment is provided by a U.S.-based care team, including board-certified doctors, who can diagnose and treat over 1,000 conditions, outline care options, prescribe* medication, and order labs or imaging when appropriate—all through the convenience of a mobile app.

Key Features:

  • Audio, video, and Spanish translation support available as needed
  • Access to care plans and lab results directly within the app
  • Referrals to in-network resources and specialists
  • Care is available in all 50 states and Washington D.C.
  • 24/7/365 access with an average wait time of under 2 minutes—no appointment required.

Available to enrolled Banner|Aetna members and covered dependents age 1+* in an eligible plan.

Cost: Low-to-no-cost per visit*, depending on plan details.

*FOR ENROLLED MEMBERS AND COVERED DEPENDENTS AGE 1+: 98point6 by Transcarent is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan. Access to 98point6 by Transcarent is not included in all plans.

*FOR LOW-TO-NO-COST WITH 98POINT6 BY TRANSCARENT: Members enrolled in a health savings account (HSA) or qualified high-deductible health plan (HDHP) must pay the applicable cost-share for virtual care visit until their deductible is met, after which services will be provided at no cost-share. All other health plan members pay $0 per virtual care visit regardless of whether their deductible has been met. Please refer to your plan documents for your applicable cost-share amounts.

*FOR 98POINT6 BY TRANSCARENT PRESCRIBING: 98point6 by Transcarent providers do not prescribe controlled substances (such as opioids), lifestyle medications (such as Viagra and Propecia) or weight loss medications (Wegovy or Ozempic). 98point6 by Transcarent and Transcarent Clinic clinicians are independent contractors and are neither agents nor employees of Banner|Aetna or plans administered by Banner|Aetna, and does not guarantee that a prescription will be written. Transcarent Clinic providers will not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. Clinicians reserve the right to deny care for potential misuse of services

This material is for information only. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Banner|Aetna. Provider participation may change without notice.

Health insurance plans contain exclusions and limitations.