Aetna expanding to ACA exchanges in four new states – Healthcare Finance News

 
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Aetna will now be in the Affordable Care Act’s exchanges in 12 states after adding four more states to that total, the insurer said.
California, Delaware, Illinois and New Jersey have been added to Aetna’s slate for the 2023 plan year, joining Arizona, Florida, Georgia, Missouri, North Carolina, Nevada, Texas and Virginia. The CVS Health subsidiary exited the exchanges in 2018 but re-entered them at the beginning of this year.
Members in the new states will be able to tap into Aetna’s network of primary care doctors, mental health providers, specialists and hospitals, and will have the chance to access telehealth services as well as walk-in clinics.
The insurance offerings on the exchanges will feature care plans with in-network $0 virtual and walk-in clinic care, as well as access to about 1,100 CVS Minute Clinic locations. Plans will provide coverage for pediatric services, including oral and vision care; ambulatory and emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and laboratory services; and preventive and wellness services and chronic disease management.
WHAT’S THE IMPACT
Open enrollment on the ACA exchanges begins November 1.
Aetna Chief Medical Officer Dr. Kyu Rhee described the company’s philosophy as “human-centered” and touted convenience and access.
“With millions of Americans being uninsured or underinsured, our plans provide quality care, at an affordable price and the ability to conveniently access this care using virtual technology and in-person care in their communities,” said Rhee. “By bridging the gap between people and the support and services they need, we can offer a human-centered approach where, when and how they need us.”
Senior Vice President of Individual Markets Anand Shukla said the company was uniquely positioned to work with members to achieve better health outcomes.
“We understand that everyone has their own unique circumstances and making healthcare simple, easy and affordable is how we are meeting them where they are on their journey,” said Shukla.
THE LARGER TREND
CVS Health President and CEO Karen Lynch made the announcement in 2021 that Aetna would be rejoining the ACA marketplace, beginning this year. 
“As the ACA has evolved there is evidence of market stabilization and remedies to earlier structural issues,” Lynch sad at the time. “It is now time for us to participate in these markets. We will show that we can bring great value to those who seek coverage. You can expect to hear more about our exchange re-entry plans and future updates.”
Aetna said in 2017 that it would leave the market in 2018. It joined other insurers in leaving or downsizing its footprint as premiums rose and insurers lost money.
In 2018, Aetna became part of CVS Health in a $69 billion merger.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com





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