Aetna Better Health Premier Plan MMAI approved to expand statewide to serve dual eligible Medicare-Medicaid customers across Illinois
Aetna, part of CVS Health (NYSE: CVS), has received approval to expand its Medicare-Medicaid Alignment Initiative (MMAI) statewide in Illinois, effective July 1, 2021. This expansion aims to provide coordinated care for dual-eligible individuals and follows extensive planning by the Illinois Department of Healthcare and Family Services in collaboration with CMS. Aetna is the sole health plan approved for the MMAI across all Illinois counties. Enrollment begins in June 2021, with passive enrollment occurring in phases for multiple cohorts.
- Approval for statewide expansion of MMAI demonstrates growth potential.
- Aetna is the only health plan authorized to operate MMAI across Illinois, positioning it uniquely in the market.
- Expansion enhances Aetna's ability to serve a larger population of dual-eligible individuals, potentially increasing membership.
- None.
CHICAGO, June 11, 2021 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), announced it has received approval to expand its existing Illinois Medicare-Medicaid Alignment Initiative (MMAI) demonstration health plan (Aetna Better Health® Premier Plan MMAI) to serve the entire state.
The MMAI is a groundbreaking joint effort by the Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare and Medicaid Services (CMS) to reform the way care is delivered to individuals eligible for both Medicare and Medicaid services ("dual eligibles"). The MMAI demonstration project began providing coordinated care to dual eligible enrollees in the Chicagoland area and Central Illinois beginning March 2014.
The statewide expansion is the result of extensive planning initiated in 2019 by HFS in collaboration with CMS, health plans and community stakeholders. The MMAI integrated delivery system and payment model aims to improve the quality, coordination and cost-effectiveness of care for dual eligibles. Aetna's approval to operate statewide comes after the company passed a readiness review and secured contracts with a robust network of providers to meet the Medicare and Medicaid service needs of dual eligible members. At this time, Aetna is the only health plan approved to operate the MMAI program across all Illinois counties.
"Aetna Better Health Premier Plan MMAI is committed to supporting additional dual eligible customers across the state of Illinois through our MMAI product offering," said Corey Taliaferro, Executive Director for the plan. "We consistently receive positive feedback from our dual eligible members who enjoy the convenience of having all of their Medicare and Medicaid benefits in one plan. They tell us having a designated care coordinator goes a long way in helping them to successfully meet their individual health care needs and goals."
Customers eligible to enroll in MMAI in the expansion counties may opt-in beginning in June 2021. They can make an active selection for a July 1, 2021 effective date. The MMAI passive enrollment1 implementation for the statewide expansion will occur in phases for multiple cohorts. Enrollment materials for the first passive enrollment cohort will be mailed in June 2021 with a September 1, 2021 effective date. For more information, see MMAI Provider Notice.
Aetna was originally selected via a competitive procurement and has served as an MMAI health plan in Cook, DuPage, Kane, Kankakee and Will counties since the program's inception. Aetna provides the full spectrum of Medicare and Medicaid covered services through an integrated care delivery system to seniors and adults (aged 21 and over) with disabilities who are eligible for both Medicare and Medicaid. Aetna welcomes current eligible Medicare Advantage and HealthChoice Medicaid members residing in expansion counties into the MMAI program where they can receive all covered services in one integrated health plan with care coordination. For more information, see Aetna Better Health Premier Plan MMAI.
1Passive enrollment means that if a customer does not choose a health plan, the customer will be auto assigned to a health plan.
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About Aetna
Aetna, a CVS Health business, serves an estimated 34 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit www.aetna.com.
Aetna Better Health Premier Plan MMAI is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees.
Aetna Medicare operates a Medicare-Medicaid Plan (MMP) under a three-way contract with Aetna Better Health of Illinois, Illinois Department of Healthcare and Family Services (HFS) and Centers for Medicare and Medicaid Services (CMS). Aetna Medicare has expertise serving members who are dually eligible for Medicare and Medicaid in 24 states. Enrollment in our plans depends on contract renewal. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.
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SOURCE CVS Health
FAQ
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