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Aetna CVS Health to enter the Affordable Care Act (ACA) individual insurance exchange marketplace in select counties in California for January 1, 2023

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Aetna, a CVS Health company, is launching individual insurance plans in California's ACA exchange, aiming to expand healthcare access to more residents. This initiative, effective January 1, 2023, will provide affordable care through a network of primary care doctors and mental health providers, along with telehealth options. The plans include comprehensive services such as pediatric care, hospitalization, and mental health services, ensuring quality care and access to over 1,100 MinuteClinic locations nationwide.

Positive
  • Launch of individual insurance plans in California's ACA exchange to enhance healthcare coverage.
  • Access to a broad network of primary care doctors and mental health providers.
  • Affordable care options through telehealth and MinuteClinic locations.
Negative
  • None.

Aetna CVS Health Individual and Family Plans combine the quality health insurance coverage of Aetna®, with affordable care options at CVS Pharmacy® and MinuteClinic® locations to help members achieve their best health.

WOONSOCKET, R.I., Aug. 3, 2022 /PRNewswire/ -- Aetna, a CVS Health company (NYSE: CVS), is entering the individual insurance exchange marketplace in California (in select counties) with its Aetna CVS Health co-branded insurance product, providing affordable access to health care for more Californians.

"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 Kyu Rhee, MD, Chief Medical Officer, Aetna. "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."

With the launch of these plans, members will have access to Aetna's expansive network of primary care doctors, mental health providers, specialists and hospitals – including Santé Physicians (Fresno) and Nivano Physicians (Sacramento). Plus, convenient and affordable care options through telehealth and MinuteClinic® and HealthHUB™ locations – removing more barriers to accessing care.

Aetna CVS Health ACA exchange products bring together the coverage of Aetna and the convenience of CVS Health. It's health insurance done differently and features:

  • Quality care with Aetna's broad network of primary care doctors, specialists and hospitals
  • Affordable care with plans that include in-network $0 virtual and walk-in clinic care*
  • Care on your schedule with 24/7 access to virtual care, plus walk-in visits at 1,100 CVS Minute Clinic locations nationwide

"We understand that everyone has their own unique circumstances and making health care simple, easy and affordable is how we are meeting them where they are on their journey," said Jeff Hermosillo, California Market President, Aetna. "We're ensuring more Californians – and Americans – can get access to Aetna's quality care. We are uniquely positioned to work with the member to achieve better outcomes, across health plans, MinuteClinic, CVS HealthHUB, CVS Pharmacy or any of our virtual care options."

The Aetna CVS Health ACA plans are comprehensive health care plans that provide care and coverage for: 

  • Pediatric services, including oral and vision care
  • Ambulatory patient services (outpatient services)
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management

This new offering will be available in select California counties, including: Sacramento County and the neighboring counties of El Dorado, Placer and Yolo; and the greater Fresno counties of Fresno, Kings and Madera.

*Members may be required to pay a cost-share based on what medical services were received and the type of provider a member visits. Please consult benefit documents for more details. Includes select walk-in clinic services. Not all walk-in clinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative walk-in clinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states. For a complete list of participating walk-in clinics, log in to Aetna.com and use our provider search tool.

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 and explore how Aetna is helping to build a healthier world.

About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that's managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.

Media contact
Jeff Swallow
401-601-4116
swallowj@cvshealth.com

 

Cision View original content to download multimedia:https://www.prnewswire.com/news-releases/aetna-cvs-health-to-enter-the-affordable-care-act-aca-individual-insurance-exchange-marketplace-in-select-counties-in-california-for-january-1-2023-301598980.html

SOURCE CVS Health

FAQ

What is CVS's new insurance offering in California?

CVS is launching individual insurance plans through Aetna in California's ACA exchange to provide affordable healthcare options.

When will Aetna's individual insurance plans be available in California?

The plans will be effective starting January 1, 2023.

What services are covered under Aetna's new insurance plans?

The plans cover pediatric services, emergency services, mental health treatment, hospitalization, and more.

Where can Californians access Aetna's insurance plans?

The plans will be available in select counties including Sacramento, El Dorado, Placer, Yolo, Fresno, Kings, and Madera.

How does Aetna ensure affordable care for its members?

Aetna offers $0 virtual care and convenient access through over 1,100 MinuteClinic locations.

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