Aetna Introduces Aetna HealthFund® HMO In California
Industry-leading innovation combines robust benefits of a traditional HMO with cost-incentive features of a consumer-directed health plan
WALNUT CREEK, Calif., October 10, 2006 — Aetna (NYSE: ΑET) announced today that it has introduced an innovative new health plan in California. The Aetna HealthFund HMO, one of the first of its kind, keeps the most popular features of typical HMO plans such as copayments for office visits while adding consumerism features that help employees increase their understanding and control of health care spending.
The unique plan design provides employers with a more affordable, comprehensive HMO option. The Aetna HealthFund HMO plan offers significant premium savings when compared to a standard HMO plan.
"As medical costs continue to rise, Californians are looking for new solutions. Aetna developed the Aetna HealthFund HMO in response to the unique needs of employers, physicians and consumers in California," said Beth Andersen, general manager in Aetna’s West region. "Aetna’s long experience with consumer-directed health plans has enabled us to begin the evolutionary process of incorporating consumer-directed components into the HMO model that is still prevalent in California today."
The Aetna HealthFund HMO includes two parts that work together — an HMO plan and a health reimbursement arrangement (HRA). Preventive care and most routine professional services, including doctor visits and diagnostic lab tests and X-rays, are covered at 100 percent in-network after applicable copayments. The funds in the HRA will reimburse for eligible expenses that apply to the plan’s deductible, including inpatient hospitalization.
The Aetna HealthFund HMO deductibles range from $500 to $1,500 for individuals and $1,000 to $3,000 for families. The HRA established by employers helps members pay expenses that are subject to the HMO deductible. Health fund ranges are $250 — $1,000 for single individuals and $500 — $2,000 for families. Any unused dollars in the fund can be carried over to provide additional plan coverage the following year as long as the employee remains in the plan.
The plan also features annual out-of-pocket maximums, which help protect members from financial exposure due to a catastrophic health event.
"The affordability and comprehensive benefits of the Aetna HealthFund HMO make it an attractive option for consumers, which may mean more consumers sticking with the HMO model they have become so familiar with in California," Andersen said.
As a further benefit, wellness and preventive care programs are included. Members will have access to Aetna Navigator™, a powerful and comprehensive online resource that enables them to manage their health and track health expenditures on a personalized, secure website, as well as obtain information about health issues. Tools available through Aetna Navigator include DocFind, Aetna’s online provider directory, and tools that enable members to estimate the cost of care and prescription drugs, and compare hospitals in their area.
"It is crucial for members to have the tools and information necessary to make the best health care decisions for themselves and their families," Andersen said. "Aetna offers one of the richest sets of informational tools in the industry, which will support and empower members to take better control of their health and become engaged health care consumers, which may help mitigate rising health care costs."
The new Aetna HealthFund HMO product is currently being sold to employers with a minimum of 50 employees, for an effective date of January 1, 2007.
About Aetna
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 29.9 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care and disability plans, and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com
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