Aetna’s Medicaid and Children’s Health Insurance Program (CHIP) achieved a higher-than-expected enrollment kickoff in Texas. “Our enrollment numbers from the state were 7,493 members for both Medicaid and CHIP in our two service areas.* This enrollment was much higher than we had anticipated,” said Nadine Hauf, executive director of the Texas Medicaid and CHIP teams.

Aetna’s Medicaid and CHIP Programs

Medicaid is a state-sponsored health care program for low-income people. CHIP, also state-sponsored, is a program for children under the age of 19 from families who make too much money for Medicaid, but who still cannot afford private health insurance for their children.

Medicaid and CHIP enrollees receive Aetna HMO coverage for doctor visits, checkups and immunizations, emergency care, hospitalization and prenatal/newborn care. It also gives them access to Aetna’s Medicaid and CHIP network of health care professionals -- including doctors, hospitals and other medical professionals who may not have taken Medicaid or CHIP patients before.

The Medicaid and CHIP recipients are different from the population we have on the commercial side. “Most of our (Medicare and CHIP) members have used the emergency room as their main doctor, so we are “re-educating” them to the HMO model with a primary care doctor and a medical home,” Hauf said.

“To reach this group, we will be working with community-based organizations. This includes a hands-on approach to focus on creating awareness of our plans in the local communities, primarily through grassroots outreach at churches, health fairs, day care centers and schools.”

The competition

We are competing with established Medicaid and CHIP plans in both service areas; but the plan benefits are regulated by the state. “The number of uninsured eligible people in our service areas is so large that we feel there is plenty of membership to go around,” Hauf said.

 “We do feel that Aetna is positioned well, and we intend to differentiate ourselves through superior service to both our members and health care professionals. We have a Dallas-based member service unit that is 100 percent bilingual and completely focused on the CHIP and Medicaid membership, as well as dedicated provider relations and community outreach teams.”

Our commitment

“Aetna is committed to the Medicaid and CHIP Business” said Pat Farrell, head of Specialty Products and Medicaid.  “It is important for Aetna to develop strategies to serve the uninsured, underinsured and the public sector. This successful launch of the Medicaid and CHIP programs in Texas is part of that strategy.”

For additional information on Texas Medicaid and CHIP, log on to www.aetnamedicaid.com.