PayFlex® features a fully integrated platform to help members plan, save and pay for personal well-being, and ease plan sponsor administration.
Pairing Aetna® health plans with PayFlex creates a truly integrated experience for members and plan sponsors. You also get these advantages:
A range of available products help members achieve health and financial well-being, like FSAs, HRAs, HSAs to COBRA, retiree billing…even assistance for tuition and adoption costs.
A proprietary administration platform integrates payment across all services — with the ease of one contract, one service team and one robust portfolio.
A team of health care and financial well-being experts is at your service, from a dedicated implementation manager to a dedicated account manager for everyday needs.
Analytics and reporting provide a holistic view of member behavior, while targeted communication campaigns engage members for measurable results.
Reimbursement
PayFlex offers many reimbursement accounts to help members plan, save and pay for personal well-being — from HRAs to dependent care FSAs to tuition, adoption and commuter accounts.
Savings
Through our Health Savings Account (HSA), members can pay for today’s eligible care costs — and save for future ones — right on the PayFlex platform. They also get competitive interest rates, planning tools and a mobile app to view claims and pay providers in one place.
Payment
With our member-to-provider payment solution, Aetna Pay, members can manage and pay all medical bills from one, secure place. For faster provider payment and an easier financial journey.
COBRA
PayFlex customers can have peace of mind knowing our compliant and secure systems handle the administrative demands for the COBRA product. This is accomplished with a dedicated account manager and call center, along with online payment and reporting capabilities.
Direct Bill
Members can pay premiums online or by mail. And customers enjoy service from a dedicated account manager and call center, and offer online payment and reporting capabilities.
Every person’s path to personal well-being is unique. PayFlex integrates the entire member experience to support them along their health and financial journey.
Highlights include:
PayFlex also gives members more purchasing power with exclusive CVS discounts. Along with other personalized tools to help them plan and save for future well-being needs.
You also get a total package of health plans, programs and services to help your business stay strong and healthy.
Explore a menu of protection for every benefit need — from group medical and Medicare options to ancillary dental and vision plans.
Keep members healthy and engaged with wellness programs, digital tools and services that keep whole health in mind.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna).
PayFlex Systems USA, Inc. is an affiliate of Aetna Life Insurance Company
This material is for information only and does not contain legal or tax advice. You should contact your legal counsel or tax advisor if you have any questions or need additional information. PayFlex does not provide any payment or service in violation of any United States economic or trade sanctions. For more information about PayFlex, go to payflex.com Information is believed to be accurate as of the production date; however, it is subject to change.
Health benefits and health insurance plans contain exclusions and limitations.
Simple payment, billing, reimbursement and savings in one integrated platform.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to the CVS Health site.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
The information you will be accessing is provided by another organization or vendor. If you do not intend to leave our site, close this message.
Just enter your mobile number and we’ll text you a link to download the Aetna Health app from the App Store or on Google Play.
Message and data rates may apply*
Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?
By clicking on “I Accept”, I acknowledge and accept that:
The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.
Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.
The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.
Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change.
Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law.
