Tag Archives: aetna

Why Montefiore Health System leaving Aetna affects Rockland, Westchester patients

Montefiore Health System sites across the Lower Hudson Valley may soon be considered out-of-network for patients with the Aetna health plan.

The planned change would take effect Sept. 8. The Montefiore sites include White Plains Hospital, its hospitals in New Rochelle and Mount Vernon, as well as Nyack Hospital.

The Journal News/lohud obtained a letter sent to Aetna clients about Montefiore becoming out-of-network, which would increase what they pay for health care at the Montefiore sites.

 

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Aetna to pass on Drug Discounts

Aetna Inc. will pass on the discounts it negotiates on prescription drugs to about 3 million of its members, the latest move by a health insurer to address Americans’ complaints about the cost of medicine.

The discounts, which can amount to more than half a drug’s list price, will be passed on at the pharmacy counter for many people starting next year, Aetna Chief Executive Officer Mark Bertolini said in a telephone interview. The move by the No. 3 U.S. health insurer follows a similar decision earlier this month by its larger peer, UnitedHealth Group Inc.

Over the last year, drugmakers, insurers and pharmacy benefit plans, or PBMs, have blamed one another for the cost of prescription drugs in the U.S. PBMs and insurers have said it’s the fault of the pharmaceutical companies that frequently raise their list prices. Drugmakers blame insurers and pharmacy benefit plans for high copays, and for not passing on to patients the discounts they negotiate. People with high deductibles or co-pays are often hurt the most.

“We want people to see the truth, and now they see it,” Bertolini said. “When drug prices keep going up, and drug costs keep going up, they’ll have one place to look.”

CVS Agrees To Buy Health Insurance Giant Aetna

The pharmacy chain CVS Health has agreed to buy Aetna in a $69 billion deal that could transform the health care industry. If the deal, which was announced by the two companies on Sunday, is approved by regulators, it would bring a large health insurance company and pharmacy provider under one umbrella.

The agreement is expected to close in the second half of 2018. The terms of the merger agreement were approved by the board of directors of both companies on Sunday.

“This transaction fills an unmet need in the current health care system and presents a unique opportunity to redefine access to high-quality care in lower cost, local settings whether in the community, at home, or through digital tools,” the two companies said in a joint announcement.

In the statement, the companies said they will become a trusted community partner who will help consumers better manage the cost of the health care they need.

As part of the deal, CVS plans to use its pharmacy locations to provide consumers with “community health-hubs” where patients can get answers to questions about their health, prescription drugs and health coverage. Pharmacy locations will also includes space for wellness, clinical and pharmacy services, vision, hearing, nutrition, beauty, and medical equipment.

The two companies touted the merger as a better opportunity to utilize local care solutions by connecting Aetna with greater consumer access through CVS’ 9,700 pharmacies and 1,100 MinuteClinic walk-in clinics. By connecting patients with community health-hubs, the companies say it will help them reduce hospital readmission costs as patients can stop at these local facilities to assess their needs.

Several news reports on the deal note that a big driving factor in the acquisition is potential competition from Amazon as it seeks to enter the pharmacy market. Corporations from all industries are dealing with the threat of Amazon and most recently the e-commerce giant entered the grocery business with its acquisition of Whole Foods.

Aetna pulls out of New Jersey markets

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Effective July 1, AETNA is withdrawing from the individual market (due to large losses) and from the small business market.

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Aetna goes to paper ID Cards

 

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Released by Aetna on 3/22:

We want you to know about a change we’re making to our medical plans in 2017. This information will help notify your clients and their members about this change.

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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