Aetna’s Affordable Healthcare Plan

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There are no co-payments for preventative care visits, company officials said. Aetna officials said the plan was made possible by partnering with healthcare providers in New York City that tend to the targeted market

Aetna’s: Affordable Employees’ Healthcare

[Health Care News]



Responding to the need for employees’ health insurance, Aetna has launched an innovative new plan designed to lower the cost of health benefits for small businesses whose employees live or work in New York City’s five boroughs.


The “NYC Community Plan,” lets companies with two-to-50 employees enroll workers for the new healthcare program from as low as $270 to $300 monthly payments for individual plans---plans for employees with dependants and family plans are also available.


There are no co-payments for preventative care visits, company officials said. Aetna officials said the plan was made possible by partnering with healthcare providers in New York City that tend to the targeted market; in return the company will drive more people to the participating providers.


At least 50% of the healthcare providers are multi-lingual, in keeping with Aetna’s goal to reach a broad multi-ethnic community. The company hopes the program will also narrow the gap in healthcare delivery that has traditionally disproportionately negatively impacted African American, Latino, and Asian communities, company officials said, at today’s launch at Pace University in Manhattan.


The New York program may eventually be followed with a national roll out in other urban areas, a company official said.


Called the NYC Community Plan, the company will use a diverse Aetna sales and service teams who live and work in the communities to help promote it. The staff are trained on the health care needs, preferences and the overall environment in the targeted communities; the company provides cultural competency training for its own staff, that is also multi-lingual, officials said.


“We negotiated special rates with these providers in exchange for attracting more traffic to them,” Miguel Centeno, vice president of business development in Aetna’s New York market, explained, adding: “To meet the needs of people in this city, you first have to understand the world they live in, the languages they speak, and the challenges they face,” he said. “We’ve designed the NYC Community Plan to provide more than just insurance.”


Aetna will make it easier for diverse people to obtain access to culturally appropriate information and health care, officials said. Literature in several languages explaining the program will be distributed throughout the City, officials said. “Over 90 languages are spoken within this network,” Centeno said, referring to the partnership with the healthcare providers.


In exchange for receiving care through the newly formed NYC Community Plan Referred Network, Aetna members will receive preventive care at 100 percent, with no co-pays, and at the significantly reduced premium.


And by covering preventive care at 100 percent, Aetna is removing a financial barrier for many employees, helping to increase access and encourage people to take advantage of wellness programs and preventive screenings.


The plan, which will be offered in Manhattan, Staten Island, Queens, Brooklyn and the Bronx, features two in-network benefit levels, “referred” and “self-referred.”


Members will be eligible for referred benefits when they receive covered medical services from or through a primary care physician (PCP) who participates in the new NYC Community Plan Referred Network.  The physician will coordinate care, and members will pay no co-pays for routine and preventive services. 


Out-of-pocket expenses will be limited to any applicable co-pays, and there will be no claim forms. Referrals will be required for services not provided by the PCP.


Members may also opt to directly access providers in the NYC Community Plan “Self-Referred Network” without receiving referrals from their PCP. In such cases, they will be responsible for an annual deductible and coinsurance, and subject to a lifetime benefits maximum. Out-of-pocket costs will be significantly more affordable when members use “referred,” participating providers, Adrian Jones, account executive, New York Emerging Markets, said.


“This is a win-win plan,” Glenis Henriquez, a New York City Department of Small Business Services official, remarked. “The general health and economy of New York’s diverse neighborhoods benefits, with more people using local hospitals and small businesses saving money on health insurance.”



For more information on the new plan call (888) 277-1053 option # 5. For more information on the company and its products see
www.aetna.com

 





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