Aetna introduces SimplePay Health

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Oct 16, 2024, 07:30 ET

This offering for self-insured customers is designed to further reduce health care costs, improve health outcomes and simplify the health care experience

HARTFORD, Conn., Oct. 16, 2024 /PRNewswire/ -- Aetna, a CVS Health company (NYSE: CVS), now offers SimplePay Health, an alternative health plan designed to further meet the diverse needs of our clients and members. This plan, for self-insured clients, works to further reduce costs, improve health outcomes and simplify the health care experience through a differentiated approach to health care coverage.

With an innovative payment model and resources for choosing high-quality providers, SimplePay Health cuts through the complexity of health care coverage and empowers members with the tools they need to make the health care decisions that are right for them.

SimplePay Health has been able to demonstrate a 60 percent increase in use of top-quality providers and 12 percent total cost of care savings for employers and members.*

"SimplePay Health showcases Aetna's growing portfolio of offerings that are flexible based on the unique needs of our members. From choosing a provider to remitting payment, we are working to create a seamless, high-quality health care delivery experience tailored to each member," said Steve Schaper, Senior Vice President, Commercial and Specialty Markets, Aetna. "We are committed to optimizing the member journey across the board and we are proud to offer SimplePay Health as an option to our clients and members."

How it works

This unique approach to health care gives members price certainty, before a visit or treatment. Members pay a copay for every covered medical and pharmacy service up to their out-of-pocket maximum.
The copay covers the end-to-end service, essentially a bundled payment, everything from admission to discharge for a hospital or facility visit, or all services in a specialty visit such as labs or EKG.
Members can search for providers using the intuitive app, which empowers members to choose the lowest cost, best outcome providers. Providers are ranked on quality and efficiency.
Instead of bills and Explanation of Benefits (EOBs), members just receive one simple monthly statement that summarizes all of their medical and pharmacy claims for the prior 30 days. Very similar to a credit card statement, but with zero percent interest and no payment is due at time of service.

"At Aetna, we are committed to a simpler end-to-end member experience and access to affordable, quality, innovative health care. SimplePay Health puts that all together for our plan sponsors and their members," said Amie Benedict, President, Diversified Commercial Solutions, Aetna. "SimplePay Health provides clear insight into cost before accessing care and provider quality information so members can make the right choice for them, while getting easy payment options and more."

Key components of SimplePay Health

No deductibles/no co-insurance (co-pay only plan).
Details on exact cost for all covered services.
Zero percent due out-of-pocket at time of provider visit or prescription pick-up.
- A unique, yet simple payment process.
- Members receive one simple monthly statement that summarizes all of their medical and pharmacy claims for the prior 30 days.
- Members are able to pay their balance off with a 0% interest rate line of credit benefit that is automatically embedded in their medical plan.

* SimplePay Health Book of Business, 2024

About Aetna
Aetna, a CVS Health business, serves an estimated 36 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).

About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues — including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health — whether that's managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system — and their personal health care — by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.

Media contact
Jeff Swallow
Phone number in 401-601-4116
[email protected]

SOURCE CVS Health