Aetna, a CVS Health company (NYSE: CVS), has introduced SimplePay Health, a new health plan tailored for self-insured clients. This plan aims to reduce costs, enhance health outcomes, and streamline the healthcare experience with a unique approach to coverage.
SimplePay Health features an innovative payment model that simplifies healthcare access, allowing members to choose high-quality providers. It has shown a 60% increase in the use of top-quality providers and a 12% reduction in overall care costs for both employers and members.
“SimplePay Health reflects Aetna’s commitment to flexibility in meeting our members’ unique needs,” said Steve Schaper, Senior Vice President of Commercial and Specialty Markets at Aetna. “We aim to provide a seamless healthcare experience, from provider selection to payment.”
How It Works
Members benefit from price certainty before receiving care, paying a copay for all covered medical and pharmacy services up to their out-of-pocket maximum. This copay covers all services related to a hospital or specialty visit, simplifying the billing process.
Using an intuitive app, members can find providers ranked by quality and efficiency, ensuring they make informed choices. Instead of traditional bills and Explanation of Benefits (EOBs), members receive a single monthly statement summarizing their claims, akin to a credit card statement, with no interest and no payment due at the time of service.
“At Aetna, we prioritize a straightforward member experience and affordable healthcare access,” said Amie Benedict, President of Diversified Commercial Solutions at Aetna. “SimplePay Health brings together cost transparency, quality information, and easy payment options.”
Key Features of SimplePay Health
- No deductibles or co-insurance—only copays.
- Clear pricing for all covered services.
- No out-of-pocket costs at the time of service.
- A streamlined payment process.
- One monthly statement for all medical and pharmacy claims.
- 0% interest rate benefit on an embedded line of credit for balance payments.
About Aetna
Aetna, a CVS Health business, serves around 36 million people, offering a wide range of health insurance products and services. Their offerings include medical, pharmacy, dental, and behavioral health plans.
