Aetna and Coventry System Issues

January 4, 2016-From Aetna: We’re working to resolve system issues affecting member status for 2016. First payment deadline extended to 1/31/16 We are working to correct data issues that are causing some members to be incorrectly listed as inactive for 2016. While we work to correct the issues, we have extended the first payment deadline for members with a valid application, enrollment, or renewal with us until January 31, 2016.

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How do Tiered Network plans like the Keystone HMO Proactive and Horizon Omnia plans work?

Tiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive HMO Plans from Independence Blue Cross  have a unique  ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 2 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split… Read More

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