Aetna Swine Flu H1N1 Coverage Information
Aetna has made the decision to cover administration of the H1N1 flu vaccine for all fully insured medical plan members and all members of self-funded plans unless directed otherwise by the plan sponsor. Aetna will provide this coverage even in instances where members’ specific health plans do not provide coverage for preventive care or have limits on such coverage. Aetna will cover the full cost cost of the administration of the vaccine with no member copay, co-insurance or deductible applied.
We are also directing self-funded plan sponsors who do not wish to cover the full cost of administration of the H1N1 vaccine to notify us by October 5, 2009.
Communicating with their members
Aetna is reaching out to all members in many ways. Educational mailings to members have begun, and messages will be included in the Member Essentials e.newsletter. In addition, professionals staffing Aetna’s member services call centers have received special materials on the H1N1 flu so they are well prepared to answer questions.
Aetna will also use information available in our CareEngine® to proactively identify members who fall into three of the five categories of “priority individuals” as defined by the Centers for Disease Control and Prevention (CDC). Aetna will reach out to these members and urge them to be vaccinated.
These three categories are:
- Members who are younger than 65 years of age who have health conditions associated with higher risk of medical complications from influenza
- Persons 6 months to 24 years of age
- Pregnant women
Members in these high-risk groups will receive Care Considerations sent to their personal health records with information on H1N1 flu, their specific risk factors and suggestions they consider vaccination. Aetna will include information about all of the priority groups, including those Aetna cannot readily identify through their records – health care workers/emergency personnel and caregivers of children six months and younger – in messages sent to all members’ Aetna Personal Health Records.
Additional preparations and resources
In a similar effort to reach high-risk members, Aetna is providing H1N1 training to nurse case managers who work with members enrolled in Aetna’s disease management, case management, and Beginning Right® maternity programs. Members in these programs may also be among those the CDC has targeted for prioritization when the vaccine is first available.
Resources available to all members on Aetna’s public website include fact sheets and Question & Answer documents, with up-to-date information on the H1N1 flu along with tips on preventing infection. Aetna has posters and flyers for download with tips on how to avoid the flu. Aetna also has a video that discusses proper hand washing technique and worksite hygiene.
Aetna will continue to update pages on aetna.com for members and plan sponsors.
Aetna’s commitment to help
Aetna is committed to doing their part to decrease barriers to vaccination and minimize the administrative complexity of providing access and financing for the administration of this vaccine. As Secretary of Health and Human Services Kathleen Sebelius said in a letter to health plans, “It is in everyone’s interests to help reduce the demand for and costs associated with emergency room use and in-patient hospitalizations and to minimize disruption in the workforce’s productivity by having as many people as possible vaccinated… Together, all of us doing our part will ensure that we minimize the consequences of the H1N1 virus on our citizens, businesses, and the economy.”
For more information and resources, visit www.aetna.com and select “H1N1 and Seasonal Flu” or contact your Aetna representative.
