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California

Find California state highlights, local network coverage, expanded footprint details and more.

 

Coverage counties

El Dorado, Fresno, Kings, Madera, Placer, Sacramento and Yolo

 

State highlights

 

  • PCP and referrals required. Plan providers must be used to receive benefits. Coverage outside the network is for emergencies only. Coverage is available at all MinuteClinic® locations* nationally.
  • Outpatient mental health/substance abuse will follow PCP (not specialist) cost share. All plans include acupuncture; this benefit follows PCP cost-share.
  • 24/7 $0 virtual care** through MinuteClinic Virtual Care.
  • Plans include mental health at in-network providers.

 

Network highlights

  • The retail pharmacy network is the Aetna® Managed Network. It consists of over 52,000 pharmacies nationwide, including but not limited to: Costco, CVS Pharmacy®, Ralph’s, Sam’s Club, Sav-On, Sharp Rees-Stealy Pharmacies and Von’s. Find all participating pharmacies in your area.
  • Four prescription tiers for all Aetna CVS Health® ACA plans: 1) Most generic and low-cost preferred brand, 2) Preferred brand and non-preferred generics, 3) Non-preferred brand  and 4) Specialty.
  • Aetna covers all California mandated prescriptions and over-the-counter medications.
  • All plans include a drug list and Preferred Pharmacy Network.

Network providers in our service areas below include, but are not limited to:

 

Central Valley

  • Adventist Medical Center
  • Barton Memorial Hospital
  • Coalinga Medical Center
  • Community Medical Centers
  • Dignity Health
  • Hill Physicians Sacramento
  • John C. Fremont Hospital District
  • Madera Medical Center
  • Marshall Medical Center
  • Mercy Medical Center
  • Nivano Physicians
  • Sante’ Physicians
  • Tahoe Forest Hospital District

Publication

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Lower your premiums brochure

California market summary

ACA individual & family plan brochure

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Lower your premiums brochure

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California market summary

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ACA individual & family plan brochure

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Check out our plans – there may be one for your clients!

 

Open Enrollment has ended. But your clients can still get coverage if they've had a big life change that qualifies them for a Special Enrollment Period. Simply search your client's ZIP code to see if our plans are in their area.

 

Great news — we’ve got plans in your area

 

If you’re a current Aetna® broker, visit Producer World® to access our quote and enroll tool.

 

Not a current broker? Join our team.

Get appointed with us

 

We’re not in your area … yet

We’ve got plans to bring our ACA individual & family plans to more areas. For now, let’s make sure your clients are covered.

 

If your client had a big life change, they can still get coverage. Visit the Health Insurance Marketplace® to shop for plans and see if they qualify for financial help.

 

Find a plan on HealthCare.gov

 
 

Great news — we’ve got plans in your area through our relationship with [JV_Partner]

 

If you’re a current Aetna® broker, visit Producer World® to access our quote and enroll tool.

Log in to Producer World

 

Not a current broker? Join our team.

Get appointed with us

 

For all Nevada counties:


If your clients qualify for a Special Enrollment Period, they can start their shopping experience for Aetna CVS Health® plans by visiting the Nevada Health Link.

 

For all California counties:


If your clients qualify for a Special Enrollment Period, they can start their shopping experience for Aetna CVS Health® plans by visiting Covered California.

 

For all New Jersey counties:


If your clients qualify for a Special Enrollment Period, they can start their shopping experience for Aetna CVS Health® plans by visiting Get Covered New Jersey.

 

We’re here to help

 

Call your broker support line

 

Our dedicated representatives are here to answer all your questions.

 

1-844-383-6130 (TTY: 711)

Call us Monday — Friday, 8 AM to 9 PM ET.

 

*For a complete list of participating walk-in clinics, use our provider lookup. Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. This benefit is not available in all states. Services at all walk-in clinics are subject to a cost-share in California. Access to MinuteClinic and other participating walk-in clinics may vary by geography. Walk-in appointments are based on availability and not guaranteed. Online scheduling is recommended.

**Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates.

Legal notices

Health plans are offered or underwritten or administered by Aetna Health of California Inc., Coventry Health Plan of Florida, Inc., Aetna Health Inc. (Florida), Aetna Health Inc. (Georgia), Aetna Life Insurance Company, Aetna Health of Utah Inc., Aetna Health Inc. (Pennsylvania), or Aetna Health Inc. (Texas) (Aetna). Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic branded walk in clinics) are part of the CVS Health® family of companies.

Health benefits and health insurance plans contain exclusions and limitations.