Publication
Coverage counties
Adams, Bond, Brown, Calhoun, Cass, Christian, Clinton, Cook, DuPage, Greene, Jersey, Kane, Lake, Logan, Macon, Macoupin, Mason, McHenry, Menard, Montgomery, Morgan, Moultrie, Pike, Randolph, Sangamon, Schuyler, Scott, Shelby, Washington
State HMO highlights
- PCP and referrals are 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.
- 24/7 $0 virtual care* through CVS Health Virtual Care™.
- Plans include mental health at in-network providers.
- Up to a $100 yearly allowance* to use on hundreds of over-the-counter health and wellness items at CVS® retail stores and online.
State PPO highlights
- PCP and referrals not 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.
- CVS Health Virtual Care™ — bundled with CVS Health Virtual Primary Care™ — provides access to general medical acute and mental health counseling services via the CVS virtual health care platform; CVS Health Virtual Primary Care is designed for members who may not have a PCP and prefer virtual access; 24/7 $0 virtual care* through CVS Health Virtual Care.
- Plans include mental health at in-network providers.
- Up to a $100 yearly allowance* to use on hundreds of over-the-counter health and wellness items at CVS® retail stores and online.
Network highlights
The retail pharmacy network is the Aetna® Managed Network. It consists of over 52,000 pharmacies nationwide including Costco, CVS Pharmacy®, Hy-Vee, Kroger, Schnucks, and Walmart. Find all participating pharmacies in your area.
Network providers in our service areas below include, but are not limited to:
Chicago HMO (Cook, Lake, McHenry)
- Edward Hospital
- Elmhurst Memorial Hospital
- NorthShore University Health System Hospitals and Physicians
Chicago PPO (Cook, DuPage, Kane, Lake, McHenry)
- Advocate Health Hospitals and Physicians
- NorthShore University Health System Hospitals and Physicians
- Northwestern Medicine Hospitals and Physicians
West Suburban HMO (DuPage, Kane)
- Duly Health and Care
- NorthShore University Health System Hospitals and Physicians
Southern HMO (Adams, Bond, Brown, Calhoun, Cass, Christian, Clinton, Greene, Jersey, Logan, Macon, Macoupin, Mason, Menard, Montgomery, Morgan, Moultrie, Pike, Randolph, Sangamon, Schuyler, Scott, Shelby, Washington)
- Springfield Clinic
Check out our plans – there may be one for your clients!
Have clients looking for 2024 plans or who qualify to get coverage today? Simply search your client’s ZIP code to see if our plans are in their area.
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 for 2023. Visit the Health Insurance Marketplace® to shop for plans and see if they qualify for financial help.
Great news — we’ve got plans in your area through our relationship with [JV_Partner]
Now’s the time to browse 2024 [JV_Partner] plans for your clients and get them ready to enroll on November 1. Or see if your clients can get coverage for 2023. Just visit our simple shopping site today.
Questions? We’re here to help.
Get in touch with us
Our navigator support team is ready to assist you with all your questions.
Notes
*FOR MINUTECLINIC VISITS: For a complete list of participating walk-in clinics, use our provider lookup. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states. Access to MinuteClinic and other participating walk-in clinics may vary by geography.
*FOR $0 VIRTUAL CARE: Members may be required to pay a cost-share based on what medical services were received and the type of provider a member visits. Please consult benefit documents for more details. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. CVS Health Virtual Care is only available in the United States. Limitations may apply based on services and location.
*FOR $100 ALLOWANCE: $25 allowance each quarter to use on select CVS Health® brand products. Unused allowance does not carry over to the next quarter. This benefit is not available in California, Maryland, Missouri or New Jersey.
Legal notices
Health plans are offered or underwritten or administered by Aetna Health of California 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.
Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Information is accurate as of the production date; however, it is subject to change.
Health benefits and health insurance plans contain exclusions and limitations.