Publication
Coverage counties
Alamance, Anson, Avery, Beaufort, Bertie, Bladen, Buncombe, Burke, Cabarrus, Camden, Carteret, Caswell, Chatham, Cherokee, Chowan, Clay, Cleveland, Craven, Cumberland, Currituck, Dare, Davidson, Davie, Durham, Edgecombe, Franklin, Forsyth, Gaston, Gates, Graham, Granville, Greene, Guilford, Halifax, Harnett, Haywood, Henderson, Hertford, Hoke, Jackson, Johnston, Lee, Lincoln, Macon, Madison, McDowell, Mecklenburg, Mitchell, Nash, Orange, Pasquotank, Perquimans, Person, Pitt, Polk, Randolph, Rockingham, Rutherford, Stanly, Stokes, Swain, Transylvania, Union, Vance, Wake, Wayne, Wilkes, Wilson, Yadkin, Yancey
State 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. All plans include acupuncture; this benefit follows PCP cost-share and allows up to 10 visits per calendar year.
- CVS Health Virtual Care™ — bundled with CVS Virtual Primary Care™ — provides access to general medical acute and mental health counseling services via the CVS virtual healthcare platform; CVS Virtual Primary Care™ is designed for members who may not have a PCP and prefer virtual access; 24/7 $0 virtual care** through CVS 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 CVS Pharmacy®, Walmart, Sam’s Club, Harris Teeter and Costco. Find all participating pharmacies in your area.
- Four prescription tiers for all Aetna CVS Health® ACA plans: 1) Preferred generic, 2) Preferred brand, 3) Non-Preferred Generic*** and Brand 4) Preferred and non-preferred specialty.
- All plans include a drug list and Preferred Pharmacy Network.
Network providers in our service areas below include, but are not limited to:
Asheville
- Mission Health Partners
- Pardee Hospital
Charlotte
- Atrium Health
- CaroMont Health
- Tryon Medical Partners
Eastern NC
- Vidant Health and Physicians East
Fayetteville
- Cape Fear Valley Medical Center
Triad
- Wake Forest Baptist Health
- Cone Health
Triangle
- Duke Health
- WakeMed Health
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Lower your premiums brochure |
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North Carolina 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.
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*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-preventative 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.
**Applicable cost-share may vary based on services and providers. Please consult benefit documents for more details. 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.
***Check your plan documents for coverage information. Some plans may cover all generics, including nonpreferred generics, at the lowest cost tier.
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.