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In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.
The healthcare provider has been in negotiations with Aetna to renew its commercial HMO, POS, PPO, Medicare Advantage and Aetna Whole Health provider agreements in California, Arizona and Nevada ...
The agreement also provides Aetna Whole Health SM, a new local option for health insurance purchasers. Aetna Whole Health plans will give members access to highly coordinated care from physicians ...
City/plan. Monthly premium. Health deductible; drug deductible. Out-of-pocket max. PCP visit. Specialist visit. Reno, NV: Aetna Medicare Value Plan (HMO-POS)
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
Aetna offer a range of Medicare Advantage plans. Coverage is the same as it is with Original Medicare, with additional benefits such as dental care.
Examples included litigation between Aetna and a group of surgical centers over an out-of-network overbilling scheme and kickbacks for referrals, where Aetna was ultimately awarded $37 million. [25] While Aetna has led the initiative, other health insurance companies have engaged in similar efforts. [26]
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related to: aetna whole health epo coverage program