CVS Health (CVS) introduces SimplePay Health

Aetna, a CVS Health company (NYSE: CVS), now offers SimplePay Health, an alternative health plan designed to further meet the diverse needs of our clients and members. This plan, for self-insured clients, works to further reduce costs, improve health outcomes and simplify the health care experience through a differentiated approach to health care coverage.

With an innovative payment model and resources for choosing high-quality providers, SimplePay Health cuts through the complexity of health care coverage and empowers members with the tools they need to make the health care decisions that are right for them.

SimplePay Health has been able to demonstrate a 60 percent increase in use of top-quality providers and 12 percent total cost of care savings for employers and members.*

"SimplePay Health showcases Aetna's growing portfolio of offerings that are flexible based on the unique needs of our members. From choosing a provider to remitting payment, we are working to create a seamless, high-quality health care delivery experience tailored to each member," said Steve Schaper, Senior Vice President, Commercial and Specialty Markets, Aetna. "We are committed to optimizing the member journey across the board and we are proud to offer SimplePay Health as an option to our clients and members."

How it works

• This unique approach to health care gives members price certainty, before a visit or treatment. Members pay a copay for every covered medical and pharmacy service up to their out-of-pocket maximum.
• The copay covers the end-to-end service, essentially a bundled payment, everything from admission to discharge for a hospital or facility visit, or all services in a specialty visit such as labs or EKG.
• Members can search for providers using the intuitive app, which empowers members to choose the lowest cost, best outcome providers. Providers are ranked on quality and efficiency.
• Instead of bills and Explanation of Benefits (EOBs), members just receive one simple monthly statement that summarizes all of their medical and pharmacy claims for the prior 30 days. Very similar to a credit card statement, but with zero percent interest and no payment is due at time of service.

"At Aetna, we are committed to a simpler end-to-end member experience and access to affordable, quality, innovative health care. SimplePay Health puts that all together for our plan sponsors and their members," said Amie Benedict, President, Diversified Commercial Solutions, Aetna. "SimplePay Health provides clear insight into cost before accessing care and provider quality information so members can make the right choice for them, while getting easy payment options and more."

Key components of SimplePay Health

• No deductibles/no co-insurance (co-pay only plan).
• Details on exact cost for all covered services.
• Zero percent due out-of-pocket at time of provider visit or prescription pick-up.
  • A unique, yet simple payment process.
  • Members receive one simple monthly statement that summarizes all of their medical and pharmacy claims for the prior 30 days.
  • Members are able to pay their balance off with a 0% interest rate line of credit benefit that is automatically embedded in their medical plan.

* SimplePay Health Book of Business, 2024

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