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Aetna will cover administration of the H1N1 vaccine for all health plan members


HARTFORD, Conn. — Aetna (NYSE: AET) announced today that it will provide first-dollar coverage for the administration of the H1N1 flu vaccine for all of its fully-insured health plan members, and for all members of self-funded plans unless directed otherwise by the plan sponsor. Aetna is offering this coverage even in instances where members’ plans do not include coverage for preventive care or have limits on such coverage. Co-pays, co-insurance and deductibles will not apply for the administration of the vaccine.

“Aetna has responded to Health and Human Services Secretary Sebelius’ call for health plans to do their part to ensure a smooth and effective national emergency vaccination program,” said William Fried, M.D., the Aetna medical director heading the company’s pandemic flu response initiative. “We’ve worked with plan sponsors to liberalize coverage policies, and remove cost or administrative obstacles that could hinder or delay members’ access to the vaccine.”

In a special effort to educate high risk members about the importance of vaccination, Aetna is providing H1N1 training to nurse case managers who work with members enrolled in Aetna’s disease management, case management, and Beginning Right® maternity programs. By definition, members in these programs fall into several of the categories of individuals the CDC has identified for prioritization when the H1N1 vaccine first becomes available. Aetna’s nurse case managers are discussing H1N1 during their ongoing conversations with these members.

Aetna’s comprehensive H1N1 influenza education program has been in place since April 2009 to provide members, customers, and Aetna’s own employees with information on the H1N1 flu and tips for preventing infection. Resources available on Aetna’s public website include fact sheets and Q&As, as well as posters and flyers businesses can download and share with employees. Aetna’s website has a video on proper hand washing technique, worksite hygiene, and social distancing techniques. The materials use plain language techniques to make them easy to understand. Educational mailings, including Aetna’s Member Essentials eNewsletter are being sent to members, and H1N1 information is included on Aetna Navigator, Aetna’s password-protected website where health information is customized for members.

Aetna is also reaching out to physicians, hospitals and health care professionals in its network of providers to inform them of Aetna’s reimbursement policies for the administration of the H1N1 vaccine and to offer assistance with preparations in medical offices and health care facilities. “We’ve encouraged providers to complete state registration requirements to become vaccinators, and to review their phone triage procedures and after-hours availability in light of the expected increased demand for medical services,” Fried added. The federal government will pay for the H1N1 vaccines and the supplies needed to administer them. Aetna will reimburse providers for administration of one or two doses of the H1N1 vaccine, based on CDC recommendations.

Aetna’s own H1N1 pandemic influenza planning includes an important business continuity component. The company has plans in place to transfer work within its many sites without disruption should that become necessary. Aetna has also taken steps to prevent infection in its workforce. Posters on preventing the spread of infection are displayed in Aetna’s offices. Aetna provided all office-based employees with antiseptic hand gel to use at work.


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