All People, Bay Area

Aetna has announced benefit changes to their portfolio for 2018. We are pleased to inform you that all of the changes result in a positive benefit for your clients.  

RX Benefit Changes-Generics

Aetna has moved all generic drugs to the Tier 1 Rx benefit level effective 1/1/18. Previously generic drugs were divided between Tier 1 and Tier 2 copay structures, meaning that some generic drugs shared a copay tier with Preferred Brand drugs.

It is especially important to note that this change impacts all active California plans in 2018, and not just those that become effective 1/1/18. For existing Aetna groups this change will happen upon their renewal in 2018; until their 2018 renewal, they will continue to see generic drugs split across Tier 1 and Tier 2.

All Other MH/SA/Behavioral Therapy and Autism ABA Changes

5 plans in the 2018 portfolio are receiving an adjustment to the following benefit categories:
  • All Other MA/SA/Behavioral Therapy
  • Autism ABA
In-network member copay is reduced to $0.  There will be no change to the out-of-network benefit on these plans. The affected plans are:
  • Platinum Savings Plus 0 90/50
  • Gold MC 0 80/50
  • Gold Savings Plus 0 80/50
  • Silver MC 2000 Copay
  • Silver Savings Plus 2000 Copay
Please contact your LISI Sales Representative with any questions.