Answers to frequently asked questions about the transition to Aetna in 2025.
ID Cards
When will I receive my ID card?
Aetna mailed the ID cards to your home address in mid-December.
If you need to access your ID card before you receive your ID card in the
mail, you can set up your member portal at
Health.Aetna.com beginning the second week of December. Once you set up your Aetna member
portal, you’ll have access to your digital ID card.
If you need to access your ID card before you receive your ID card in the
mail, you can set up your member portal at
Health.Aetna.com beginning the second week of December. Once you set up your Aetna member
portal, you’ll have access to your digital ID card.
Aetna resources
What resources are available to me?
Aetna Service Advocates at 833-529-1661. The Service Advocates are available 24/7 beginning Jan. 1, 2025.
Set up your Aetna Health member portal
Get the most from your plan by setting up your member portal on the Aetna
Health website - or download the free Aetna Health app from the app store
to your mobile device for easy, on-the-go access.
Your Aetna Health member portal is your one-stop to access your digital
medical/prescription drug ID card, find a provider or a pharmacy, review
the prescription drug formulary and access tools and resources to help
you manage your health care and your out-of-pocket costs.
To set up your online Aetna Health member portal, go to
Health.Aetna.com. Under New Members, click the Create Account button, then follow the prompts
to set up your account. Or if you are logged in to the network at work,
you can single-sign on from the Aetna app on the home page of
CaregiverServicePortal.org under My applications.
If you need assistance setting up your Aetna Health member portal, call
the Aetna Service Advocates at 833-529-1661.
Visit MyChooseWell.Aetna.com to:
Review the Aetna provider directory and pharmacy directory, * based on the providers, clinics, facilities and pharmacies that are contracted
with Aetna.
Review the Aetna prescription drug formulary.*
Review information on transition of care (TOC) or to access the TOC Request form.
* Aetna provider and pharmacy directories and prescription drug formulary
are subject to change at any time.
Health incentive
When will I receive my health incentive?
If you enrolled in a medical plan for 2025 and earned your health incentive,
here’s when to expect those funds:
HRA medical plan: Your 2025 health incentive will be deposited into your
HealthEquity account by mid-January.
HSA medical plan: Your 2025 health incentive will be deposited into your
HealthEquity account by the end of January.
Any other medical plan (PPO, EPO or HMO): Your 2025 health incentive is
a premium credit, resulting in a reduced medical plan premium beginning
on your first paycheck in January.
How do I submit a health incentive appeal?
You have certain rights if you believe you were denied a benefit for which
you are entitled. If you believe there was a plan administrative error,
system error, technology problem or other circumstance outside of your
control affecting your ability to complete the 2025 health incentive activities,
you may file an appeal. Your appeal must be submitted by March 31, 2025.
2025 health incentive appeals will be accepted between Nov. 16, 2024 and
March 31, 2025. You will need to file an appeal with Personify Health
(formerly Virgin Pulse) Member Services via one of the options below.
Let them know you would like to request a health incentive appeal. You
will need to provide details and facts that would support your appeal.
Phone: 844-930-1238
Chat: Click on the Support button (by your profile picture) via your account
and request a health incentive appeal
Email: support@virginpulse.com
HealthEquity accounts
Will my HealthEquity card funds continue to be available, or will they
be forfeited?
The health reimbursement and health savings accounts offered with our HRA
or HSA medical plans are not included in the Aetna plan administration
change. These accounts are administered by HealthEquity and the balances
will rollover in 2025 for caregivers who remain enrolled in the same plan
they are currently enrolled in (for example, caregivers currently enrolled
in the HRA medical plan and remain enrolled in the HRA for 2025.)
Does this transition to Aetna administration impact me?
My medical ID card has the Blue Cross/Blue Shield, the Baylor Scott &
White or PHP/Cigna logo:
Yes, this change impacts you. Your medical and prescription drug plan will
transition to Aetna administration effective Jan. 1, 2025. The medical plans you’re offered, coverage levels and plan design
are not changing. You will receive new ID cards. Visit
MyChooseWell.Aetna.com during open enrollment to review the Aetna provider and pharmacy directories
and prescription drug formulary.
My medical ID card has the Blue Shield of California logo:
Yes, this change impacts you. Your 2025 medical plan stays with Blue Shield of CA, but
your prescription drug plan will move to Aetna administration effective
Jan. 1, 2025. You will receive new ID cards. Visit
MyChooseWell.Aetna.com during open enrollment to review the Aetna pharmacy directory and prescription
drug formulary.
Prescription drug plan administration change for Blue Shield HMO members
What is changing for my prescription drug plan for 2025?
Effective Jan. 1, 2025, Aetna will replace Express Scripts as the prescription
drug plan administrator for the Blue Shield of California HMO plans. There
is no change to your medical plan – Blue Shield of California will
continue to administer the HMO medical plans.
How can I find out which pharmacies are in the Aetna network?
You can use the current Aetna pharmacy directory to assist you. Note: the
pharmacy directory is subject to change at any time.
How can I find out if my prescription medication is in the Aetna formulary?
You can use the Aetna prescription drug formulary to assist you. Note:
the prescription drug formulary is subject to change at any time.
About the change to Aetna administration
What is changing?
Aetna will become the third-party administrator (TPA) for our caregiver
medical and prescription drug plans beginning Jan. 1, 2025.
Here’s what is changing for 2025:
If you are enrolled in the
HRA, HSA, EPO or PPO medical plan =
your medical and Rx will be administered by Aetna
If you are enrolled in the
Blue Shield HMO medical plan (where available in S CA)
your medical will continue to be administered by Blue Shield of CA HMO
your Rx will transition to be administered by Aetna (administered by Express Scripts in 2024)
What is a third-party administrator (TPA)?
A TPA is engaged to handle certain administrative functions for self-funded
medical and pharmacy benefit plans. Aetna, as the new TPA, will perform
streamlined administrative services for claims processing, network administration,
customer service and utilization and care management for medical, surgical,
mental and behavioral health and prescription drugs benefits. Aetna will
administer the benefits in accordance with the plan design and various
regulations governing the plans.
Why is Providence changing from Providence Health Plan (and Baylor Scott
& White in Texas) for our medical and pharmacy plan administration?
Operating nationwide, Aetna is one of the largest and most diversified
health care benefits companies. Aetna offers robust member support through
advocacy, an integrated medical and behavioral health network, care management
and 24/7 access. We believe that Aetna’s scope and scale will offer
streamlined and enhanced benefit services to our caregivers and their
family members.
What fitness center discounts will be available under Aetna?
In 2025, Aetna will offer enrolled caregivers access to the Active &
Fit Direct gym membership discount program. The One Pass Select option
will no longer be offered under our caregiver benefits plans in 2025.
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