Aetna, Geisinger reach agreement
Aetna members now will see lower out-of-pocket costs and improved benefits when receiving care at Geisinger Health System facilities.
The national insurance carrier and Geisinger on Monday announced an agreement on a five-year contract, which adds all Geisinger facilities to Aetna's commercial network.
Aetna, which acquired Coventry Health Care in 2013, provides health benefits to more than a million Pennsylvania residents. Combined, the two insurers have between 20,000 and 40,000 commercial members across Northeast Pennsylvania, estimated Dan Day, Aetna's head of sales and service for central and east Pennsylvania.
"It is our hope that more people in this region will be able to remain close to home when seeking care," Geisinger spokesman Matt Van Stone said in an emailed statement.
In addition to the hospitals, the agreement includes Geisinger physician clinics, ambulatory surgery centers, skilled nursing facilities and ancillary home health and hospice services across Northeast and central Pennsylvania.
The deal, which marks the first systemwide agreement between the two parties, adds 1,100 physicians to Aetna's commercial network.
Aetna also has an existing agreement with Community Health Systems, which owns 21 hospitals in Pennsylvania, including Regional Hospital of Scranton and Moses Taylor Hospital, Day said.
Members who receive care at in-network facilities could get 80 to 100 percent reimbursements compared to a 50 to 60 percent reimbursement at out-of network providers. Also, members who get care at out-of-network facilities pay higher out-of-pocket costs.
"It broadens access for Aetna members," Aetna spokesman Walt Cherniak said. "Anyone who is advising someone with a health benefits plan would encourage them to get as much care as they can inside the network because it's more beneficial for the member."