Aetna Unveils New Prescription Drug Coverage

July 6, 2005 (PLANSPONSOR.com) - Aetna has announced that mid-sized and larger clients who buy its high-deductible health plans with Health Savings Accounts (HSA) can pay first dollar benefits to employees with stepped-up risk for a handful of serious maladies.

A news release said companies will be able to cover preventive medications for employees with increased health risks due to hypertension, high cholesterol, diabetes, asthma or osteoporosis. As with other preventive benefit provisions, employees may receive coverage for these drugs before meeting their deductible. This coverage option will be effective January 1, 2006.

According to the announcement, the drug classes included for first-dollar coverage are:

  • antihypertensives including beta-blockers, calcium channel blockers and ACE inhibitors
  • diuretics
  • antihyperlipidemics
  • antidiabetics
  • antiasthmatic agents
  • antiosteoporosis medications
  • anticoagulants
  • platelet aggregation inhibitors
  • pediatric vitamins with fluoride
  • prenatal multivitamins with iron and folic acid.

The release went on to say that Aetna identified these drug classes specifically because drugs within them are substantially used for preventive purposes.

The first-dollar program allows employers to tailor their HSA-compatible plans to provide additional support for individuals with common chronic conditions, the announcement said. “We specifically identified conditions for which preventive medication is particularly effective in reducing the risk of acute episodes of illness,” said Dr. Andrew Baskin, Aetna senior medical director. “In addition to reducing overall health care costs for these individuals, use of these drugs – particularly in concert with a condition management program – also helps these individuals to maximize their quality of life and sense of well-being.”

According to the news release, the program reflects guidance provided by the US Department of Treasury indicating that certain drugs could be covered as preventive for selected conditions under a High-Deductible Health Plan.

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