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Aetna is Leaving the Marketplace in 2017

Our nation’s fourth open enrollment period will kick off on Tuesday, November 1, 2016.

We have already learned of some changes to this open enrollment period. You may have heard that Aetna will not be offering insurance plans in the Marketplace this year. This decision was made on Monday, August 15, 2016, before the beginning of open enrollment to cause as little disruption as possible.

If you currently have Aetna, here are a few things that you need to know.

  • Your health insurance plan remains active until the end of 2016. Please continue to pay your premiums on time. All doctors, hospitals, pharmacies, etc. are required by their contracts to continue treating you until the end of the year.

  • You will need to enroll in a new health insurance plan before December 15, if you would like that plan to begin on January 1, 2017. Free assistance is available to help consumers review their new plan options

    If you would like to go ahead and schedule an appointment to discuss your options, you can contact Sharita Moultrie via email or at 231-6330.

    Frequently Asked Questions

    1. Why is Aetna leaving? Aetna cited the large losses that the company has incurred from the exchange business.

    2. How will Aetna leaving affect my current insurance coverage? Current plans will continue uninterrupted through December 31, 2016. Members can continue to use their insurance through that time period and continue to submit claims for all medical expenses that occur through December 31, 2016.

    3. Do I need to keep paying Aetna?

    Yes. You should continue to pay your insurance premiums through the end of December to have coverage.

    4. Can I get a replacement policy now? No, but members will be able to choose a new health insurer for 2017 during the next open enrollment period, which begins on November 1, 2016 and runs through January 31, 2017. Consumers should enroll in replacement coverage by December 15, 2016 to have insurance on January 1, 2017.

    5. Where can I get help finding a new policy for 2017? If you are receiving federal subsidies, you must enroll in a Qualified Health Plan through the Federal Marketplace. You can shop for a new plan by working with an agent, broker, or navigator or by calling the Marketplace at 1-800-318-2596. Plans for 2017 can also be reviewed at www.healthcare.gov. Additional helpful information is available at the South Carolina Department of Insurance ACA page by clicking here.

    6. Will my current plan change today? No, there will be no change in your current plan and Aetna will continue to process claims incurred through December 31, 2016.

    7. Can I continue to see my doctors and have my prescriptions filled? Yes, members can continue to use their insurance as they have all year. The provider network should remain in place through 2016. When you shop for new coverage for 2017, be sure to check the network directories for other companies to ensure your doctors and preferred facilities are members of those networks.

    8. What can providers expect?

    The provider network should remain in place through 2016 and the company will continue to process claims.

    9. Who should I call if I have questions? If you have coverage questions, you may contact Aetna at 1-800-872-3862.

    The South Carolina Department of Insurance can also assist you. The Department can help consumers understand their rights and responsibilities during this process and may be reached at 803-737-6160.

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