Aetna medical insurance and CVS have joined forces to make healthcare more accessible and affordable.
Their 2018 merger created a unique model, blending insurance with retail pharmacy services.
This partnership offers members seamless care through Aetna’s coverage and CVS’s community presence. This article explores how this collaboration works, its benefits, and recent developments in 2024.
The CVS-Aetna Merger
In 2018, CVS Health acquired Aetna for $69 billion. This landmark deal combined Aetna’s insurance expertise with CVS’s vast pharmacy network. It aimed to lower costs and improve care access.
The merger created a healthcare giant serving millions. Aetna operates as a standalone unit within CVS Health. The goal was to make healthcare local, simple, and affordable.
How the Partnership Works
Aetna medical insurance and CVS integrate insurance with retail services. Members can access care at CVS’s 9,000+ stores and 1,100 MinuteClinics. These clinics offer low-cost treatments for minor conditions.
Aetna members use their ID cards for benefits like discounts on CVS Health products. The partnership also includes pharmacy benefit management through CVS Caremark. This streamlines prescriptions and care coordination.
Benefits for Aetna Members
The partnership enhances convenience for Aetna members. MinuteClinics provide walk-in or virtual visits for quick care. Services include vaccinations, screenings, and minor injury treatment.
Members get a 20% discount on CVS Health brand products. The Extra Benefits Card, available in some 2025 plans, combines allowances for OTC items and other services. This saves money and simplifies health management.
Over-the-Counter (OTC) Benefits
Aetna’s OTC benefit, offered through CVS, is a standout feature. Members receive a quarterly allowance to buy health products like vitamins and pain relievers. The CVS OTC catalog lists eligible items.
In 2024, Aetna expanded in-store OTC access to 48 states. Members can shop at CVS, online, or by phone with free shipping. This supports preventive care without extra costs.
Key OTC Benefit Features
- Quarterly Allowance: Varies by plan, typically $25–$100.
- Shopping Options: In-store, online, or phone orders.
- Eligible Products: Pain relievers, cold remedies, and supplements.
- Easy Access: Use Aetna ID card or CVS OTC Health Solutions app.
These features make health essentials affordable. Members can manage minor issues at home.
MinuteClinic Integration
MinuteClinics, located in CVS stores, are a cornerstone of the partnership. They offer affordable care for Aetna members, often with $0 copays for select services. Services include wellness exams and chronic disease management.
In 2024, MinuteClinics expanded age-friendly care for seniors using the 4Ms framework: what matters, medication, mentation, and mobility. Virtual care is also available, enhancing accessibility.
Pharmacy Services and Caremark
CVS Caremark, the pharmacy benefit manager, supports Aetna members with prescription services.
Members can fill prescriptions at CVS pharmacies or via mail order. Caremark negotiates drug prices to keep costs low.
In 2025, Caremark secured a deal with Novo Nordisk for preferred access to Wegovy, a weight-loss drug. This move aims to expand access while managing costs, though it may impact competitors like Eli Lilly.
Recent Developments in 2024
In 2024, Aetna faced challenges with high medical costs and lower Medicare Advantage star ratings.
CVS reported a $2 billion cost-cutting plan to address these issues. Aetna’s medical loss ratio (MLR) reached 95.2% in Q3 2024, reflecting high claim costs.
CVS appointed Steve Nelson, former UnitedHealthcare CEO, to lead Aetna. This leadership change aims to improve financial performance. Aetna also streamlined prior authorizations to simplify care access.
Aetna’s 2024 Financial Snapshot
| Metric | Q3 2024 Value | Change from 2023 |
|---|---|---|
| Medical Loss Ratio | 95.2% | Up from 85.7% |
| Operating Income | $938M | Down 39% YoY |
| Total Membership | 27.1M | Up 1.1% |
| Revenue | $94.6B (CVS) | Up 7% YoY |
This table highlights Aetna’s financial challenges. CVS is addressing these through strategic changes.
Medicare Advantage Offerings
Aetna’s 2025 Medicare plans emphasize affordability and choice. Every plan includes $0 copays for primary care, Tier 1 drugs, and dental, vision, and hearing benefits.
The Extra Benefits Card offers allowances for OTC items and fall prevention products.
Despite improved star ratings in 2024, Aetna faced high utilization costs. CVS expects membership to stabilize at 26.4 million by year-end. These plans leverage CVS’s network for community-based care.
ACA Marketplace Challenges
Aetna announced its exit from ACA individual exchanges in 2026, affecting 1 million members across 17 states.
The decision stems from $350–$400 million in projected losses in 2025. High enrollment and an adverse risk pool drove costs.
Members will retain coverage through 2025, with guidance provided by July 2025. CVS is focusing on Medicare and commercial plans where it sees stronger potential.
Commitment to Community Health
The partnership prioritizes community health through preventive screenings and chronic disease management. CVS’s Project Health offers free screenings in high-risk areas. Aetna supports these with its provider network.
In 2024, Aetna expanded fall prevention benefits for Dual Eligible Special Needs Plans (D-SNPs). Members can access safety items like grab bars through their OTC allowance. This reduces risks for seniors.
Challenges and Criticisms
The merger faced scrutiny for potential anticompetitive effects. The American Medical Association opposed it, citing risks to Medicare Part D and pharmacy markets. However, the deal was approved after Aetna divested its Part D plans.
High medical costs in 2024 strained Aetna’s finances. Members in some plans reported confusion over OTC benefits and store restrictions. CVS is addressing these through better communication and technology.
Technology and Innovation
Aetna medical insurance and CVS use technology to enhance care. The CVS OTC Health Solutions app lets members check balances and shop online. Virtual care platforms support 24/7 consultations.
CVS is exploring AI and automation to streamline operations. These tools aim to improve scheduling and reduce administrative costs. The focus is on making healthcare simpler and more efficient.
Future Outlook
CVS views 2025 as a transition year for Aetna. The company aims to stabilize finances through cost-cutting and leadership changes. Aetna’s focus will shift to Medicare and self-funded commercial plans.
The partnership will continue leveraging CVS’s retail network for care delivery. New products, like expanded OTC kits, are planned for 2025. The goal is affordable, accessible healthcare.
Member Satisfaction
Aetna members value the convenience of CVS MinuteClinics and OTC benefits. About 85% report satisfaction with these services, per industry surveys. The ability to access care locally is a key driver.
Some members face issues with benefit clarity or store access. Aetna is improving its portal and customer service to address feedback. Overall, the partnership enhances member experience.
Summary
Aetna medical insurance and CVS have created a powerful healthcare model since their 2018 merger.
By combining insurance with retail and pharmacy services, they offer convenient, affordable care. Members benefit from MinuteClinics, OTC allowances, and integrated prescriptions.
Despite 2024 challenges like high costs and ACA exit plans, Aetna is adapting with new leadership and cost-saving measures. The partnership’s focus on community health and innovation ensures a strong future. It continues to redefine healthcare access.
FAQ
What is the Aetna-CVS partnership?
CVS Health acquired Aetna in 2018 for $69 billion. It combines Aetna’s insurance with CVS’s pharmacies and MinuteClinics. Members get affordable care and discounts on CVS products.
How do Aetna members use CVS services?
Members can visit MinuteClinics for low-cost care or use OTC allowances at CVS. They access prescriptions via CVS Caremark. The Extra Benefits Card simplifies benefit use.
What are the benefits of the OTC program?
Members get a quarterly allowance for health products like vitamins. They can shop at CVS, online, or by phone. Free shipping and in-store access enhance convenience.
Why is Aetna exiting ACA exchanges in 2026?
Aetna projects $350–$400 million in losses due to high costs. The decision affects 1 million members. Coverage continues through 2025 with guidance provided.
How does the partnership support seniors?
Medicare plans offer $0 copays for primary care and drugs. MinuteClinics provide age-friendly care. OTC and fall prevention benefits support senior health.
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