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Program Provisions

Discount Program Disclaimer

Discount offers provide access to discounted services and are not part of a health benefit plan. Discount offers are rate-access offers and may be in addition to any plan benefits. Check any plan you have before using these discount offers, as those benefits may result in lower costs to you than using these discounts. Sutter Health | Aetna and its affiliates make no payment to the discount vendor. The member is responsible for the full cost of the discounted services. Aetna may receive a percentage of the fee paid to a discount vendor.

Simple Steps Disclaimer

This information is not meant to be either a recommendation for medical treatment or a diagnosis of medical condition. Please consult your health care provider for the advice and care appropriate for your specific medical needs. The availability of a program may vary by plan design. While this material is believed to be accurate as of the staging date, it is subject to change. Aetna and its affiliates provide certain management services for Sutter Health | Aetna.

Personal Health Record

The Aetna Personal Health Record is offered by Aetna Life Insurance Company and should not be used as the sole source of information about the member's medical history. Aetna and its affiliates provide certain management services for Sutter Health | Aetna. Information is believed to be accurate as of the staging date; however, it is subject to change.

Informed Health Line Disclaimer

While only your doctor can diagnose, prescribe or give medical advice, the Informed Health® Line nurses can provide information on more than 5,000 health topics. Contact your doctor first with any questions or concerns regarding your health care needs. While this material is believed to be accurate as of this date, it is subject to change.

Note: Topics discussed by nurses or online are not necessarily covered by your health plan.

Pharmacy Disclaimers

Aetna Pharmacy Management may at times collaborate with, or delegate to, another entity to carry out a function that it would otherwise perform. The goal is to make any of these processes seamless to our members. Thus Aetna does not notify our members and providers when a service is delegated. We continuously review any delegated activities to ensure that the collaborator is properly performing the assigned functions and to meet the requirements of the accreditation agency URAC, the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid services (CMS), as well as state regulations.

Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions.  Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC, a subsidiary of Aetna Inc., which is a licensed pharmacy providing prescription services by mail.  This pharmacy is a for-profit entity.  Aetna Specialty Pharmacy refers to Aetna Specialty Pharmacy, LLC, a subsidiary of Aetna Inc., which is a licensed pharmacy that operates through specialty pharmacy prescription fulfillment.  This pharmacy is a for-profit entity.  The charges that Aetna negotiates with Aetna Rx Home Delivery and Aetna Specialty Pharmacy may be higher than the cost they pay for the drugs and the cost of the mail order pharmacy services they provide. For these purposes, the pharmacies’ cost of purchasing drugs takes into account discounts, credits and other amounts that they may receive from wholesalers, manufacturers, suppliers and distributors.

Aetna and its affiliates provide certain management services for Sutter Health | Aetna.

Health Care Provider Network Disclaimer

Providers are independent contractors and are not our agents. Provider participation may change without notice.  We do not provide care or guarantee access to health services.

Health Information Program Disclaimer

Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.

Our Collaboration

The new joint venture brings together Sutter Health’s network of nationally recognized, high-quality* doctors and hospitals with Aetna’s leading health plan expertise, cutting-edge data, analytics and health information technology, and shared care management capabilities. This joint venture aims to deliver a differentiated, personalized experience for members and is designed to improve efficiency and lower the cost of care, resulting in greater affordability.

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*Many of the hospitals and physician organizations in the Sutter Health network have been recognized for quality achievements from The Joint Commission, The Leapfrog Group®, Integrated Healthcare and CAPG.

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Health benefit plans are administered by Sutter Health and Aetna Administrative Services LLC. Sutter Health | Aetna is the brand name used for products and services provided by Sutter Health and Aetna Administrative Services LLC. Sutter Health | Aetna is an affiliate of Sutter Health and of Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Sutter Health | Aetna.

This material is for information only and is not an offer or invitation to contract.  Health benefit plans contain exclusions and limitations. Providers are independent contractors and not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability are subject to change and may vary by location. Information is believed to be accurate as of the production date; however, it is subject to change.

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