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Program Provisions

Discount Program Disclaimer

Discount offers provide access to discounted services and are not part of an insured plan or policy. Discount offers are rate-access offers and may be in addition to any plan benefits. Check any insurance benefits you have before using these discount offers, as those benefits may result in lower costs to you than using these discounts. Banner|Aetna and its affiliates make no payment to the discount vendor. The member is responsible for the full cost of the discounted services. We 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. These programs are NOT insured benefits. Aetna and its affiliates provide certain management services for Banner|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 Banner|Aetna. Information is believed to be accurate as of the staging date; however, it is subject to change.

Informed Health Line & Banner Nurse On-Call 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 and its affiliates provide certain pharmacy services to Banner|Aetna. 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 Banner|Aetna does not notify 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 the Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions.  CVS Caremark® Mail Service Pharmacy refers to CVS Caremark® Mail Service Pharmacy, LLC. CVS Caremark® Mail Service Pharmacy and Aetna are part of the CVS Health family of companies, 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 CVS Caremark® Mail Service Pharmacy 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.

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.

Transforming health care, together

Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.

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Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.

98point6® is a registered trademark of 98point6 Inc. Access to 98point6® is not included in all plans. 98point6 is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan.

This material is for information only. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Banner|Aetna. Provider participation may change without notice.

Health insurance plans contain exclusions and limitations.

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