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By using our Applications you are agreeing to these Terms. Please read them carefully.
We may modify these Terms at any time by posting the revised Terms on the Applications. You can determine when these Terms were last revised by referring to the "LAST UPDATED" legend at the bottom of these Terms. Any modifications will be effective immediately upon such posting. Your use of or access to the Applications after such modifications are posted will signify your acceptance of the modifications and your agreement to be bound by them. Notwithstanding the foregoing, any modifications to these Terms shall not apply to any dispute between us arising prior to the date on which we post the revised Terms that contain such modifications.
Information on the Applications is provided "AS IS" without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantability, fitness for a particular purpose, or non-infringement. Some jurisdictions do not allow the exclusion of implied warranties, so the above exclusion may not apply to you. The data set forth herein is for informational purposes only, and no warranty is made that the information is error-free. Please note that once you leave an Application or arrive at an Application from another non-Aetna location, either by using a link we may have provided for your convenience or by specifying your own destination, Aetna accepts no responsibility for the content, products and/or services provided at these non-Aetna locations. Aetna does not control, endorse, promote or have any affiliation with any other website or software application (including mobile applications) unless expressly stated herein.
Limitation of Liability
IN NO EVENT WILL AETNA BE LIABLE TO ANY PARTY FOR ANY DIRECT, INDIRECT, SPECIAL OR OTHER CONSEQUENTIAL DAMAGES ARISING OUT OF ANY USE OF THE APPLICATIONS, OR ANY OTHER HYPER-LINKED WEBSITE OR SOFTWARE APPLICATION (INCLUDING MOBILE APPLICATIONS), INCLUDING, WITHOUT LIMITATION, ANY LOST PROFITS, BUSINESS INTERRUPTION, LOSS OF PROGRAMS OR DATA ON YOUR EQUIPMENT, OR OTHERWISE, EVEN IF WE ARE EXPRESSLY ADVISED OF THE POSSIBILITY OR LIKELIHOOD OF SUCH DAMAGES.
Changes to the Applications
Information may be changed or updated without notice. Aetna has no obligation to update information presented on the Applications, so information contained herein may be out of date at any given time. Aetna may also make improvements and/or changes in the products and/or programs described in this information at any time without notice.
Certain information related to financial and operating performance contained on the Applications is forward-looking. You should consider forward-looking statements to have been made only as of the date of their original publication and you should not put undue reliance on forward-looking statements. Those statements, while included on the Applications for historical reference, speak only as of the date of their original publication and have not been updated. We disclaim any intention or obligation to update or revise forward-looking statements, whether as a result of new information, future events, uncertainties or otherwise. Forward-looking information is based on management's estimates, assumptions and projections, and is subject to significant uncertainties and other factors, many of which are beyond Aetna's control. Important risk factors could cause actual future results and other future events to differ materially from those currently estimated by management, including, but not limited to: the implementation of health care reform legislation, including collection of Health Care Reform fees, assessments and taxes through increased premiums; the implementation of health insurance exchanges; the profitability of our public health insurance exchange products, where membership is greater than our initial projections and may have more adverse health status and/or higher medical benefit utilization than we projected; our ability to achieve the synergies and value creation contemplated by the proposed Humana acquisition; our ability to effectively integrate Humana's businesses; the diversion of management time on Humana integration-related issues; the final allocation of the Humana purchase price in our financial statements; our ability to offset Medicare Advantage and PDP rate pressures; and changes in our future cash requirements, capital requirements, results of operations, financial condition and/or cash flows. Health care reform will significantly impact our business operations and financial results, including our pricing and medical benefit ratios. Components of the legislation will be phased in over the next several years, and we will be required to dedicate material resources and incur material expenses during that time to implement health care reform. Many significant parts of the legislation, including aspects of public health insurance exchanges, Medicaid expansion, enforcement related reporting for the individual and employer mandates, and reinsurance, risk corridor and risk adjustment, require further guidance and clarification at both the federal level and/or in the form of regulations and actions by state legislatures to implement the law. In addition, pending efforts in the U.S. Congress to amend or restrict funding for various aspects of health care reform, and additional litigation challenging aspects of the law continue to create additional uncertainty about the ultimate impact of health care reform. As a result, many of the impacts of health care reform will not be known for the next several years. Other important risk factors include: adverse changes in health care reform and/or other federal or state government policies or regulations as a result of health care reform or otherwise (including legislative, judicial or regulatory measures that would affect our business model, restrict funding for or amend various aspects of health care reform, limit our ability to price for the risk we assume and/or reflect reasonable costs or profits in our pricing, such as mandated minimum medical benefit ratios or eliminate or reduce ERISA pre-emption of state laws (increasing our potential litigation exposure); adverse and less predictable economic conditions in the U.S. and abroad (including unanticipated levels of, or increases in the rate of, unemployment); our ability to diversify our sources of revenue and earnings (including by expanding our direct-to-consumer sales and capabilities and our foreign operations), transform our business model, develop new products and optimize our business platforms; the success of our HealthagenSM, Accountable Care Solutions and health information technology initiatives; unanticipated increases in medical costs (including increased intensity or medical utilization as a result of flu or otherwise; changes in membership mix to higher cost or lower-premium products or membership-adverse selection; increases resulting from unfavorable changes in contracting or re-contracting with providers (including as a result of provider consolidation and/or integration); and increased pharmacy costs (including in our health insurance exchange products); adverse changes in size, product or geographic mix or medical cost experience of membership; managing executive succession and key talent retention, recruitment and development; failure to achieve and/or delays in achieving desired rate increases and/or profitable membership growth due to regulatory review or other regulatory restrictions, the difficult economy and/or significant competition, especially in key geographic areas where membership is concentrated, including successful protests of business awarded to us; failure to adequately implement Health Care Reform; reputational or financial issues arising from our social media activities, data security breaches, other cybersecurity risks or other causes; the outcome of various litigation and regulatory matters, including audits, challenges to our minimum MLR rebate methodology and/or reports, guaranty fund assessments, intellectual property litigation and litigation concerning, and ongoing reviews by various regulatory authorities of, certain of our payment practices with respect to out-of-network providers and/or life insurance policies; our ability to integrate, simplify, and enhance our existing information technology systems and platforms to keep pace with changing customer and regulatory needs; our ability to successfully integrate our businesses (including Coventry, the InterGlobal group and other businesses we may acquire in the future) and implement multiple strategic and operational initiatives simultaneously; our ability to manage health care and other benefit costs; adverse program, pricing, funding or audit actions by federal or state government payors, including as a result of sequestration and/or curtailment or elimination of the Centers for Medicare & Medicaid Services' star rating bonus payments; our ability to reduce administrative expenses while maintaining targeted levels of service and operating performance; failure by a service provider to meet its obligations to us; our ability to develop and maintain relationships (including collaborative risk-sharing agreements) with providers while taking actions to reduce medical costs and/or expand the services we offer; our ability to demonstrate that our products lead to access to quality care by our members; our ability to maintain our relationships with third-party brokers, consultants and agents who sell our products; increases in medical costs or Group Insurance claims resulting from any epidemics, acts of terrorism or other extreme events; changes in medical cost estimates due to the necessary extensive judgment that is used in the medical cost estimation process, the considerable variability inherent in such estimates, and the sensitivity of such estimates to changes in medical claims payment patterns and changes in medical cost trends; the ability to successfully complete the implementation of our agreement with CVS Caremark Corporation on a timely basis and to achieve projected operating efficiencies for the agreement; a downgrade in our financial ratings; and adverse impacts from any failure to raise the U.S. Federal government's debt ceiling or any sustained U.S. Federal government shut down. For more discussion of important risk factors that may materially affect Aetna, please see the risk factors contained in Aetna's 2017 Annual Report on Form 10-K ("Aetna's 2017 Annual Report") on file with the Securities and Exchange Commission (the "SEC") and Aetna’s subsequent quarterly reports on form 10-Q when filed with the SEC. You also should read Aetna’s 2017 Annual Report and Aetna’s subsequent quarterly reports on Form 10-Q when filed with the SEC for a discussion of Aetna’s historical results of operations and financial condition.
Products and Services Offerings
“Aetna” is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. These companies include Aetna Health Inc.; Aetna Health of the Carolinas Inc.; Aetna Health of Illinois Inc.; Aetna Health of California Inc.; Aetna Dental Inc.; Aetna Dental of California Inc.; Aetna Life Insurance Company; Aetna Health Insurance Company of New York; and Aetna Health Insurance Company; Coventry Health Care; Coventry Health and Life Insurance Company; Coventry Health Care National Accounts, Inc.; Coventry Health Care Workers Compensation, Inc..
The product and/or services descriptions, if any, provided on this site are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable regulation areas and in many instances may be offered only through employers or other plan sponsors. Specific products may not be available in both self-funded and insured forms.
Covered services and preferred benefits are provided under the terms of the applicable plan contract, including limitations and exclusions.
Anyone interested in a particular product should contact their local Aetna representative to determine whether the product and/or service is available in their jurisdiction, and to request a copy of the applicable policy or prospectus for a complete description of the product and/or service in question.
Payment Service Offerings
A payment service may be available to some members of one or more of the Aetna Applications. The payment service is powered by our payment service vendor, Change Healthcare, Inc.
The payment service allows you to make payments to certain health care providers based on our calculation of your patient responsibility. If you make use of the payment service, you are responsible for determining the amount that you owe, which may be less than the patient responsibility shown through our Application. This may be due to other payments you may have already made directly with the provider, or other factors that may reduce your outstanding balance with your health care provider.
You may be able to make payments using a variety of your existing financial accounts, such as credit card accounts and checking accounts. If you are able to use an account that is regulated by section 213(d) of the IRS code, such as a health saving account (HSA) or flexible spending account (FSA), you are responsible for ensuring the eligibility of the expense under section 213(d). Not all 213(d) accounts are eligible to be used through the payment service.
By using the payment service to make a payment, you authorize our payment service vendor to process payment transactions initiated by you through the payment service using your financial accounts that you designate. You agree that you are fully responsible for any such transactions and agree to only use financial accounts where you are an authorized user on the financial account. You authorize our payment service vendor to make any debits, withdrawals, charges or transfers from your financial account in the amount you ask for, including any surcharges or fees that may apply.
In the event that there is an issue with our payment service vendor delivering your funds to a provider, our vendor will make best efforts to resolve the issue on your behalf in a timely manner. In certain cases, you can request a refund of a specific payment. Contact the Aetna contact center to answer any additional questions. When our payment service vendor needs to return funds to you, the funds will be returned to the same financial account you originally used to make the payment.
In no event will we or our payment service vendor be liable to any party for any direct, indirect, special or other consequential damages arising out of any use of the payment service. When using the payment service, your entered payment method information will be protected by us and our payment service vendor. Our payment service vendor follows major payment card industry (PCI) data security standards.
The Aetna logo, Aetna, Aetna Navigator®, Aetna Better Health®, ActiveHealth®, bSwift®, CareEngine®, Carelink®, Coventry®, DocFind®, Healthagen®, Healthy Merits®, Innovation Health®, iTriage®, Medicity®, Meritain Health®, NeoCare Solutions®, PayFlex®, Practice IQ®, Prodigy Health Group®, Resources for Living®, WellMatch® and all other trademarks, service marks, trade names, logos, domain names, URLs and icons ("Marks") appearing on this website, registered or not, are the property of Aetna Inc. or their respective owners. Nothing on this website grants you any right or license to use any of the Marks on this site without the express written permission of Aetna Inc. or the third party owners of the Marks. Unauthorized use may violate trademark and other laws.
Ownership of the Applications
The Applications (including any content made available through the Applications) are the property of Aetna (or its licensors) and are protected by applicable intellectual property laws. The Applications are licensed, not sold, to you. You may utilize the Applications only as permitted by these Terms. You may not, and will not permit any other party to: (1) modify, adapt, alter, translate or create derivative works of the Applications; (2) use or merge the Applications, or any component or element thereof, with other software, databases or services not provided by Aetna; (3) sublicense, distribute, sell or otherwise transfer the Applications to any third party; (4) use the Applications as a service bureau, or lease, rent or loan the Applications to any third party; (5) reverse engineer, decompile, disassemble or otherwise attempt to derive the source code or structure of the Applications; (6) interfere in any manner with the operation of the Applications; (7) circumvent, or attempt to circumvent, any electronic protection measures in place to regulate or control access to the Applications; (8) create a database by systematically downloading and storing the Applications; (9) use any robot, spider, site search/retrieval application or other manual or automatic device to retrieve, index, “scrape” “data mine” or in any way gather the Applications or reproduce or circumvent the navigational structure or presentation of the Applications without our express prior written consent; or (10) use the Applications for any commercial purposes. You agree not to develop, distribute or sell any software or other functionality capable of launching, being launched from or otherwise integrated with the Applications. You may not remove, alter or obscure any copyright notice or any other proprietary notice that appears on or in the Applications.
Aetna may suspend or terminate your use of or access to the Applications if you fail to comply with these Terms. Such suspension or termination may result in the permanent deletion of your information or other previously available content.
Not a Solicitation
Nothing in this site should be construed as a solicitation or offer to purchase coverage from Aetna or any of its affiliated companies.
Not a Substitute for Professional Health Care or Advice
The health information contained in these Applications (for example, Aetna InteliHealth, Aetna Behavioral Health, Aetna Pharmacy and Aetna Dental) is general in nature and is not a substitute for professional health care. It is not meant to replace the advice of health care professionals. If you have specific health care needs, or for complete health information, please see a doctor or other health care provider.
Apple-Specific Terms and Conditions
In addition to your agreement with the foregoing Terms, and notwithstanding anything to the contrary herein, you acknowledge and agree to the following provisions with respect to your use of any Application that is compatible with the iOS operating system of Apple Inc. (“Apple”). Apple is not a party to these Terms and does not own and is not responsible for the Application. Apple is not providing any warranty for the Application, except if applicable, to refund the purchase price for it. Apple is not responsible for maintenance or other support services for the Application and shall not be responsible for any other claims, losses, liabilities, damages, costs or expenses with respect to the Application, including, without limitation, any third-party product liability claims, claims that the Application fails to conform to any applicable legal or regulatory requirement, claims arising under consumer protection or similar legislation, and claims with respect to intellectual property infringement. Any inquiries or complaints relating to the use of the Application, including those pertaining to intellectual property rights, must be directed to Aetna. The license you have been granted herein is limited to a non-transferable license to use the Application on an Apple-branded product that runs Apple's iOS operating system and is owned or controlled by you, or as otherwise permitted by the Usage Rules set forth in Apple's App StoreTM Terms of Service. In addition, you agree to comply with the terms of any third-party agreement that is applicable to you when using the App, such as your wireless data service agreement. You acknowledge and agree that Apple and Apple's subsidiaries are third-party beneficiaries of this Agreement and that, upon your acceptance of the terms and conditions of this Agreement, Apple will have the right (and will be deemed to have accepted the right) to enforce this Agreement against you as a third-party beneficiary thereof. Notwithstanding the immediately preceding sentence, Aetna's right to enter into, rescind or terminate any variation, waiver or settlement under these Terms is not subject to the consent of any third party.
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