ACA plan resources for providers
Innovation Health Affordable Care Act (ACA) plans are now available for coverage starting 2025.
General questions
General questions
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What is a qualified health plan (QHP)?How can I identify an exchange member?When do the 2025 Innovation Health individual and family plans first become effective?Are the payer ID and claim address the same for exchange plans?How can I check my product participation status?Will our online eligibility and benefits verification system indicate if a patient is on a state exchange plan and who their PCP is?If I need to refer patients for care, do I have to refer patients to other providers within an exchange?Are there more provider resources available to support me with providing care, managing my practice and working with Innovation Health?How can I maintain my provider profile information?
Plan benefits
Plan benefits
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Are claims filing timelines different for the Innovation Health individual & family plans?What ID should I use to verify member benefits or submit an inquiry or claim?How do individual and family insurance plans work with Coordination of Benefits (COB)?If a member does not select, or Aetna doesn’t assign them a PCP, how long does it take for a PCP selection to take effect?Do members have out-of-network benefits?Where can I find the formulary information for Innovation Health individual & family plans?
Payment and billing
Payment and billing
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I’ve heard that some exchange members qualify for a grace period if they don’t pay their premiums. What does that mean?How will Innovation Health reimburse out-of-network claims?How will the plan reimburse me as a participating provider of the Innovation Health individual & family plans?
Now that’s innovation
Innovation Health is transforming the health care journey. Through innovative programs, coordinated care, and convenient access, our health plans are personalized to fit our members’ needs. Discover how we are helping members achieve their health ambitions right in their community.