Aetna Opens Gate With Several New No-Referral Plans

MANAGED CARE November 2000. ©2000 MediMedia USA

Aetna U.S. Healthcare will launch a series of products Jan. 1 that will drop the gatekeeper function. In most cases, the new plans, called Aetna Open Access, will allow members to receive care from specialists without a referral from their primary care physicians.

Meanwhile, HealthPartners, the Minneapolis-based health system and HMO, plans to offer its members direct access to behavioral health services.

Starting Jan. 1, enrollees will be able to receive up to 20 outpatient visits for psychiatric assessments, individual therapy, and drug abuse services without a referral. Referrals will still be required for partial and residential programs or for non-network providers.