Transparency in Coverage

In October 2020, the Department of Health and Human Services, the Department of Labor, and the Department of Treasury finalized the Transparency in Coverage Rule.  Under this rule, health plans and insurers are required to post provider-specific reimbursement rates via machine readable files that can be imported into or read by a computer no later than July 1, 2022.

These files are not designed as a consumer tool. Members are encouraged to use the more member-friendly price estimator tools available through the health plan's public website. These files are not a guarantee of coverage, nor a guarantee of the reimbursement rate that will be applied for any procedure. The information in these files is accurate as of the date noted for each file and is subject to change without notice.

To comply with this rule, the following link is available:

Aetna — Machine Readable Files (MRFs)