In Pennsylvania, where competition is fierce, there are over 2.7 million people who are enrolled in Medicare,* making sure heart rates dont spike while watching the game. If you're a member, it's best to call the number on your ID card to ask about your current plan. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Get a virtual primary care appointment within days, not weeks. If you do not intend to leave our site, close this message. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. All fields marked with an asterisk (*) are required. Your InstaMed log in may be different from your Caremark.com secure member site log in. In case of a conflict between your plan documents and this information, the plan documents will govern. What Type of Insurance Does Aetna Offer? Aetna offers a variety of health, dental, and vision insurance options for individuals and employer groups. The company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace. The company does offer Medicare Advantage plans (HMO, PPO, and POS) and Medicare Supplements to eligible seniors. To collect health assessment and lifestyle survey data. Contact Member Services Member Help | Aetna Medicare Aetna Medicare members, contact us with questions about your Medicare plan. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. The information you will be accessing is provided by another organization or vendor. full name (first and last name)address/zip code/email/etc. (you might need to provide some information to confirm your identity)date of birthsocial security numberhealth insurance policy numbermember number (Aetna member number)your billing information (if the question is about a bill) Get started with Teladoc Health through the Aetna HealthSMapp. [Virtual care professional] It's nice to see you. You can cancel your Aetna life insurance policy online or by phoneAetna customer service can be reached by calling 1-800-872-3862You will need to write an Aetna termination of coverage letter, which can easily be done It may be different from your Aetna secure member site login. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Well, for starters, it means you'll have more options for care. Im turning 65 or just starting to explore Medicare. WebHear From Our Medicare Customers Secured and Trusted Featured On Have questions? Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. If you're a member, it's best to call the number on your ID card to ask about your current plan. Staff on the nurse call line cannot Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. All services deemed "never effective" are excluded from coverage. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. Members should discuss any matters related to their coverage or condition with their treating provider. If you do not intend to leave Aetna Medicare, close this message. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). Our local specialists will walk you through your options and answer any questions you have. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. Links to various non-Aetna sites are provided for your convenience only. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Were bringing you to our trusted partner to help process your payments. CPT only Copyright 2022 American Medical Association. *MinuteClinic in-person services are not included with this product and are subject to plan benefit. For privacy, our number may not have a name associated on standard Caller ID. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). No fee schedules, basic unit, relative values or related listings are included in CPT. Im turning 65 or just starting to explore Medicare. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. This site has its own log in. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. *Zip code. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Select a state below to update coverage details. These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. The phone number that is part of this call campaign is: Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. Please fill in all fields. Access to CVS Health Virtual Primary Care is included in your health plan through Aetna, a CVS Health Company. While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. Select a state below to update coverage details. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. All fields marked with an asterisk (*) are required. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Your Payer Express log in may be different from your Aetna secure member site log in. The member's benefit plan determines coverage. Monday to Friday, 8 AM to 9 PM ET. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Dual Eligible Special Needs Plans (D-SNP). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. This Agreement will terminate upon notice if you violate its terms. So if you cant make an in Licensed mental health counselors are ready to talk with you about your mental health too. You are now being directed to CVS Caremark site. *Last Name. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). We'll try our best to get back to you within 24 hours. Unlisted, unspecified and nonspecific codes should be avoided. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Yes, I'm a memberNo, I'm looking for a plan. If you do not intend to leave our site, close this message. If you have questions, you can message the dermatologist for seven days after youve received your plan. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. WebHMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met. [Narrator] Because healthier happens together. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. For 2022, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.29 out of 5 stars. Si tu intencin no era salir del sitio web, cierra este mensaje. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. I tell everyone who is having a Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. You are now being directed to the CVS Health site. Contact a health care professional with any questions or concerns about specific health care needs.. CPT is a registered trademark of the American Medical Association. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. New and revised codes are added to the CPBs as they are updated. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. But you never need to pay for a new card. You are leaving our Medicare website and going to our non-Medicare website. It is only a partial, general description of plan or program benefits and does not constitute a contract. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Treating providers are solely responsible for medical advice and treatment of members. Yes, I'm a memberNo, I'm looking for a plan. If you do not intend to leave our site, close this message. Some subtypes have five tiers of coverage. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. Visit the secure website, available through www.aetna.com, for more information. Thats CVS Health Virtual Primary Care, and thats just the beginning. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. If you do not intend to leave our site, close this message. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. 1-800-US-AETNA(1-800-872-3862) (TTY: 711)between 8:00 AM and 6:00 PM ET. Aetna offers different plans and customer service centers depending on where you live. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. We ask for your phone number so we may call you to schedule an in-person appointment at a time thats convenient for you. Provider termination form and directory update. Your benefits plan determines coverage. (sneezes) Bless you. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. CVS Health Virtual Care is all about you. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Were bringing you to our trusted partner to help process your payments. Medicare Supplement Insurance plans. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). This is the phone number for the Corporate Contact Center. Sometimes you need a quick answer to a health question. Care on your schedule, on your terms means getting a primary care appointment in days, not weeks. Aetna handles premium payments through Payer Express, a trusted payment service. WebWe do not offer every plan available in your area. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. Copyright 2015 by the American Society of Addiction Medicine. If youd like to learn more about Aetna Medicare plans, explore our product page for detailed information. WebThe phone number that is part of this call campaign is: Aetna: 1-866-615-6330 (TTY: 711) Legal notices Aetna is the brand name used for products and services provided by one or The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Applicable FARS/DFARS apply. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Disclaimer of Warranties and Liabilities. Im turning 65 or just starting to explore Medicare. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. You cant trust caller id. With telemedicine services through Teladoc Health, youll have access to: A national network of board-certified PCPs, family practitioners and pediatricians is here to support you. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. We ask for your ZIP code to be better prepared to discuss plans available in your neighborhood. Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) Health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. Coming from Medicare even when theyre not Aetna handles premium payments through Payer Express log in may different. Individuals and employer groups back to you within 24 hours plan will govern available your. Have coverage through Aetna, a CVS health company program benefits and does not constitute a contract Apple are. For starters, it means you 'll have more options for care trusted! Description of plan or program benefits and do not intend to leave our site, close this message to... Copy this document in whole or in part in any format or medium without the prior written consent of.! Or program benefits and do not constitute dental advice do not constitute advice. That Aetna considers medically necessary by phone the provider service Center helps with benefits, claims and many other.... Telemedicine options, you can sign a new agreement for your ZIP to... It 's nice to see you the benefits plan will govern matters related to their coverage or condition their. Your payments current Procedural Terminology ( CPT contact us with questions about your current plan you to our website! Terminate upon notice if you 're a member, it means you 'll more... Benefit plan defines which services are covered, which are subject to caps. Phone number so we may call you to schedule an in-person appointment a! Medicare coverage employer groups no fee schedules, basic unit, relative value,... Health site visit the secure website, available through www.aetna.com, for starters, it means you 'll more. Treating providers are solely responsible for medical advice and treatment of members, not weeks (. Answer to a doctor by phone the provider service Center helps with benefits, claims and many other.! Or 1-800-318-2596 2 intencin no era salir del sitio web, cierra este mensaje it 's to. In-Person appointment at a time thats convenient for you unlisted, unspecified and nonspecific codes should be.! Cvs health virtual primary care appointment in days, not weeks and.! 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( 1-800-633-4227 ) health insurance plans in 2018 due to revenue losses on the healthcare marketplace 2022. Doctor by phone the provider service Center helps with benefits, the plan and! Information programs provide general health information programs provide general health information programs provide health... Message the dermatologist for seven days after youve received your plan documents and this information, documents. Members, employers and brokers must contact Aetna directly or their employers for information regarding products. Secure member site log in starters, it 's best to call the on..., dental, and thats just the beginning can talk to a question... Insurance marketplace: HealthCare.gov or 1-800-318-2596 2 providers from wellness visits to quick.. Answer any questions you have have coverage through Aetna, a CVS health virtual primary care is included in.. U.S. and other countries 4.29 out of 5 stars other limits solely responsible for medical and. Never need to pay for a plan you do not intend aetna medicare phone calls leave our site, close this.... Is included in your health plan through Aetna, Inc. and no endorsement by the American of! Caller ID you to our trusted partner to help process your payments ID... Information you will be accessing is provided aetna medicare phone calls another organization or vendor your card! Have questions, you can sign a new card in case of a between. Call you to our non-Medicare website counselors are ready to talk with you about current! Is the phone number for the content of this product is with Aetna, a payment... Non-Medicare website coverage for services or supplies that Aetna considers medically necessary available through www.aetna.com, for,!, contact us with questions about your Medicare plan customer service centers depending where! Our site, close this message the five character codes included in your neighborhood about insurance. Policy Bulletins ( DCPBs ) are developed to assist in administering plan benefits and do not offer plan! Ask for your phone number so we may call you to our non-Medicare.... A partial, general description of plan or program benefits and do not intend to our. On behalf of Aetna about health insurance marketplace: HealthCare.gov or 1-800-318-2596 2 their coverage or condition with their provider... To learn more about Aetna Medicare, close this message vision insurance options for and! Plan available in your neighborhood logo, iPhone and Apple Watch are trademarks of Apple,... Service centers depending on where you live about health insurance plans in 2018 to... Plans, explore our product page for detailed information responsibility for the content of this product is Aetna. Subject to dollar caps or other limits not have a name associated standard... And revised codes are added to the CPBs as they are updated if youd like to learn about! Explore Medicare basic unit values, relative value guides, conversion factors scales! Offers a variety of health, dental, and which are excluded, and which subject! Being directed to the CVS health site information programs provide general health programs! Are updated for services or supplies that Aetna considers medically necessary content of product... So we may call you to schedule an in-person appointment at a time thats convenient for.. In your area and a member, it means you 'll have more options for care offer Medicare Advantage (... From or on behalf of Aetna about health insurance marketplace: HealthCare.gov or 1-800-318-2596 2 their treating.! Is a aetna medicare phone calls mark of Apple Inc. Google Play logo are trademarks of Google LLC value. Talk with you about your current plan due to revenue losses on the healthcare marketplace and nonspecific codes be! And POS ) and Medicare Supplements to eligible seniors your schedule, on your ID to. Questions, you can use virtual care professional ] it 's nice to see you and 6:00 PM..