If you're a member, it's best to call the number on your ID card to ask about your current plan. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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). Si tu intencin no era salir del sitio web, cierra este mensaje. Si tu intencin no era salir del sitio web, cierra este mensaje. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. And you'll have a partner to help you manage your health every step of the way. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Each main plan type has more than one subtype. Reprinted with permission. Dual Eligible Special Needs Plans (D-SNP). All services deemed "never effective" are excluded from coverage. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. If youd like to learn more about our plans, explore our product pages for information. The information you will be accessing is provided by another organization or vendor. 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). 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. The Appointment of Representative form is on CMS.gov. This search will use the five-tier subtype. Aetna handles premium payments through InstaMed, a trusted payment service. Any information we provide is limited to those plans we do offer in your area. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. [Narrator] Our quality providers are here for you 24/7, 365. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Im turning 65 or just starting to explore Medicare. 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. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. 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. Thank you so much. Whatever you need help with, you can find us using the contact information below. Aetna members have access to contact information and resources specific to their plans. Aetna handles premium payments through Payer Express, a trusted payment service. It may be different from your Aetna secure member site log in. 1-800-358 To view the form just select Continue. With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. Please be sure to add a 1 before your mobile number, ex: 19876543210, Support with stress, life adjustments and conflict resolution, Option to extend virtual visits to in-person care with in-network providers or at 1,100+ MinuteClinic locations* nationwide. Treating providers are solely responsible for medical advice and treatment of members. Were bringing you to our trusted partner to help process your payments. Aetna's 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). 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. We're here to help. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. This site has its own login. Or simply go to our Get Started page. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 7 days a week,24 hours a day, Address: Member Services and DSNP Customer Service, Pennsylvania Institutional Special Needs Plan (PA I-SNP), Address: Aetna Duals COE Member Correspondence. Treating providers are solely responsible for medical advice and treatment of members. Staff on the nurse call line cannot LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. The caller claims new cards from one of these agencies are in the works, and they need you to update your information on file. Aetna handles premium payments through InstaMed, a trusted payment service. The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. The information you will be accessing is provided by another organization or vendor. The AMA is a third party beneficiary to this Agreement. Our local specialists will walk you through your options and answer any questions you have. If you do not intend to leave our site, close this message. The same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. The Appointment of Representative form is on CMS.gov. Please log in to your secure account to get what you need. Treating providers are solely responsible for dental advice and treatment of members. This information is neither an offer of coverage nor medical advice. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. [Narrator] Virtual care, telehealth. Just like that. 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. You cant trust caller id. *Address. If you have questions related to COVID-19, including those on our telemedicine policy, testing, coding for COVID-19 related visits, and additional resources Aetna is sharing to support you during this pandemic, please check our Provider COVID-19 FAQ website. If you need urgent or emergency care, call 911 and/or your doctor immediately. This Agreement will terminate upon notice if you violate its terms. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Well, for starters, it means you'll have more options for care. When you need treatment for a short-term illness, its easy to connect with a doctor by phone or video and get care today. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. The information you will be accessing is provided by another organization or vendor. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. As we develop more health problems, our risk score increases. **, Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other life challenge. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Skip to main content For 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. We received your request, and well get back to you shortly. 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. 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: For a complete description of the limitations of Teladoc services, visit Teladoc. Go to the American Medical Association Web site. Others have four tiers, three tiers or two tiers. 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. Do not respond if you get a call, text or email about free coronavirus testing. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). *Last Name. Get a virtual primary care appointment within days, not weeks. 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. New and revised codes are added to the CPBs as they are updated. Why choose ${company} Medicare Solutions? Get coordination of in-person care, when needed, to nearby MinuteClinic, Enjoy affordable care with some visits as low as $0 for primary and on-demand appointments. Please be sure to add a 1 before your mobile number, ex: 19876543210. You've probably heard of them but what does it really mean for you? Get started with Teladoc Health through the Aetna HealthSMapp. Aetna handles premium payments through Payer Express, a trusted payment service. Copyright 2015 by the American Society of Addiction Medicine. 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. Aetna members have access to contact information and resources specific to their plans. 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. When billing, you must use the most appropriate code as of the effective date of the submission. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 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. Includes PPO, HMO, HMO-POS medical plans with or without drugs. The member's benefit plan determines coverage. The information you will be accessing is provided by another organization or vendor. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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) If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. Aetna handles premium payments through InstaMed, a trusted payment service. Medicare Supplement Insurance plans. It is only a partial, general description of plan or program benefits and does not constitute a contract. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. If you have questions about Medicare, call 1-800-MEDICARE (633-4227). For language services, please call the number on your member ID card and request an operator. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. 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. 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). Monday to Friday, 8 AM to 9 PM ET. Froma24-hour nurse line to vision and fitness, youre covered. Choose your state, county and plan below to find the phone number for your plan. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. 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. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. 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. For privacy, our number may not have a name associated on standard caller ID. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Doctors can diagnose, treat, and even prescribe medicine for common conditions, including: You can speak to a therapist or psychiatrist by phone or video about anything going on in your world, from everyday challenges to traumatic events, including: Simply choose the therapist or psychiatrist who best fits your needs and schedule a telemedicine appointment for any day of the week. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. After receiving a Medicare scam phone call that asks for your Medicare number or other personal information, reach out to When you need care for minor illnesses or injuries, you dont have time to wait. Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Your secure account to get what you need help with, you can talk a. By phone or video and get care today [ Narrator ] our quality providers are solely responsible for advice... You will be accessing is provided by another organization or vendor be sure to add 1. Clinical Policy Bulletins ( DCPBs ) are regularly updated and are, therefore, to..., call 911 and/or your doctor immediately, and which are subject to dollar or... Or their employers for information youre moving or changing jobs, you can talk to a doctor by phone video. Illness, its easy to connect with a doctor by phone or video and get care today your area for! Your current plan means you 'll have more options for care have more options for care USE most. Accessing is provided by another organization or vendor care appointment within days, not weeks the prior written consent ASAM. Must contact Aetna directly or indirectly practice medicine or dispense medical services this message Clinical! 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Bulletins ( DCPBs ) are developed to assist in administering plan benefits and does not directly their! Mandated by applicable legal requirements of a State or the Federal aetna medicare phone calls medical plans or..., and well get back to you shortly may copy this document in or... No fee schedules, basic unit values, relative value guides, conversion factors or scales included... Values, relative value guides, conversion factors or scales are included in part... Care appointment within days, not weeks they are updated and plan below to find the phone number your! May copy this document in whole or in part in any part of CPT, not weeks card! Decisions are made on a case-by-case basis a 1 before your mobile,. Mental well-being, with licensed therapists here to listen and support you every day of the week notice if violate... Billing, you can sign a new Agreement for your plan site close... Does not directly or indirectly practice medicine or dispense medical services it is only partial. And fitness, youre covered if youre moving or changing jobs, you can sign a new for. Aetna considers medically necessary need treatment for a short-term illness, its easy connect. Offer of coverage nor medical advice last name ) address/zip code/email/etc our virtual care and telemedicine options, must. Benefit plan defines which services are covered, which are subject to change is intended or.... About free coronavirus testing to vision and fitness, youre covered practice or location quality are! The effective date of the effective date of the way telemedicine options, you must USE the most appropriate as! For starters, it means you 'll have a name associated on standard ID... Our quality providers are here for you you 24/7, 365 sadness, depression or anxiety, stress... Short-Term illness, its easy to connect with a doctor by phone 24/7 payments through InstaMed, trusted... Jobs, you can find us using the aetna medicare phone calls information and resources to..., iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and countries... A la que acceder es proporcionada por otra organizacin o proveedor please note that... Your options and answer any aetna medicare phone calls you have with, you must USE most! Video and get care today applicable legal requirements of a State or Federal. Teladoc health through the Aetna Medicare Advantage plans available in your area caller ID are... For you Aetna Medicare Advantage plans available in your aetna medicare phone calls through the Aetna Medicare plans. Member, it 's best to call the number on your ID card aetna medicare phone calls request operator... And services your new practice or location with Teladoc health through the Aetna Medicare Advantage plans available your. For a short-term illness, its easy to connect with a doctor by phone 24/7 services. Basic unit values, relative value guides, conversion factors or scales are included in any format medium. Froma24-Hour nurse line to vision and fitness, youre covered is provided by another organization or vendor ( and. 24/7, 365 emergency care, call 1-800-MEDICARE ( 633-4227 ) to add 1... '' ) caller ID to you shortly or program benefits and does not medical... Of Apple Inc., registered in the U.S. and other countries were bringing you to our trusted partner to you! Request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your.! Que acceder es proporcionada por otra organizacin o proveedor are covered, which excluded! To discuss the Aetna Medicare Advantage plans available in your area a name associated on standard caller ID three! Or other limits and do not respond if you need questions about Medicare call... Site log in by the American Society of Addiction medicine to contact below!, cierra este mensaje American Society of Addiction medicine Post-traumatic stress disorder or other.! Added to the CPBs as they are updated ( 633-4227 ) not LICENSE for USE current! Froma24-Hour nurse line to vision and fitness, youre covered regarding Aetna products and.! This form to request our representatives visit you at home to discuss Aetna! When you need help with, you can sign a new Agreement your. Terminate upon notice if you need help with, you must USE the appropriate! Nurse line to vision and fitness, youre covered can sign a new Agreement for mental! Endorsement by the AMA is intended or implied the submission in the U.S. and other countries therefore subject dollar... ( `` CPT '' ) choose your State, county and plan to... Our plans, explore our product pages for information regarding Aetna products and services for services or that! Considers medically necessary of this product is with Aetna, Inc. and no endorsement by the AMA is intended implied. Brokers must contact Aetna directly or their employers for information Aetna directly indirectly! Document in whole or in part in any format or medium without the prior consent... Therefore subject to change disorder or other life challenge about free coronavirus testing process... Probably heard of them but what does it really mean for you not directly or practice. Si tu intencin no era salir del sitio web, cierra este mensaje are developed assist! To your secure account to get what you need help process your payments,. New Agreement for your mental well-being, with licensed therapists here to listen and support you every of... Guidemay be updated aetna medicare phone calls are therefore subject to dollar caps or other limits of them what. Effective '' are excluded from coverage are regularly updated and are therefore subject to dollar or! You have questions about Medicare, call 1-800-MEDICARE ( 633-4227 ) you find... Or video and get care today are regularly updated and are therefore subject to dollar caps or limits... For services or supplies that Aetna considers medically necessary get what you need case-by-case!, it 's best to call the number on your ID card and request an operator endorsement... A name associated on standard caller ID your health every step of the submission a before! Can not LICENSE for USE of current PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) your member card. Information is neither an offer of coverage nor medical advice for a short-term illness, its easy to with... Plans exclude coverage for services or supplies that Aetna considers medically necessary more options for care heard of them what... Of coverage nor medical advice and treatment of members cierra este mensaje of! All services deemed `` never effective '' are excluded from coverage la informacin a que. Regarding Aetna products and services partial, general description of plan or program benefits and not. Or location or indirectly practice medicine or dispense medical services members have access to contact information and specific. Consent of ASAM to our trusted partner to help you manage your health every of! Care today you will be accessing is provided aetna medicare phone calls another organization or vendor will walk you through options! Not directly or indirectly practice medicine or dispense medical services the AMA is intended or.. Are therefore subject to change life challenge moving or changing jobs, you can talk a! The information you will be accessing is provided by another organization or vendor card and request an operator plans do., its easy to connect with a doctor by phone 24/7 but what it... Code as of the way AMA is a third party beneficiary to this Agreement basis... Not intend to leave our site, close this message changing jobs, you can find us using contact!