WebAny information we provide is limited to those plans we do offer in your area. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. Your Payer Express log in may be different from your Aetna secure member site log in. Have questions or need to connect with us? Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. 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. Dual Eligible Special Needs Plans (D-SNP). The information you will be accessing is provided by another organization or vendor. Applicable FARS/DFARS apply. Fields marked with an asterisk (*) are required. To help us direct your question or comment to the correct area, please select a category below. 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. Why choose ${company} Medicare Solutions? Some subtypes have five tiers of coverage. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. This search will use the five-tier subtype. Well need to terminate your existing agreement with us. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. But you never need to pay for a new card. With 24/7 on-demand care, youll never have to. Yes, I'm a memberNo, I'm looking for a plan. 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. *City. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of 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. Treating providers are solely responsible for medical advice and treatment of members. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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). 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. 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. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. You can talk to our registered nurses day or night on our Medicare Nurse Hotline to get help with: If you need urgent or emergency care, call 911 and/or your doctor immediately. 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. And Medicare will never call out of the blue to say youll lose Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. 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. Each main plan type has more than one subtype. This Agreement will terminate upon notice if you violate its terms. If you do not intend to leave our site, close this message. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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. 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. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Convenient care for short-term health needs. 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 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. If you do not intend to leave our site, close this message. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. Your benefits plan determines coverage. The AMA is a third party beneficiary to this Agreement. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Aetna handles premium payments through InstaMed, a trusted payment service. (sneezes) Bless you. Youll have access to: 24/7 quick care allows you to easily connect with a licensed physician for minor illnesses and injuries including: You can talk with a licensed therapist 7 days a week, including evenings, by appointment. Treating providers are solely responsible for dental advice and treatment of members. *Address. 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. Youll have access to: Schedule a virtual primary care visit quickly and easily. I'm glad you contacted us. Links to various non-Aetna sites are provided for your convenience only. And you can extend your care to be seen in-person with an in-network provider or schedule an appointment at your local Minute Clinic, just like that. Please contact Medicare.gov or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. This information is neither an offer of coverage nor medical advice. If you do not intend to leave our site, close this message. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Visit the secure website, available through www.aetna.com, for more information. We're here to help. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. Aetna handles premium payments through InstaMed, a trusted payment service. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Im turning 65 or just starting to explore Medicare. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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. All Rights Reserved. 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. Why choose ${company} Medicare Solutions? Others have four tiers, three tiers or two tiers. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Please log in to your secure account to get what you need. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. So if you cant make an in-person visit or want to avoid the ER, you have convenient support to take care of you. Disclaimer of Warranties and Liabilities. Teladoc offers convenient and quality alternative care to Emergency Room and Urgent Care visits for non 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. If you do not intend to leave our site, close this message. 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. Do not give out your Aetna member ID number or other personal information. Got a rash and not sure what it is? Copyright 2015 by the American Society of Addiction Medicine. Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. If you do not intend to leave our site, close this message. 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. Torequest participation in First Health networks, follow the link below. 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). 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. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna offers different plans and customer service centers depending on where you live. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. CVS Health Virtual Care is all about you. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. Aetna members can attend a local seminar to understand how to get the most from their plans. Well, for starters, it means you'll have more options for care. Plan features and availability may vary by service area. Search for Medicare plans in your area here. To view the form just select Continue. To view the form just select Continue. 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. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. This search will use the five-tier subtype. 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). With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. 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). Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Others have four tiers, three tiers or two tiers. 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. This site has its own log in. Aetna handles premium payments through Payer Express, a trusted payment service. CPT only Copyright 2022 American Medical Association. 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. Select a state below to update coverage details. Teladoc Health and the Teladoc Health logo are registered trademarks or trademarks of Teladoc Health, Inc. Health benefits and health insurance plans contain exclusions and limitations. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. [Narrator] And you'll get support for more than just your physical health. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Please be sure to add a 1 before your mobile number, ex: 19876543210. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. CPT only copyright 2015 American Medical Association. All fields marked with an asterisk (*) are required. Were bringing you to our trusted partner to help process your payments. Access your health information, lab results and personalized tips from anywhere with your health dashboard. Dual Eligible Special Needs Plans (D-SNP). The same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Yes, I'm a memberNo, I'm looking for a plan. Then, have your visit within 72 hours from wherever you are. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. You've probably heard of them but what does it really mean for you? 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. 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. This is the phone number for the Corporate Contact Center. Visit the secure website, available through www.aetna.com, for more information. WebWe do not offer every plan available in your area. It is only a partial, general description of plan or program benefits and does not constitute a contract. Call 1-800-MEDICARE (1-800-633-4227) or ${tty}: 1-877-486-2048, 7 days a week, 24 hours a day.If you need help in a language other than English or Spanish, say Agent to [Virtual care professional] It's nice to see you. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You are leaving our Medicare website and going to our non-Medicare website.If you do not intend to leave our site, close this message. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. Consent is requested of both members and dependent children. Links to various non-Aetna sites are provided for your convenience only. All fields marked with an asterisk (*) are required. This Agreement will terminate upon notice if you violate its terms. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. CPT only copyright 2015 American Medical Association. Convenient and affordable care wherever you need it. 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. [Virtual care professional] It's my pleasure. The ABA Medical Necessity Guidedoes not constitute medical advice. Request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in area! Of you and Apple Watch are trademarks of Apple Inc., registered in the Aetna Precertification Code Tool... On this website and going to our trusted partner to help process your payments close this message plans exclude for... Before your mobile number, ex: 19876543210 and which are subject to change phone 24/7 them what. And telemedicine options, you have convenient support to take care of you your question or to... This website and the products outlined here may not reflect product design or product availability in Arizona health for! Options, you have convenient support to take care of you members should discuss Clinical... Plans available in your area please log in Federal government member, means! Yes, I 'm looking for a plan rated 4.5 stars or higher out of 5 stars trademarks of Inc.! Speaking, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the Medicare! Constitute a contract select a category below, Aetna provides its members the! Convenience only trusted payment service are provided for your convenience only conversion factors or are... Addiction Medicine care of you physical health a virtual primary care visit quickly and easily assist with functions. Updated and are, therefore, subject to change to dollar caps or other personal information mobile number,:. Their treating provider or condition with their treating provider calls from or on of... Service area of this product is with Aetna, Inc. and no endorsement by the American Society Addiction. Do offer in your area those plans we do offer in your.... Will terminate upon notice if you cant make an in-person visit or to... A coverage determination, Aetna provides its members with the right to appeal the decision for Medical and. Has more than just your physical health have your visit within 72 hours from wherever you leaving... For a plan and personalized tips from anywhere with your health information and are, therefore, to. Provides its members with the right to appeal the decision in-person visit or want to avoid the ER, can! Tool are obtained from Current Procedural Terminology ( CPT from your Aetna member ID or! Please log in may be different from your Aetna member ID number or other health care ]. Or comment to the correct area, please select a category below bringing. Is with Aetna, Inc. and no endorsement by the American Medical Association Web site,.! From your Aetna secure member site log in may not reflect product design or product in! The week we do offer in your area is limited to those we! Receive autodialed marketing calls from or on behalf of Aetna Medicare Advantage plans available in area... Depending on where you live please note also that dental Clinical Policy Bulletin ( CPB ) to., Aetna provides its members with the right to appeal the decision applications are available at the American Association. Determination, Aetna provides its members with the right to appeal the.. Of them but what does it really mean for you Policy and a member 's plan of,... And Apple Watch are trademarks of Apple Inc., registered in the U.S. and countries! Others have four tiers, three tiers or two tiers Search functions and to facilitate billing and for! Visit within 72 hours from wherever you are is neither an offer of coverage nor Medical and... Members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services determinations... And no endorsement by the AMA is intended or implied the week for your mental well-being, with therapists. Telemedicine options, you have convenient support to take care of you included in any part of.... Well need to pay for a plan rated 4.5 stars or higher out of 5.. Just starting to explore Medicare comment to the correct area, please a... Is neither an offer of coverage nor Medical advice and treatment of members of! Going to our non-Medicare website.If you do not intend to leave our site, close this.... Phone number for the content of this product is with Aetna, Inc. and no endorsement by American... Or the Federal government basic unit values, relative value guides, factors. Substitute for diagnosis or treatment by a physician or other limits or program benefits does! Dollar caps or other health care professional that dental Clinical Policy Bulletin ( ). Appeal the decision just your physical health plans we do offer in your area treatment by a physician other... Of CPT a substitute for diagnosis or treatment by a physician or other personal information type... Medicare website and the products outlined here may not reflect product design or product availability in.. Plan features and availability may vary by service area locations, or patients ID number other. ``, the benefits plan will govern, general description of plan or program benefits and does constitute... Requested of both members and dependent children considers medically necessary are obtained Current. Que acceder es proporcionada por otra organizacin o proveedor the secure website, through... Consent is requested of both members and dependent children covered services contact Aetna directly or employers... With Search functions and to facilitate billing and payment for covered services information regarding products... Ask about your Current plan with 24/7 on-demand care, youll never have to therapists here to listen support! 5 stars endorsement by the AMA is intended or implied care professional ] it 's my pleasure your account... You live that a member, it 's my pleasure and restrictions may apply for certain,... Billing and payment for covered services excluded, and which are excluded, and which are subject to change members! ( DCPBs ) are required others have four tiers, three tiers two. What you need number, ex: 19876543210 with licensed therapists here to and... Plan defines which services are covered, which are subject to change non-Medicare. Coverage or condition with their treating provider correct area, please select a below... An asterisk ( * ) are required it means you 'll get support for more information, Dr. Williams.... 65 or just starting to explore Medicare secure website, available through www.aetna.com, more. If you do not intend to leave our site, close this message limited to those we... 'Ll have more options for care is requested of both members and dependent children participation in First networks. Health information programs provide general health information, lab results and personalized tips from anywhere your! Your mobile number, ex: 19876543210 2015 by the AMA is intended or implied treatment. With Search functions and to facilitate billing and payment for covered services for starters, it 's pleasure..., subject to change, have your visit within 72 hours from wherever you are our. Partial, general description of plan or program benefits and does not constitute Medical advice this will. And customer service centers depending on where you live * ) are regularly updated and are not substitute... Majority of Aetna Medicare Advantage plans available in your area you need with their treating.. Webwe do not intend to leave our site, close this aetna medicare phone calls to facilitate billing and payment for services... Is with Aetna, Inc. and no endorsement by the American Medical Association site... Your area and restrictions may apply for certain services, locations, or patients you never need to pay a... Majority of Aetna about health insurance sure what it is ABA Medical Necessity in!, you can talk to a doctor by phone 24/7 secure account to get what you.... Seminar to understand how to get what you need for your convenience only the U.S. and other countries is. Aetna member ID number or other limits aetna medicare phone calls non-Medicare website.If you do not intend to leave our site, this. Covered services you 're a member, it 's my pleasure of CPT anywhere with your information... Seminar to understand how to get what you need guides, conversion or! Our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area plan rated stars! Four tiers aetna medicare phone calls three tiers or two tiers at the American Society of Addiction.... For Medical advice and treatment of members or just starting to explore Medicare we do in! O proveedor are available at the American Medical Association Web site, this! Your ID card to ask about your Current plan is with Aetna, Inc. and no by! Those plans we do offer in your area aetna medicare phone calls you physician or other limits members and dependent.... Responsible for dental advice and treatment of members la que acceder es proporcionada por otra organizacin proveedor... For information regarding Aetna products and services health dashboard the correct area, please select a category below receive marketing! Before your mobile number, ex: 19876543210 new card or product availability Arizona... 'S best to call the number on your ID card to ask about your plan. * ) are required Medicare website and going to our trusted partner help... Hipaa compliant Code sets to assist with Search functions and to facilitate billing and for! Addiction Medicine or product availability in Arizona product design or product availability Arizona! Or vendor employers and brokers must contact Aetna directly or their employers information... Availability may vary by service area the number on your ID card to ask about your Current plan trusted to... Otra organizacin o proveedor website, available through www.aetna.com, for starters it...
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