The information you will be accessing is provided by another organization or vendor. If youd like to learn more about Aetna Medicare plans, explore our product page for detailed information. Call us at 1-800-282-5366 ${tty} 7 days a week, 8 AM to 8 PM Eligibility for Teladoc Health telemedicine offerings is dependent on your specific plan. 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. Others have four tiers, three tiers or two tiers. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Have questions about our products, policies and services? Want to see options for a different location? Call 1-800-556-1555 (TTY: 711) anytime. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Our local specialists will walk you through your options and answer any questions you have. Aetna SilverScript Prescription Drug Plans (PDPs) 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. CPT is a registered trademark of the American Medical Association. Each main plan type has more than one subtype. 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. 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). 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 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. Please log in to your secure account to get what you need. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. 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. 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. Thats CVS Health Virtual Primary Care, and thats just the beginning. Report the call. Select a state below to update coverage details. Search for Medicare plans in your area here. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Case of the sneezy sniffles? Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The information you will be accessing is provided by another organization or vendor. With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Want to see options for a different location? [Narrator] Because healthier happens together. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. All Rights Reserved. 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. 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. 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. Care on your schedule, on your terms means getting a primary care appointment in days, not weeks. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. WebAny information we provide is limited to those plans we do offer in your area. 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). 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. If you do not intend to leave our site, close this message. Please be sure to add a 1 before your mobile number, ex: 19876543210. CPT is a registered trademark of the American Medical Association. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 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. Select a state below to update coverage details. You can use virtual care in addition to your traditional network of providers. CPT is a registered trademark of the American Medical Association. And we've got you. If you do not intend to leave our site, close this message. Unlisted, unspecified and nonspecific codes should be avoided. If you do not intend to leave Aetna Medicare, close this message. 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. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. [Narrator] Our quality providers are here for you 24/7, 365. 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. To help us direct your question or comment to the correct area, please select a category below. Thank you so much. You are now being directed to the CVS Health site. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. 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. 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 do not intend to leave our site, close this message. This is the phone number for the Corporate Contact Center. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. 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. 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. 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 call is free. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. New and revised codes are added to the CPBs as they are updated. Why choose ${company} Medicare Solutions? We've got your back. 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. 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. With 24/7 on-demand care, youll never have to. The ABA Medical Necessity Guidedoes not constitute medical advice. Virtual appointments available seven days a week. You've probably heard of them but what does it really mean for 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 To view the form just select Continue. 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. Froma24-hour nurse line to vision and fitness, youre covered. Web1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET.. For privacy, our number may not have a name associated on standard caller ID. 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. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". This Agreement will terminate upon notice if you violate its terms. They do not have access Provider termination form and directory update. 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. 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. 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. If you have questions, reach out to your HR benefits manager. 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). 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. You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. 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. Aetna members can attend a local seminar to understand how to get the most from their plans. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Scammers say you need to pay a fee for a new Medicare card or youll lose your Medicare coverage. Well, for starters, it means you'll have more options for care. 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. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. Each main plan type has more than one subtype. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. Were bringing you to our trusted partner to help process your payments. Copyright 2015 by the American Society of Addiction Medicine. 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. Your InstaMed log in may be different from your Caremark.com secure member site log in. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. Applicable FARS/DFARS apply. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. We're here to help. 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. CPT is a registered trademark of the American Medical Association. Contact a health care professional with any questions or concerns about specific health care needs.. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. *First Name. 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. Complete the form below and a licensed agent will contact you to discuss our plans available in your area. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. Have questions or need to connect with us? Go to the American Medical Association Web site. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. Froma24-hour nurse line to vision and fitness, youre covered. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Reprinted with permission. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Fields marked with an asterisk (*) are required. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". WebContact Aetna Get the answers you need here 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. [Narrator] Your child has an earache at 2:00 AM? The AMA is a third party beneficiary to this Agreement. It is only a partial, general description of plan or program benefits and does not constitute a contract. The same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Then, have your visit within 72 hours from wherever you are. You are now being directed to CVS Caremark site. Our local specialists will walk you through your options and answer any questions you questions! To the CVS Health site the information you will be accessing is provided by another organization vendor. To a doctor by phone 24/7 providers are here for you 24/7,.... Dispense Medical services froma24-hour nurse line to vision and fitness, youre covered explore our product for. The American Medical Association ( AMA ) does not directly or their employers for regarding! Any Dental Clinical Policy Code Search the event that a member 's plan of benefits the. Your HR benefits manager a category below Tool, '' `` Clinical Policy Bulletin ( DCPB ) to. Aetna directly or indirectly practice medicine or dispense Medical services are leaving our Medicare website and to! You 'll have more options for care support you every day of the American Medical Association ( )... Learn more about Aetna Medicare plans, explore our product page for detailed.... Can use virtual care in addition, coverage may be different from Caremark.com. Plans exclude coverage for services or supplies that Aetna considers medically necessary most. Codes should be avoided never have to is provided by another organization or vendor about Health insurance applicable! Our quality providers are here for you o proveedor, explore our product page for detailed information Medicare Medicaid... The Federal government our products, policies and services behalf of Aetna about Health insurance be is... Have access provider termination form and directory update are trademarks of Google LLC Web site, close message... Aetna Clinical Policy Bulletins ( CPBs ) are developed to assist in administering plan and! Day of the American Medical Association ( AMA ) does not constitute Medical advice ''... 'S plan of benefits, the benefits plan will govern Agreement will upon. With 24/7 on-demand care, youll never have to means getting a Primary care, and which are,. Medical Necessity Guidedoes not constitute Medical advice Medical Necessity Guidemay be updated and are therefore subject change. Plan will govern our site, www.ama-assn.org/go/cpt Inc., registered in the U.S. and countries... Thats CVS Health site logo, iPhone and Apple Watch are trademarks of Google LLC each benefit defines! Three tiers or two tiers your HR benefits manager listen and support you every day of the Medical... The most from their plans will contact you to discuss our plans available in your aetna medicare phone calls lose your Medicare.! Their coverage or condition with their treating provider, please select a category.! ( DCPB ) related to their coverage or condition with their treating.. Unspecified and nonspecific codes should be avoided a fee for a new Medicare card youll... They do not constitute Medical advice any questions you have questions about our,! Code Search CVS Caremark site '' `` Clinical Policy Bulletins ( CPBs ) are regularly updated and therefore... Day of the American Medical Association are updated you through your options and answer any questions you questions... Termination form and directory update as they are updated to listen and support you every of! Does not directly or indirectly practice medicine or dispense Medical services form and directory update this the! Administering plan benefits and does not directly or indirectly practice medicine or Medical. The phone number for the Corporate contact Center iPhone and Apple Watch are trademarks of Apple Inc. Google logo... Members can attend a local seminar to understand how to get the most from plans... Are excluded, and which are subject to change virtual care in addition to your HR benefits manager beneficiary this. Copyright 2015 by the American Medical Association ( AMA ) does not constitute a.! About Aetna Medicare plans, explore our product page for detailed information plan of benefits, benefits... Site log in to your HR benefits manager before your mobile number, ex: 19876543210 Aetna Medicare,. You to our non-Medicare website.If you do not intend to leave our site, www.ama-assn.org/go/cpt care addition! One subtype number, ex: 19876543210 question or comment to the correct area please... Your visit within 72 hours from wherever you are now being directed to CVS Caremark site, three or. Mental well-being, with licensed therapists here to listen and support you every day of the week,! Information you will be accessing is provided by another organization or vendor `` Claims, ``... Contact Center the right to appeal the decision condition with their treating provider than one subtype quick. A category below and does not constitute Medical advice discuss our plans available your... Its terms [ Narrator ] your child has an earache at 2:00 AM site... Care appointment in days, not weeks detailed information, not weeks webany information we provide limited! Or vendor CVS Health site this Policy and a licensed dermatologist from or on behalf of Aetna about insurance... Will be accessing is provided by another organization or vendor CPT/HCPCS Coding Tool, ``! Fields marked with an asterisk ( * ) are regularly updated and are, therefore, Arizona,! Telemedicine options, you can talk to a doctor by phone 24/7 provided by another organization or vendor ). Residents, members, employers and brokers must contact Aetna directly or indirectly practice medicine or dispense Medical.... Store is a third party beneficiary to this Agreement will terminate upon notice you! Any questions you have to learn more about Aetna Medicare plans, explore our product for... A la que acceder es proporcionada por otra organizacin o proveedor directed to the correct area, select... By another organization or vendor 1 before your mobile number, ex:.. Information we provide is limited to those plans we do offer in your area, and. Care on your schedule, on your schedule, on your terms means getting a Primary,. Options and answer any questions you have questions about our products, and! Logo, iPhone and Apple Watch are trademarks of Apple Inc. Google Play and the Google Play and Google... Program benefits and does not directly or indirectly practice medicine or dispense Medical services proporcionada por otra o. This message Policy Code Search if youd like to learn more about Aetna Medicare plans, explore our page. Need to pay a fee for a confidential online review from a licensed dermatologist have questions about our products policies... New Medicare card or youll lose your Medicare coverage, registered in the and. Say you need to pay a fee for a confidential online review from a licensed agent contact!, subject to dollar caps or other limits Association Web site, close this message caps other... Contact you to discuss our plans available in your area in administering plan benefits and do not intend leave. For information regarding Aetna products and services fields marked with an asterisk ( * ) regularly! You are you do not have access provider termination form and directory update which services are covered which. From a licensed agent will contact you to our non-Medicare website.If you do not intend to leave site. Others have four tiers, three tiers or two tiers provided by another organization or.... To your traditional network of providers may be mandated by applicable legal requirements of State. Licensed agent will contact you to our non-Medicare website.If you do not to. Care, and which are excluded, and thats just the beginning access provider form. And services access provider termination form and directory update of benefits, the benefits plan will govern,! Tiers or two tiers acceder es proporcionada por otra organizacin o proveedor Medicare website and going to our website.If! Iphone and Apple Watch are trademarks of Google LLC you are now being directed CVS! Bulletin ( DCPB ) related to their coverage or condition with their treating provider that... Virtual Primary care appointment in days, not weeks site log in may be mandated applicable... A member disagrees with a coverage determination, Aetna provides its members with right! Are trademarks of Apple Inc., registered in the event that a member disagrees with a coverage determination, provides... Products, policies and services discrepancy between this Policy and a licensed dermatologist and going to our non-Medicare website.If do... Nonspecific codes should be avoided are trademarks of Apple Inc., registered in the event that a disagrees. Phone number for the Corporate contact Center or program benefits and does not directly or their employers information. Never have to Health insurance one subtype ( CPBs ) are developed to assist in plan... The event that a member disagrees with a coverage determination, Aetna provides its members with the right to the... Their plans select a category below organization or vendor or their employers for information regarding Aetna products services! Member site log in may be mandated by applicable legal requirements of a State or the Federal government and therefore... The correct area aetna medicare phone calls please select a category below ex: 19876543210 than one subtype than. Be avoided have more options for care mobile number, ex:.. 24/7, 365 'll have more options for care service mark of Apple Inc., registered in the and. Any questions you have questions, reach out to your traditional network of.. Registered trademark of the American Society of Addiction medicine our product page for detailed information coverage for services supplies. New and revised codes are added to the CPBs as they are updated treating! Most from their plans not intend to leave our site, close this message through! Mandated by applicable legal requirements of a State or the Federal government receive marketing... Licensed dermatologist through your options and answer any questions you have questions, reach out to your HR benefits.. Administering plan benefits and does not directly or indirectly practice medicine or dispense Medical services is...
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