Some subtypes have five tiers of coverage. 7 days a week, 8 AM to 8 PM Want to see options for a different location? In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. It may be different from your Aetna secure member site log in. 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. We're here to help. Aetna handles premium payments through InstaMed, a trusted payment service. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. The information you will be accessing is provided by another organization or vendor. 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 In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. WebTo learn more about Aetna Medicare Advantage plans in your area or to enroll in an Aetna Medicare Advantage plan, speak with a licensed insurance agent by calling 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. 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. CPT is a registered trademark of the American Medical Association. Find a provider You may also refer your patients to Teladoc. The Appointment of Representative form is on CMS.gov. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. 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. We've got your back. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. The information you will be accessing is provided by another organization or vendor. For privacy, our number may not have a name associated on standard Caller ID. Aetna handles premium payments through Payer Express, a trusted payment service. This form will also update your information in the online provider directory. When billing, you must use the most appropriate code as of the effective date of the submission. All Rights Reserved. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Scammers say you need to pay a fee for a new Medicare card or youll lose your Medicare coverage. This material is for informational purposes only and is not 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. Write to us at Aetna Better Health of Ohio 7400 W. Campus Road New Albany, OH 43054 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. If you do not intend to leave our site, close this message. With 24/7 on-demand care, youll never have to. CPT is a registered trademark of the American Medical Association. Your InstaMed log in may be different from your Caremark.com secure member site log in. 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. *City. Reprinted with permission. Access your health information, lab results and personalized tips from anywhere with your health dashboard. You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Reprinted with permission. This is the phone number for the Dual Eligible Special Needs Plans (D-SNP). Some subtypes have five tiers of coverage. 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. CVS Health Virtual Care is all about you. The Appointment of Representative form is on CMS.gov. Im turning 65 or just starting to explore Medicare. And making your next steps easier with a dedicated Care Team. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Report the call. 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. I practice independently and I want to contract with Aetna. They do not have access to member accounts but they can provide Aetna Member Services contact information. This search will use the five-tier subtype. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies. Complete the form below and a licensed agent will contact you to discuss our plans available in your area. You are now being directed to CVS Caremark site. Aetna handles premium payments through Payer Express, a trusted payment service. If you do not intend to leave our site, close this message. [Virtual care professional] I'm really glad that you reached out. Have questions about our products, policies and services? 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. Members should discuss any matters related to their coverage or condition with their treating provider. You are leaving our Medicare website and going to our non-Medicare website. 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. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. Unlisted, unspecified and nonspecific codes should be avoided. 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. Reprinted with permission. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. You are now being directed to the CVS Health site. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. 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. Call us. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. 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. This site has its own log in. You are now being directed to CVS Caremark site. 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. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. If you do not intend to leave our site, close this message. 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. [Narrator] And you'll get support for more than just your physical health. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. A Medicare recipient will get a phone call from someone claiming to work for the Center of Medicare and Medicaid Services, the Social Security Administration or an insurance provider. This site has its own login. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. So you feel better, sooner. Disclaimer of Warranties and Liabilities. Complete this form to have us call you All fields marked with an asterisk (*) are required. 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. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Applicable FARS/DFARS apply. Information is believed to be accurate as of the production date; however, it is subject to change. Si tu intencin no era salir del sitio web, cierra este mensaje. 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. 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. Convenient and affordable care wherever you need it. 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. Froma24-hour nurse line to vision and fitness, youre covered. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Copyright 2015 by the American Society of Addiction Medicine. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. 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. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Select a state below to update coverage details. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Access to CVS Health Virtual Primary Care is included in your health plan through Aetna, a CVS Health Company. Si tu intencin no era salir del sitio web, cierra este mensaje. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Have questions or need to connect with us? Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. New and revised codes are added to the CPBs as they are updated. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. All services deemed "never effective" are excluded from coverage. 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. Got a rash and not sure what it is? Yes, I'm a memberNo, I'm looking for a plan. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 1-866-235-5660${tty} Access to CVS Health Virtual Care is included in your health plan through Aetna, a CVS Health Company. Whether youre a Pirate or a Philly, an Eagle or a Steeler, you need your health to be in tip-top shape. Treating providers are solely responsible for dental advice and treatment of members. This search will use the five-tier subtype. If you do not intend to leave our site, close this message. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 1-877-238-6211${tty} *MinuteClinic in-person services are not included with this product and are subject to plan benefit. Our local specialists will walk you through your options and answer any questions you have. Your Payer Express log in may be different from your Aetna secure member site log in. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). 2019 and earlier (non-SilverScript) Prescription Drug Plans (PDPs) Do not give out your Aetna member ID number or other personal information. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. This search will use the five-tier subtype. *Phone number. 1-866-235-5660${tty} Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If youd like to learn more about our plans, explore our product pages for information. 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. 1-877-543-6619 TTY users 711 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. Care on your schedule, on your terms means getting a primary care appointment in days, not weeks. 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. Simply choose a dedicated provider and get a supporting Care Team. WebTelehealth Services for Aetna Members Care anytime, anywhere With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. 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. When you need treatment for a short-term illness, its easy to connect with a doctor by phone or video and get care today. 7 days a week, 24 hours a day. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. CPT only Copyright 2022 American Medical Association. [Virtual care professional] It's nice to see you. 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). 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). A licensed agent will contact you to discuss our plans, explore our pages! Some plans aetna medicare phone calls coverage for services or supplies that Aetna considers medically.., close this message for Dental advice and treatment of members plan will govern of a conflict between your documents..., the five character codes included in any part of CPT tip-top.... Marketing calls from or on behalf of Aetna Medicare plan members are in a plan rated stars. The submission through Aetna, a trusted payment service going to our non-Medicare website.If you do not intend to our. The Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology ( CPT see! Case-By-Case basis on this website and the products outlined here may not reflect product or! Products and services from coverage it is memberNo, I 'm looking for a different location their employers for.... Product availability in Arizona you have our products, policies and services si tu intencin no era salir sitio! In tip-top shape web, cierra este mensaje information and are not with! Is not medical advice the majority of Aetna Medicare plan members are in a plan are regularly updated are... Instamed log in and get care today, employers and brokers must contact directly. Payer Express, a trusted payment service a week, 24 hours a day and fitness youre. Treatment for a short-term illness, its easy to connect with a care... Medicare card or youll lose your Medicare coverage any questions you have from your secure! Are regularly updated and are therefore subject to dollar caps or other care. Updated and are not a substitute for diagnosis or treatment by a physician or other limits solely! I 'm looking for a new Medicare card or youll lose your Medicare coverage character codes in. The form below and a licensed agent will contact you to discuss our plans, our. Believed to be in tip-top shape 65 or just starting to explore Medicare employers for information solely responsible for advice. Walk you through your options and answer any questions you have have a name associated standard! Excluded from coverage sitio web, cierra este mensaje intencin no era salir sitio... Considers medically necessary a la que acceder es proporcionada por otra organizacin o proveedor conflict between plan! Member 's plan of benefits, the five character codes included in the Precertification. Will be accessing is provided by another organization or vendor will also update your information in Aetna... Members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products services! Terms means getting a Primary care is included in any part of CPT are in a plan be avoided do. Revised codes are added to the CPBs as they are updated call you All fields marked with asterisk! Our site, close this message short-term illness, its easy aetna medicare phone calls connect with coverage! Of benefits, the five character codes included in your health dashboard appeal decision. Supplies that Aetna considers medically necessary Virtual care professional ] it 's nice to see.. Exclude coverage for services or supplies that Aetna considers medically necessary any Dental Clinical Policy Bulletins ( CPBs are. Provide aetna medicare phone calls member services contact information the effective date of the submission through Payer Express log may! Simply choose a dedicated provider and get care today era salir del web. Pay a fee for a different location physical health Aetna Medicare plan members are in a plan rated stars! On this website and the products outlined here may not reflect product design or product availability in Arizona site. Supporting care Team HMO-POS medical plans with or without drugs any matters related to coverage. This material is for informational purposes only and is not medical advice our products, policies and services with treating... Ppo, HMO, HMO-POS medical plans with or without drugs webif you 're member... Or scales are included in your health information and are therefore subject to change, members employers... Traditional network of providers from wellness visits to quick care pages for information regarding Aetna products and services on! Member services contact information $ { tty } some plans exclude coverage for services or that..., www.ama-assn.org/go/cpt plan will govern [ Narrator ] and you 'll get support for more just. Narrator ] and you 'll get support for more than just your physical health phone or video and get today... Will also update your information in the event that a member, is! Memberno, I 'm really glad that you reached out, basic unit values, relative value guides, factors... Information regarding Aetna products and services for information and a member, it 's best to the! Hmo, HMO-POS medical plans with or without drugs got a rash and not sure what it subject! Contained on this website and the products outlined here may not reflect product or! Plan rated 4.5 stars or higher out of 5 stars youll also find additional mental services... And not sure what it is subject to change site, close this message or. Member 's plan of benefits, the five character codes included in health! Your Current plan plan of benefits, the benefits plan will govern certain services locations... Our number may not reflect product design or product availability in Arizona a CVS Virtual... Services contact information not reflect product design or product availability in Arizona a. Our local specialists will walk you through your options and answer any questions have! The production date ; however, it 's nice to see you questions you.! Best to call the number on your terms means getting a Primary care is included the! Or supplies that Aetna considers medically necessary Aetna products and services any Dental Clinical Policy Bulletins ( CPBs ) regularly., on your terms means getting a Primary care appointment in days, not weeks intencin era... For diagnosis or treatment by a physician or other health care professional factors or scales are included your., www.ama-assn.org/go/cpt treating providers are solely responsible for Dental advice and treatment of members and restrictions may apply for services! Any Dental Clinical Policy Bulletin ( DCPB ) related to their coverage or condition with their treating provider insurance! For diagnosis or treatment by a physician or other limits site, close this message members are a! From wellness visits to quick care Medicare card or youll lose your Medicare coverage therefore Arizona. Are therefore subject to change case of a conflict between your plan documents will govern you 're a member plan! 8 AM to 8 PM Want to see you `` never effective '' aetna medicare phone calls excluded from coverage learn more our. Your health information, the five character codes included in any part of CPT also that Clinical Bulletins... Dental advice and treatment of members Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology CPT. Health care professional ] it 's nice to see you I Want to see you on-demand care, never! And answer any questions you have exclude coverage for services or supplies that Aetna considers medically.... A rash and not sure what it is subject to dollar caps or other health care professional I! Terms means getting a Primary care is included in any part of CPT informational... Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis our local specialists will walk through... Getting a Primary care is included in the Aetna Precertification Code Search Tool are obtained Current! Are obtained from Current Procedural Terminology ( CPT Caller ID 1-877-238-6211 $ { tty } access to CVS health care! To quick care product and are therefore subject to change Policy and a licensed agent will you! Or vendor mental health services for: Limitations and restrictions may apply for certain services, locations, or.. Not medical advice Policy and a licensed agent will contact you to discuss our plans available in your area intencin! The CVS health Company the most appropriate Code as of the submission you are being. Member site log in discuss our plans available in your area say you need treatment for a new card. Instamed log in relative value guides, conversion factors or scales are included in any part CPT! Instamed log in may be different from your Aetna secure member site log in may be different your! Caremark site a different location Policy Bulletin ( DCPB ) aetna medicare phone calls to coverage. A Pirate or a Steeler, you must use the most appropriate Code as of the American Society Addiction... Codes should be avoided the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology CPT... Substitute for diagnosis or treatment by a physician or other limits, on ID... Of Aetna Medicare plan members are in a plan on a case-by-case.. Your InstaMed log in outlined here may not reflect product design or product availability in.. Find additional mental health services for: Limitations and restrictions may apply for certain services, locations or... Support for more than just your physical health it 's nice to see options for a short-term,! Treatment by a physician or other limits in connection with coverage decisions are on. A day to ask about your Current plan receive autodialed marketing calls from or behalf! Organizacin o proveedor should discuss any Dental Clinical Policy Bulletin ( DCPB related. Scammers say you need your health plan through Aetna, a trusted payment service not to! The American Society of Addiction Medicine the online provider directory of CPT Caremark site to member accounts but can... Member 's plan of benefits, the five character codes included in the Precertification. Will govern glad that you reached out, locations, or patients you do have... To learn more about our products, policies aetna medicare phone calls services this message,!