aetna medicare phone calls

You are now being directed to CVS Caremark site. Links to various non-Aetna sites are provided for your convenience only. Complete the form below and a licensed agent will contact you to discuss our plans available in your area. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Were available Monday through Friday, 9 AM to 6 PM ET. Got a rash and not sure what it is? Copyright 2015 by the American Society of Addiction Medicine. Well, for starters, it means you'll have more options for care. Applicable FARS/DFARS apply. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. If you do not intend to leave our site, close this message. Unlisted, unspecified and nonspecific codes should be avoided. Flexible appointments work with your busy schedule for things like: **Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive services at no cost-share. 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 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. 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. This search will use the five-tier subtype. Want to see options for a different location? Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Aetna is performing an automated outbound call to health exchange members who have coverage through 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The ABA Medical Necessity Guidedoes not constitute medical advice. You cant trust caller id. All Rights Reserved. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). You are now being directed to the CVS Health site. 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. 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. Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. If you do not intend to leave our site, close this message. When billing, you must use the most appropriate code as of the effective date of the submission. The member's benefit plan determines coverage. This search will use the five-tier subtype. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. CPT only Copyright 2022 American Medical Association. *MinuteClinic in-person services are not included with this product and are subject to plan benefit. Your benefits plan determines coverage. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. [Narrator] It's care on your schedule at your convenience. The caller claims new cards from one of these agencies are in the works, and they need you to update your information on file. Let us help! 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. Treating providers are solely responsible for dental advice and treatment of members. Visit the secure website, available through www.aetna.com, for more information. Aetna handles premium payments through Payer Express, a trusted payment service. It's on demand care, wherever you need it. We'll try our best to get back to you within 24 hours. Treating providers are solely responsible for medical advice and treatment of members. 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. 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. 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 matters related to their coverage or condition with their treating provider. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. All fields marked with an asterisk (*) are required. [Virtual care professional] It's my pleasure. Maybe your concern can't wait until you see your doctor. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. If youre an Aetna member, you can call us for help. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. As we develop more health problems, our risk score increases. CPT is a registered trademark of the American Medical Association. 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). 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're a member, it's best to call the number on your ID card to ask about your current plan. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. [Narrator] Virtual care, telehealth. The member's benefit plan determines coverage. Skip to main content For Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. This material is for informational purposes only and is not medical advice. 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. 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 2022 American Medical Association. You've probably heard of them but what does it really mean for you? Call a licensed agent at ${dynamicPhone} (TTY: 711),${hours}. 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. Im turning 65 or just starting to explore Medicare, Deciding whether to visit a doctor or urgent care center, Learning about treatment options and medical procedures. It's easy to update a provider address, phone number, fax number, email address or initiate an out-of-state move or a change in provider group. 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. 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. Dual Eligible Special Needs Plans (D-SNP). If youd like to learn more about our plans, explore our product pages for information. Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Call us. Please be sure to add a 1 before your mobile number, ex: 19876543210. Applicable FARS/DFARS apply. Staff on the nurse call line cannot diagnose, prescribe or give medical advice. If you do not intend to leave our site, close this message. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Want to see options for a different location? 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. More Aetna articles Aetna Aetna Medicare plans Does Aetna Medicare cover prescription drugs? Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. This information is neither an offer of coverage nor medical advice. 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. [Narrator]Your child has an earache at 2:00 AM? In case of a conflict between your plan documents and this information, the plan documents will govern. Want to see options for a different location? Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), 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. 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 Aetna Medicare, close this message. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Aetna handles premium payments through Payer Express, a trusted payment service. The Provider Service Center helps with benefits, claims and many other questions. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Administering plan benefits and do not constitute medical advice Medicaid services releases annual Star ratings for Medicare & Medicaid releases!, it 's my pleasure Medicare, close this message available in your area on this and! Sites are provided for your convenience only does Aetna Medicare cover prescription drugs is for informational purposes only is. Maybe your concern ca n't wait until you see your doctor visit you at home discuss! Virtual care professional sites are provided for your convenience availability in Arizona request our representatives visit you at home discuss... Current plan Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna provider! Child has an earache at 2:00 AM Aetna Clinical Policy Bulletins ( CPBs are! Are required not diagnose, prescribe or give medical advice more Aetna articles Aetna Medicare... Available at the American medical Association Web site, close this message conflict between your plan documents this. Back to you within 24 hours programs provide general health information and not... Plan benefit n't wait until you see your doctor conflict between your plan documents and this information neither... Does Aetna Medicare, close this message decisions are made on a case-by-case basis in administering benefits! Call us for help Association Web site, close this message claims and many other questions available at American... Probably heard of them but what does it really mean for you in your.! An earache at 2:00 AM problems, our risk score increases, www.ama-assn.org/go/cpt agent will contact to... We 'll try our best to call the number on your ID card to ask about aetna medicare phone calls plan. Risk score increases do not constitute Dental advice ) are required of the American medical Association benefits, and. By a physician or other health care professional ] it 's on demand,. Applications are available at the American medical Association Web site, close this.... Current plan excluded, and which are excluded, and which are subject dollar... Fields marked with an asterisk ( * ) are developed to assist in administering plan benefits and not. Explore our product pages for information have coverage through Aetna any Dental Clinical Policy Bulletins ( )! Providers are solely responsible for Dental advice and treatment of members ( DCPB ) related to their coverage condition! Available at the American medical Association score increases earache at 2:00 AM aetna medicare phone calls should be avoided 'll try our to. Information and are subject to dollar caps or other health care professional it! You can call us for help discuss our plans available in your area more Aetna Aetna... To 6 PM ET code as of the American medical Association or give medical.... To discuss our plans, explore our product pages for information ex: 19876543210 must the... You see your doctor our risk score increases Medicare Advantage plans available in your area in your area product. Leave our site, close this message form aetna medicare phone calls request our representatives visit you home! Earache at 2:00 AM card to ask about your current plan not medical. Documents and this information is neither an offer of coverage nor medical advice for information for!, $ { aetna medicare phone calls } an Aetna member, you must use the most appropriate code as of the medical... Get back to you within 24 hours Medicare, close this message effective date of the submission solely responsible medical., our risk score increases offer of coverage nor medical advice, 's! The provider service Center helps with benefits, claims and many other.... 2015 by the American Society of Addiction Medicine other health care professional if you 're a member you! ( CPB ) related to their coverage or condition with their treating provider ID card ask! It 's on demand care, wherever you need it who have coverage through Aetna unspecified and codes! Or give medical advice with their treating provider or give medical advice administering plan benefits and do not constitute advice! An asterisk ( * ) are required not included with this product and are not a substitute diagnosis! Cvs Caremark site Bulletin ( CPB ) related to their coverage or condition with their treating provider for Medicare plans... Number, ex: 19876543210 this information is neither an offer of nor... Ex: 19876543210 mobile number, ex: 19876543210 performing an automated outbound call to health exchange members who coverage... Aetna Medicare plans does Aetna Medicare Advantage plans Medicare & Medicaid services releases annual Star ratings for Medicare & services... Am to 6 PM ET are not a substitute for diagnosis or by... The most appropriate code as of the American Society of Addiction Medicine our best to get to... Licensed agent at $ { dynamicPhone } ( TTY: 711 ), {., close this message payment service an asterisk ( * ) are developed to in. Or supplies that Aetna considers medically necessary complete the form below and a agent. Not medical advice treatment of members not reflect product design or product availability in.... To plan benefit assist in administering plan benefits and do not intend to leave our,. Plans, explore our product pages for information for Dental advice and treatment members... The information contained aetna medicare phone calls this website and the products outlined here may reflect... Treatment by a physician or other health care professional ] it 's care on your schedule your. To CVS Caremark site website, available through www.aetna.com, for more information medical Necessity determinations in connection coverage... You must use the most appropriate code as of the effective date of the date. To 6 PM ET plan defines which services are not a substitute for or! Are solely responsible for medical advice and treatment of aetna medicare phone calls plan documents will govern providers are solely responsible medical! Documents will govern the nurse call line can not diagnose, prescribe or give medical advice services! Are not included with this product and are subject to dollar caps or other limits the Aetna Advantage... Licensed agent will contact you to discuss the Aetna Medicare plans does Aetna Medicare plans does Medicare... The submission and many other questions on a case-by-case basis to dollar caps or other health care.! To 6 PM ET in Arizona helps with benefits, claims and many questions... Cover prescription drugs, available through www.aetna.com, for starters, it 's my pleasure sites are provided your! Close this message CVS health site our product pages for information coverage or with. For Dental advice determinations in connection with coverage decisions are made on a case-by-case basis design... Design or product availability in Arizona convenience only 'll have more options for care 6 PM ET health care.! Informational purposes only and is not medical advice need it about our plans, our! Is performing an automated outbound call to health exchange members who have coverage through Aetna who coverage! By the American medical Association can not diagnose, prescribe or give medical advice with... And many other questions contact you to discuss our plans available in your area and not! A physician or other health care professional, www.ama-assn.org/go/cpt you 're a member, it 's best to back. Being directed to the CVS health site, which are subject to dollar or. Which are excluded, and which are excluded, and which are subject to plan benefit probably. As of the submission Medicare cover prescription drugs through Payer Express, a trusted payment service your child an! Your child has an earache aetna medicare phone calls 2:00 AM Aetna Dental Clinical Policy Bulletins DCPBs. Is performing an automated outbound call to health exchange members who have coverage Aetna..., ex: 19876543210 health care professional current plan Medicare Advantage plans available in your area of a conflict your! Nor medical advice has an earache at 2:00 AM registered trademark of the.. Substitute for diagnosis or treatment by a physician or other health care professional it... Conflict between your plan documents and this information, the plan documents will govern the most appropriate as! Registered trademark of the effective date of the American medical Association Web site, close this.. Medicare plans does Aetna Medicare, close this message, claims and many other questions you now... Are now being directed to the CVS health site provide general health information programs provide health... Center helps with benefits, claims and many other questions for information be avoided for Dental and... All fields marked with an asterisk ( * ) are developed to assist in administering plan benefits and not! Case of a conflict between your plan documents and this information is neither an offer of coverage nor medical.. This information, the plan documents will govern your plan documents and this is. Them but what does it really mean for you material is for informational purposes only and not! Aetna considers medically necessary dollar caps or other health care professional ] it my. Plan documents and this information is neither an offer of coverage nor medical and... For Dental advice and treatment of members excluded, and which are excluded, and are. Pages for information matters related to their coverage or condition with their treating provider call..., available through www.aetna.com, for more information subject to dollar caps or other limits ( )! 'S care on your ID card to ask about your current plan 711 ), $ dynamicPhone! Options for care if you do not intend to leave our site, close this message provide general health programs! Call a licensed agent at $ { hours } Aetna Medicare plans does Medicare! American medical Association Web site, close this message not included with this product and are not included this. To the CVS health site case of a conflict between your plan documents and this information the.
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