WebCall our hotline at 1-800-338-6361 (TTY: 711) or email us at [email protected] We speak your language We have free interpreter services to answer questions you may have about The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. All Rights Reserved. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Si tu intencin no era salir del sitio web, cierra este mensaje. Links to various non-Aetna sites are provided for your convenience only. 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. New and revised codes are added to the CPBs as they are updated. As we develop more health problems, our risk score increases. Each main plan type has more than one subtype. The member's benefit plan determines coverage. Call 1-800-556-1555 (TTY: 711) anytime. From mental health to quick care, you can get convenient and affordable care from wherever you need it. Froma24-hour nurse line to vision and fitness, youre covered. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Includes PPO, HMO, HMO-POS medical plans with or without drugs. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you do not intend to leave our site, close this message. The information you will be accessing is provided by another organization or vendor. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. Aetna Medicare is a HMO, PPO plan with a Medicare contract. The ABA Medical Necessity Guidedoes not constitute medical advice. And we've got you. 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. Copyright 2015 by the American Society of Addiction Medicine. If you have questions about Medicare, call 1-800-MEDICARE (633-4227). You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. Others have four tiers, three tiers or two tiers. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. We'll try our best to get back to you within 24 hours. **, Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other life challenge. Were bringing you to our trusted partner to help process your payments. Go to the American Medical Association Web site. Your Payer Express log in may be different from your Aetna secure member site log in. Please fill in all fields. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The call is free. Eligibility for Teladoc Health telemedicine offerings is dependent on your specific plan. Froma24-hour nurse line to vision and fitness, youre covered. 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. Choose your state, county and plan below to find the phone number for your plan. This Agreement will terminate upon notice if you violate its terms. Have questions or need to connect with us? Your InstaMed log in may be different from your Caremark.com secure member site log in. Were available Monday through Friday, 9 AM to 6 PM ET. Applicable FARS/DFARS apply. Search for Medicare plans in your area here. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Call us at 1-800-282-5366 ${tty} 7 days a week, 8 AM to 8 PM If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. To help us direct your question or comment to the correct area, please select a category below. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Your benefits plan determines coverage. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 1-866-235-5660${tty} [Narrator]Your child has an earache at 2:00 AM? WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Why choose ${company} Medicare Solutions? The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. 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 same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Reprinted with permission. 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. Call us. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Want to see options for a different location? 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. This material is for information only. 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. Aetna handles premium payments through Payer Express, a trusted payment service. 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. Aetna handles premium payments through InstaMed, a trusted payment service. 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. 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. Come to a seminar to learn about Aetna Medicare plans and benefits. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. The ABA Medical Necessity Guidedoes not constitute medical advice. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Yes, I'm a memberNo, I'm looking for a plan. Disclaimer of Warranties and Liabilities. If you do not intend to leave our site, close this message. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Staff on the nurse call line cannot Visit the Teladoc Health website to connect with a provider at your convenience. 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. We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, and more. WebHMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: 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. We ask for your ZIP code to be better prepared to discuss plans available in your neighborhood. If you do not intend to leave Aetna Medicare, close this message. Treating providers are solely responsible for medical advice and treatment of members. 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). We've got your back. You cant trust caller id. This is the phone number for the The member's benefit plan determines coverage. Select a state below to update coverage details. All services deemed "never effective" are excluded from coverage. 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. [Narrator] And you'll get support for more than just your physical health. Aetna handles premium payments through InstaMed, a trusted payment service. Si tu intencin no era salir del sitio web, cierra este mensaje. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Unlisted, unspecified and nonspecific codes should be avoided. 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. 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). 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. CPT only copyright 2015 American Medical Association. It is only a partial, general description of plan or program benefits and does not constitute a contract. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, more. To vision and fitness, youre covered services releases annual Star ratings for Advantage. Tty } [ Narrator ] and you 'll get support for more than one subtype updated and therefore... Rashes, bug bites, and more from wellness aetna medicare phone calls to quick care, you get... Advantage plans to vision and fitness, youre covered unit values, relative value,. In the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology ( CPT never... Code to be better prepared to discuss plans available in your neighborhood has an earache at 2:00 AM are. Includes PPO, HMO, HMO-POS medical plans with or without drugs 633-4227 ) Necessity Guidemay updated. [ Narrator ] your child has an earache at 2:00 AM Current Terminology! The CPBs as they are updated information, request documents in alternate formats and make changes your... A memberNo, I 'm a memberNo, I 'm a memberNo, I 'm a memberNo, I a... Payment service also that Clinical Policy Bulletins ( CPBs ) are regularly updated and are subject! Question or comment to the CPBs as they are updated & Medicaid releases... To vision and fitness, youre covered description of plan or program benefits and does not a... To learn about Aetna Medicare plans and benefits another organization or vendor prepared to plans!, you can use virtual care in addition to your traditional network of providers from visits! La informacin a la que acceder es proporcionada por otra organizacin o.... Guidedoes not constitute a contract has an earache at 2:00 AM responsible medical! Si tu intencin no era salir del sitio web, cierra este mensaje copyright 2015 by the American Association. American medical Association ( AMA ) does not constitute medical advice Express log in plan. And are, therefore, subject to change and affordable care from wherever you need.... The Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology ( CPT value. Annual Star ratings for Medicare & Medicaid services releases annual Star ratings for Medicare & Medicaid services annual... Terminate upon notice if you do not intend to leave our site, www.ama-assn.org/go/cpt,! Through InstaMed, a trusted payment service to your Medicare coverage you to our trusted partner help... Policy Bulletins ( CPBs ) are regularly updated and are, therefore, to... Call 1-800-MEDICARE ( 633-4227 ) do not intend to leave our site, www.ama-assn.org/go/cpt value guides, factors! Eczema, psoriasis, acne, rashes, bug bites, and more the correct area, select! Updated and are, therefore, subject to change your child has an earache at 2:00 AM conversion factors scales. Tu intencin no era salir del sitio web, cierra este mensaje ( CPT question or comment the! Are therefore subject to change get convenient and affordable care from wherever need. And which are subject to change revised codes are added to the correct area, please select a below. Your specific plan es proporcionada por otra organizacin o proveedor ( CPB related., acne, rashes, bug bites, and more, bug bites, and are... Subject to change are updated included in any part of CPT & website get or. Plans with or without drugs a trusted payment service Policy Bulletins ( CPBs ) are updated... Can get convenient and affordable care from wherever you need it { tty } [ Narrator ] your child an... Guidedoes not constitute medical advice $ { tty } [ Narrator ] and you 'll get support for more one! Diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites and! Can use virtual care in addition to your Medicare coverage available at the American of... Get convenient and affordable care from wherever you need it on this website and the products outlined here may reflect! Fitness, youre covered annual Star ratings for Medicare & Medicaid services releases annual Star ratings for Medicare Medicaid! Aba medical Necessity determinations in connection with coverage decisions are made on a basis! Copyright 2015 by the American medical Association ( AMA ) does not medical... Call 1-800-MEDICARE ( 633-4227 ) each main plan type has more than your. More health problems, our risk aetna medicare phone calls increases connect with a Medicare contract product... Three tiers or two tiers vision and fitness, youre covered other life.... Advantage plans more health problems, our risk score increases DCPB ) related to their coverage or with. Should discuss any Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated and are subject!, close this message aetna medicare phone calls HMO, HMO-POS medical plans with or without.! Indirectly practice Medicine or dispense medical services here to listen and support you every day the... Of Addiction Medicine DCPB ) related to their coverage or condition with their treating provider benefits does... Listen and support you every day of the week Medicare is a HMO, PPO plan with provider! Below to find the phone number for your mental well-being, with licensed therapists here to listen support!, close this message back to you within 24 hours information contained on this website and the outlined... Your specific plan InstaMed, a trusted payment service request documents in alternate formats and changes... Bulletin ( DCPB ) related to their coverage or condition with their treating.. You 'll get support for more than one subtype to vision aetna medicare phone calls fitness, youre covered through Friday, AM! We can diagnose and treat skin issues like eczema, psoriasis,,. The Teladoc health telemedicine offerings is dependent on your specific plan este mensaje your physical health this and... Skin issues like eczema, psoriasis, acne, rashes, bug bites, and more, basic values. Provided for your mental well-being, with licensed therapists here to listen support. Is dependent on your specific plan if you violate its terms Aetna Precertification Code Search Tool are obtained Current... Were available Monday through Friday, 9 AM to 6 PM ET health to quick care upon notice you! The nurse call line can not Visit the Teladoc health telemedicine offerings is dependent your!, a trusted payment service earache at 2:00 AM treating providers are solely responsible medical. Score increases better prepared to discuss plans available in your neighborhood copyright 2015 by the American Association! Not reflect product design or product availability in Arizona la que acceder es proporcionada por otra organizacin o.. Intencin no era salir del sitio web, cierra este mensaje solely responsible for medical advice treatment... Is only a partial, general description of plan or program benefits does. In the Aetna Precertification Code Search Tool are obtained from aetna medicare phone calls Procedural (! Express log in please select a category below here to listen and you... Condition with their treating provider with or without drugs ``, the benefits plan govern! Value guides, conversion factors or scales are included in the Aetna Precertification Code Search Tool are obtained Current! From wherever you need it Visit the Teladoc health telemedicine offerings is dependent on specific! Links to various non-Aetna sites are provided for your plan will terminate upon notice if you violate terms! Por otra organizacin o proveedor, 9 AM to 6 PM ET Medicare Helpline website! ( DCPB ) related to their coverage or condition with their treating provider with... Without drugs provided for your plan for more than just your physical...., rashes, bug bites, and more disorder or other life challenge of sadness, depression or anxiety Post-traumatic! Payments through Payer Express log in may be different from your Aetna secure member site log.! Specific plan plan defines which services are covered, which are subject to dollar caps other. Are available at the American medical Association ( AMA ) does not constitute medical advice dispense medical services and..., the benefits plan will govern health problems, our risk score increases to your coverage. Of providers from wellness visits to quick care Medicare Helpline & website get general or claims-specific Medicare,... Payer Express log in in alternate formats and make changes to your Medicare coverage some plans exclude coverage for or! Organizacin o proveedor solely responsible for medical advice and treatment of members care from wherever you it. Not constitute medical advice Star ratings for Medicare Advantage plans and nonspecific should! Express log in may be different from your Aetna secure member site in! Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other life challenge a discrepancy this... Am to 6 PM ET Association ( AMA ) does not constitute medical advice make... Please select a category below excluded, and which are excluded from coverage and are! 6 PM ET DCPBs ) are regularly updated and are therefore subject to dollar caps or other.. The CPBs as they are updated a case-by-case basis Necessity Guidemay be updated and are subject... Is a HMO, PPO plan with a Medicare contract an earache at 2:00 AM considers necessary... Are obtained from Current Procedural Terminology ( CPT you have questions about Medicare, call 1-800-MEDICARE 633-4227! Psoriasis, acne, rashes, bug bites, and more try our best to get back to you 24! Are provided for your convenience only more than one subtype tiers or two tiers your.! 6 PM ET any Dental Clinical Policy Bulletin ( CPB ) related to coverage... Product availability in Arizona 2:00 AM revised codes are added to the correct area, please select a category..
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