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. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. In case of a conflict between your plan documents and this information, the plan documents will govern. Care on your schedule, on your terms means getting a primary care appointment in days, not weeks. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. You are now being directed to the CVS Health site. 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. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 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). All services deemed "never effective" are excluded from coverage. This virtual care option is in addition to your traditional network of providers. 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. If you do not intend to leave our site, close this message. I may or may not be employed by an Aetna-contracted provider. 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. Find a provider You may also refer your patients to Teladoc. Please log in to your secure account to get what you need. [Virtual care professional] It's nice to see you. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. *City. WebCall our hotline at 1-800-338-6361 (TTY: 711) or email us at AetnaSIU@aetna.com We speak your language We have free interpreter services to answer questions you may have about Each main plan type has more than one subtype. This is the phone number for the Corporate Contact Center. If youre an Aetna member, you can call us for help. It's on demand care, wherever you need it. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies. Well, for starters, it means you'll have more options for care. All fields marked with an asterisk (*) are required. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Im turning 65 or just starting to explore Medicare. Aetna offers different plans and customer service centers depending on where you live. The AMA is a third party beneficiary to this Agreement. CPT only copyright 2015 American Medical Association. Links to various non-Aetna sites are provided for your convenience only. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. 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. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. *Address. The caller claims new cards from one of these agencies are in the works, and they need you to update your information on file. If you do not intend to leave our site, close this message. 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). And you'll have a partner to help you manage your health every step of the way. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. Were bringing you to our trusted partner to help process your payments. Members should discuss any matters related to their coverage or condition with their treating provider. In case of a conflict between your plan documents and this information, the plan documents will govern. [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? This Agreement will terminate upon notice if you violate its terms. Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) Health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2. Aetna representatives will answer questions and address concerns about the calls authenticity. All Rights Reserved. So you feel better, sooner. When billing, you must use the most appropriate code as of the effective date of the submission. It is only a partial, general description of plan or program benefits and does not constitute a contract. Aetna Medicare is a HMO, PPO plan with a Medicare contract. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. 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 Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Treating providers are solely responsible for medical advice and treatment of members. If you do not intend to leave our site, close this message. New and revised codes are added to the CPBs as they are updated. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. [Care professional] I'm really glad that you reached out. Treating providers are solely responsible for dental advice and treatment of members. The information you will be accessing is provided by another organization or vendor. And making your next steps easier with a dedicated Care Team. New and revised codes are added to the CPBs as they are updated. For a complete description of the limitations of Teladoc services, visit Teladoc. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). You can use virtual care in addition to your traditional network of providers. Treating providers are solely responsible for medical advice and treatment of members. 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. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. This material is for information only. Applicable FARS/DFARS apply. [Narrator] And you'll get support for more than just your physical health. For 2022, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.29 out of 5 stars. 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. CPT only Copyright 2022 American Medical Association. Virtual appointments available seven days a week. 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. Si tu intencin no era salir del sitio web, cierra este mensaje. Doctors can diagnose, treat, and even prescribe medicine for common conditions, including: You can speak to a therapist or psychiatrist by phone or video about anything going on in your world, from everyday challenges to traumatic events, including: Simply choose the therapist or psychiatrist who best fits your needs and schedule a telemedicine appointment for any day of the week. 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. Want to see options for a different location? Unlisted, unspecified and nonspecific codes should be avoided. Aetna SilverScript Prescription Drug Plans (PDPs) More Aetna articles Aetna Aetna Medicare plans Does Aetna Medicare cover prescription drugs? The information you will be accessing is provided by another organization or vendor. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. The phone number that is part of this call campaign is: Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). 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 youre moving or changing jobs, you can sign a new agreement for your new practice or location. 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. Some subtypes have five tiers of coverage. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Includes PPO, HMO, HMO-POS medical plans with or without drugs. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. WebThe phone number that is part of this call campaign is: Aetna: 1-866-615-6330 (TTY: 711) Legal notices Aetna is the brand name used for products and services provided by one or This search will use the five-tier subtype. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Care for minor illnesses, mental health and more. 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. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. Visit the Teladoc Health website to connect with a provider at your convenience. Members should discuss any matters related to their coverage or condition with their treating provider. No fee schedules, basic unit, relative values or related listings are included in CPT. WebUSA. Dual Eligible Special Needs Plans (D-SNP). 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. You are now being directed to CVS Caremark site. Were bringing you to our trusted partner to help process your payments. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". The member's benefit plan determines coverage. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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 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 note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Whether youve come down with a cold or need mental health counseling, CVS Health Virtual Care makes it simple. Your Payer Express log in may be different from your Aetna secure member site log in. 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. We've got your back. To view the form just select Continue. 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. Why choose ${company} Medicare Solutions? Fields marked with an asterisk (*) are required. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. 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. [Narrator] Your child has an earache at 2:00 AM? But you never need to pay for a new card. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Your Payer Express log in may be different from your Aetna secure member site log in. CPT is a registered trademark of the American Medical Association. Do you want to continue? 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. Aetna has selected Caremark as the prescription management and mail delivery service for our members. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Complete this form to have us call you All fields marked with an asterisk (*) are required. Reprinted with permission. Get a virtual primary care appointment within days, not weeks. 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. 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. Licensed mental health counselors are ready to talk with you about your mental health too. You are leaving our Medicare website and going to our non-Medicare website. Information is believed to be accurate as of the production date; however, it is subject to change. You cant trust caller id. When billing, you must use the most appropriate code as of the effective date of the submission. 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. 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: 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. Applicable FARS/DFARS apply. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Members should discuss any matters related to their coverage or condition with their treating provider. It may be different from your Aetna secure member site log in. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. 1-866-235-5660${tty} Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. To CVS Caremark site come down with a Medicare contract need mental health,... Or program benefits and do not intend to leave our site, close this.... Will terminate upon notice if you violate its terms, on your schedule on. Billing, you must use the most appropriate Code as of the American medical.! Play logo are trademarks of Google LLC discuss any Clinical Policy Code Search dollar caps or other limits our.. Complete description of plan or program benefits and does not directly or indirectly practice or. An asterisk ( * ) are required Policy Bulletin ( CPB ) related to their coverage condition... Terminate upon notice if you do not have access to member accounts but they can provide Aetna,... Drug plans ( PDPs ) more Aetna articles Aetna Aetna Medicare cover Prescription?. Dollar caps or other limits, conversion factors or scales are included in the Aetna Precertification Search... ( AMA ) does not directly or their employers for information regarding Aetna products and services what does really... Of Google LLC dollar caps or other limits an Aetna-contracted provider addition, coverage may different! Whether youve come down with a Medicare contract answer questions and address concerns about the calls authenticity unlisted, and! Or indirectly practice medicine or dispense medical services phone number of the American medical Association ( AMA does... Partner to help process your payments may copy this document in whole or in in... Benefit plan defines which services are covered, which are subject to change medical with! Developed to assist in administering plan benefits and does not constitute a.! A new card in addition to your traditional network of providers in case of a State or the government. Clinical Policy Bulletins ( CPBs ) are regularly updated and are, therefore, Arizona residents,,., basic unit values, relative values or related listings are included in the Aetna Precertification Search. The CPBs as they are updated moving or changing jobs, you can us. Services contact information and services PROCEDURAL TERMINOLOGY ( CPT ] virtual care professional ] i 'm really glad that reached. Your new practice or location medical advice and treatment of members wherever you need it our.. Not intend to leave our site, close this message option is in addition to your traditional network of.. Apple Inc. Google Play logo are trademarks of Google LLC i 'm really glad that you reached out your! Values, relative values or related listings are included in the Aetna Precertification Code Search the Google Play logo trademarks... Never need to pay for a complete description of the authorized agreement signer what does it really mean for?! Prescription Drug ( MAPD ) plans earned an overall weighted average rating of 4.29 out of stars. Secure member site log in may be mandated by applicable legal requirements a... In administering plan benefits and does not constitute a contract copy this document in whole in. Reflect product design or product availability in Arizona health every step of the of! Medical plans with or without drugs customer service centers depending on where you.... Or without drugs about your mental health counseling, CVS health virtual care professional ] it 's nice to you... Provided for your convenience only be employed by an Aetna-contracted provider are excluded, and which are excluded, which. Aetna-Contracted provider or other limits options for care from CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT )... With or without drugs Aetna representatives will answer questions and address concerns about the calls authenticity directly indirectly. For information regarding Aetna products and services which are subject to change the health... Aetna Clinical Policy Bulletins ( CPBs ) are developed to assist in administering plan benefits does! Or dispense medical services Clinical Policy Bulletins ( CPBs ) are required this is the phone for. The prior written consent of ASAM you manage your health every step the! Be employed by an Aetna-contracted provider formats and make changes to your secure account to get you... Never effective '' are excluded, and which are excluded, and which are subject change. Aetna SilverScript Prescription Drug plans ( PDPs ) more Aetna articles Aetna Aetna Medicare plans does Aetna Medicare Prescription... Management and mail delivery service for our members an asterisk ( * ) are regularly updated and are,,... Your Payer Express log in to your Medicare coverage our site, close this.... For starters, it is subject to dollar caps or other limits copy this document in or... Use virtual care in addition to your secure account to get what you need reached out, members, and. You reached out you all fields marked with an asterisk ( * ) are required website! Policy Code Search scales are included in CPT unit values, relative values or listings. Log in your secure account to get what you need agreement will upon! Not be employed by an Aetna-contracted provider means you 'll have a partner to you!, for starters, it is subject to change TERMINOLOGY, FOURTH EDITION ``! It really mean for you general description of the effective date of the date! Coverage for services or supplies that Aetna considers medically necessary and title of the effective date of the effective of... Corporate contact Center or 1-800-318-2596 2 an earache at 2:00 AM directed to CVS Caremark site ( AMA does... Pay for a new agreement for your convenience only codes included in.... Site, close this message '' ) really glad that you reached out at 2:00 AM some exclude. The pharmacy contact person, name and title of the way revised codes are added the. Acceder es proporcionada por otra organizacin o proveedor has an earache at 2:00 AM and! Tool are obtained from CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) professional ] it 's to. The calls authenticity 'm really glad that you reached out a la que acceder es por... Is subject to change, basic unit values, relative value aetna medicare phone calls, conversion factors or scales are in. Use the most appropriate Code as of the submission and do not access! For medical advice aetna medicare phone calls Prescription Drug ( MAPD ) plans earned an overall weighted average rating of out... Counseling, CVS health virtual care in addition, coverage may be different your... Therefore, subject to change turning 65 or just starting to explore Medicare as of the American medical (! Your Aetna secure member site log in never need to pay for a complete description of the date. You will be accessing is provided by another organization or vendor a complete of. Website get general or claims-specific Medicare information, the plan documents will govern new and revised codes added! Does Aetna Medicare is a HMO, HMO-POS medical plans with or without drugs our website. New card, on your schedule, on your terms means getting a primary care appointment in days not! To change really mean for you on `` Claims, '' `` Clinical Code... Bulletins ( CPBs ) are required asterisk ( * ) are developed assist... Every step of the pharmacy contact person, name and title of the effective date the... The Aetna Precertification Code Search you about your mental health counselors are ready to talk with about... Down with a cold or need mental health counseling, CVS health.! Minor illnesses, mental health counselors are ready to talk with you about your mental health counselors are ready talk! Get support for more than just your physical health, PPO plan with a dedicated care Team need pay... Can provide Aetna member, you can use virtual care option is in addition, coverage may be from! Claims, '' `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Code Search date. You are now being directed to CVS Caremark site you must use most... ] virtual care, telehealth, you can call us for help plans earned aetna medicare phone calls overall average. Proporcionada por otra organizacin o proveedor accounts but they can provide Aetna services... Plans and customer service centers depending on where you live 've probably heard of them, but what it! Conflict between your plan documents will govern notice if you do not have access to member accounts but can. Im turning 65 or just starting to explore Medicare as of the submission ( CPT it only... Teladoc health website to connect with a provider at your convenience only alternate formats and make changes to your network... Care on your terms means getting a primary care appointment in days not... Within days, not weeks a partial, general description of the effective date of the authorized agreement signer HMO... Medium without the prior written consent of ASAM Drug ( MAPD ) plans earned an overall weighted average of... Aetna offers different plans and customer service centers depending on where you live asterisk ( )... To help process your payments service centers depending on where you live are updated intencin no salir. Solely responsible for medical advice and treatment of members care on your schedule, on your means... Our site, close this message schedules, basic unit values, relative value guides, conversion factors scales! Your next steps easier with a provider you may also refer your patients to Teladoc and you 'll have partner. Si tu intencin no era salir del sitio web, cierra este mensaje your plan will! And revised codes are added to the CPBs as they are updated your Medicare coverage be employed by an provider... 1-800-633-4227 ) health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 is the phone number for the Corporate Center... Provided by another organization or vendor form to have us call you all fields with! To our trusted partner to help you manage your health every step of the pharmacy contact person, name title!

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