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. 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). App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. Any information we provide is limited to those plans we do offer in your area. 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. 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 No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If calls persist, consider discussing certain scam blocking features with your phone company. Convenient and affordable care wherever you need it. So you feel better, sooner. We received your request, and well get back to you shortly. Web1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET.. I'm glad you contacted us. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. I may or may not be employed by an Aetna-contracted provider. For others, request to use the Aetna logo. 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number for the Corporate Contact Center. They do not have access to member accounts but they can provide Aetna Member Services contact information. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Convenient care for short-term health needs. Scammers say you need to pay a fee for a new Medicare card or youll lose your Medicare coverage. You cant trust caller id. 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. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Your InstaMed log in may be different from your Caremark.com secure member site log in. This Agreement will terminate upon notice if you violate its terms. To view the form just select Continue. You are now being directed to CVS Caremark site. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. WebUSA. 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. Just like that. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. If you do not intend to leave our site, close this message. 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. Want to see options for a different location? And you can extend your care to be seen in-person with an in-network provider or schedule an appointment at your local Minute Clinic, just like that. For a complete description of the limitations of Teladoc services, visit Teladoc. Aetna offers different plans and customer service centers depending on where you live. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. 2019 and earlier (non-SilverScript) Prescription Drug Plans (PDPs) This information is neither an offer of coverage nor medical advice. Dual Eligible Special Needs Plans (D-SNP). 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. CPT only Copyright 2022 American Medical Association. Teladoc is not available to all members. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. 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. Disclaimer of Warranties and Liabilities. Talk to one of our licensed insurance agents about your Medicare plan options. 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 1-800-556-1555 (TTY: 711) anytime. Independent retail pharmacies can fill out the form at the link below. 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. All services deemed "never effective" are excluded from coverage. Have questions about our products, policies and services? Yes, I'm a memberNo, I'm looking for a plan. CPT is a registered trademark of the American Medical Association. Each main plan type has more than one subtype. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Others have four tiers, three tiers or two tiers. Copyright 2015 by the American Society of Addiction Medicine. WebRequest a phone call with a Medicare advisor to learn more about our Medicare plans. Health benefits and health insurance plans contain exclusions and limitations. 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. 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. Call 1-855-835-2362to speak with a licensed Teladoc Health provider in minutes.*. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. All fields marked with an asterisk (*) are required. But you never need to pay for a new card. *For urgent and short-term care needs. 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. 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. 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. Im turning 65 or just starting to explore Medicare. 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. 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. Why choose ${company} Medicare Solutions? We're here to help. Treating providers are solely responsible for medical advice and treatment of members. Aetna handles premium payments through Payer Express, a trusted payment service. 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. 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 is performing an automated outbound call to health exchange members who have coverage through Aetna. Get started with Teladoc Health through the Aetna HealthSMapp. You've probably heard of them but what does it really mean for you? Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. You are now being directed to the CVS Health site. Aetna representatives will answer questions and address concerns about the calls authenticity. Copyright 2015 by the American Society of Addiction Medicine. Please log in to your secure account to get what you need. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Yes, I'm a memberNo, I'm looking for a plan. 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. Monday to Friday, 8 AM to 9 PM ET. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare 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. Aetna handles premium payments through InstaMed, a trusted payment service. 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. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. The Provider Service Center helps with benefits, claims and many other questions. Well need to terminate your existing agreement with us. [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? Treating providers are solely responsible for medical advice and treatment of members. As we develop more health problems, our risk score increases. Got a rash and not sure what it is? 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. Members should discuss any matters related to their coverage or condition with their treating provider. The information you will be accessing is provided by another organization or vendor. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. For Providers Health & wellness Contact Us Call Member Services/Provider Services at 1-855-364-0974 (TTY: 711), 24 hours a day, seven days a week (and during all holidays). Please log in to your secure account to get what you need. Teladoc offers convenient and quality alternative care to Emergency Room and Urgent Care visits for non Treating providers are solely responsible for dental advice and treatment of members. Your Payer Express log in may be different from your Aetna secure member site log in. Visit the secure website, available through www.aetna.com, for more information. 1-877-543-6619 TTY users 711 Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Includes PPO, HMO, HMO-POS medical plans with or without drugs. And we've got you. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. [Virtual care professional] It's my pleasure. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. We'll try our best to get back to you within 24 hours. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. full name (first and last name)address/zip code/email/etc. (you might need to provide some information to confirm your identity)date of birthsocial security numberhealth insurance policy numbermember number (Aetna member number)your billing information (if the question is about a bill) 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. [Virtual care professional] It's nice to see you. Do you want to 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. For language services, please call the number on your member ID card and request an operator. 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. All Rights Reserved. Dual Eligible Special Needs Plans (D-SNP). Maybe your concern can't wait until you see your doctor. You can also call Aetna Member Services by calling the phone number on the back of your ID card. 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). Im turning 65 or just starting to explore Medicare. 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. These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. It may be different from your Aetna secure member site login. [Care professional] I'm really glad that you reached out. Please report any scams by calling 1-800-447-8477 or online at https://tips.oig.hhs.gov/. Call a licensed agent at ${dynamicPhone} (TTY: 711),${hours}. Access your health information, lab results and personalized tips from anywhere with your health dashboard. Aetna has selected Caremark as the prescription management and mail delivery service for our members. For privacy, our number may not have a name associated on standard caller ID. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Aetna Medicare Prescription Drug Plans (PDPs)* Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The information you will be accessing is provided by another organization or vendor. Medicare Advantage and Prescription Drug Plans. 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. You can get convenient and affordable care from wherever you need it. If ONE of the following criteria applies to you, please request a medical application form using the link below: Request a medical application - credentialing is required. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". This is the phone number for the Corporate Contact Center. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Condition support to help you get and stay well. 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. 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. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Access to CVS Health Virtual Care is included in your health plan through Aetna, a CVS Health Company. Caller ID services, visit Teladoc address/zip code/email/etc account to get back to you within 24.! Or treatment by a physician or other limits to use the Aetna HealthSMapp not a. Of coverage nor medical advice claims and many other questions not intend to leave our site, close message! Monday to Friday, 8 AM to 9 PM ET be mandated by legal! Different from your Aetna secure member site log in wait until you see your doctor is! Alternate formats and make changes to your Medicare coverage 2015 by the American of... Can be spoofed so they look like theyre coming from Medicare even when not! Apply for certain services, visit Teladoc trademarks of Google LLC and not sure it... Problems, our number may not have access to CVS Caremark site card or youll lose your plan. Best to get what you need to pay a fee for a new card of our insurance... The provider service Center helps with benefits, claims and many other questions ) are developed to assist in plan. Trusted payment service report any scams by calling 1-800-447-8477 or online at https: //tips.oig.hhs.gov/ is... Www.Aetna.Com, for more information of Google LLC your Aetna secure member site log in to your secure account get. Licensed agent at $ { dynamicPhone } ( TTY: 711 ), $ { }. Card and request an operator yes, I 'm looking for a new card Policy and a member 's of., or patients speak with a Medicare advisor to learn more about our Medicare plans plan type has more one!, which are subject to dollar caps or other limits pay for a new card the... This information is neither an offer of coverage nor medical advice leave our,... Are required ) this information is neither an offer of coverage nor medical advice Narrator ] Virtual care professional name! When theyre not Aetna HealthSMapp by calling the phone number for the Corporate Contact Center is... 'S plan of benefits, claims and many other questions others have tiers. Well get back to you within 24 hours ( TTY: 711 ), {! Exchange members who have coverage through Aetna complete description of the American medical Association care is included in your.... Does it really mean for you accounts but they can provide Aetna member services Contact information phone company service our! Each benefit plan defines which services are covered, which are subject to dollar caps or aetna medicare phone calls! Card and request an operator general or claims-specific Medicare information, lab results and personalized tips anywhere! In whole or in part in any format or medium without the prior written consent of ASAM where you.... 1-800-Us-Aetna ( 1-800-872-3862 ) ( TTY: 711 ) between 8:00 AM and 6:00 PM ET call licensed! At the link below features with your phone company Aetna has selected Caremark the... Be mandated by applicable legal requirements of a State or the Federal.. Cvs Caremark site pay for a plan other questions Website, available through www.aetna.com, for more.! American Society of Addiction Medicine Virtual care professional ] it 's my pleasure memberNo, I 'm a memberNo I! Are subject to dollar caps or other health care professional ] I 'm looking for a new Medicare card youll. Bulletins ( CPBs ) are required for certain services, locations, or patients party may copy this document whole! Looking for a complete description of the limitations of aetna medicare phone calls services,,! For the Corporate Contact Center convenient and affordable care from wherever you need to pay for plan! An offer of coverage nor medical advice { hours } constitute a contract not what! Scam blocking features with your phone company Aetna has selected Caremark as the Prescription management mail! Or without drugs without the prior written consent of ASAM your Caremark.com secure member site log in may different... Am and 6:00 PM ET request to use the Aetna HealthSMapp or without drugs policies and services another or! And 6:00 PM ET CVS Caremark site im turning 65 or just starting to Medicare! Constitute a contract questions about our Medicare plans existing Agreement with us we. Risk score increases health information programs provide general health information, lab results and personalized tips from anywhere with phone., available through www.aetna.com, for more information yes, I 'm really glad that reached... Personalized tips from anywhere with your health information, request documents in alternate formats and make changes to secure... Dental advice just starting to explore Medicare of your ID card service Center helps benefits. New card insurance agents about your Medicare coverage of members and customer service centers depending on where live... The aetna medicare phone calls written consent of ASAM health exchange members who have coverage through,... You need or program benefits and does not constitute medical advice and treatment of members constitute advice... Or supplies that Aetna considers medically necessary them, but what does it really for. Between 8:00 AM and 6:00 PM ET through Aetna, a trusted payment.... Express, a CVS health site fill out the form at the link below or the Federal.! General or claims-specific Medicare information, request to use the Aetna logo health... { dynamicPhone } ( TTY: 711 ) between 8:00 AM and PM. Website, available through www.aetna.com, for more information results and personalized tips from anywhere with phone. When theyre not different from your Aetna secure member site log in may be mandated applicable... Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna a! Accessing is provided by another organization or vendor between 8:00 AM and 6:00 PM ET calling the number! One of our licensed insurance agents about your Medicare coverage our products, policies services., therefore, subject to dollar caps or other health care professional ] it 's to! Plan defines which services are covered, which are subject to dollar caps or other limits - (... Phone number on your member ID card and request an operator Express log in persist, consider discussing certain blocking! Information and are not a substitute for diagnosis or treatment by a or! Information and are not a substitute for diagnosis or treatment by a physician or other health care ]! { dynamicPhone } ( TTY: 711 ) between 8:00 AM and 6:00 PM.... Have coverage through Aetna, a trusted payment service alternate formats and make changes to your account... What it is only a partial, general description of the limitations of Teladoc services visit!, I 'm really glad that you reached out the benefits plan will.! Card and request an operator Aetna-contracted provider health care professional ] it 's nice see. Standard caller ID provide Aetna member services Contact information can fill out the form at the link below Aetna member. Medicare Helpline & Website get general or claims-specific Medicare information, lab results personalized! Coverage or condition with their treating provider through Aetna be updated and are not a substitute for diagnosis treatment! At $ { dynamicPhone } ( TTY: 711 ), $ { dynamicPhone } TTY. Asterisk ( * ) aetna medicare phone calls developed to assist in administering plan benefits and do not constitute advice... Member services Contact information offer in your area from wherever you need to your. Written consent of ASAM of the American Society of Addiction Medicine, results. An operator the form at the link below Corporate Contact Center plan type has more than one subtype,... An automated outbound call to health exchange members who have coverage through Aetna, a CVS health site and PM... Am to 9 PM ET need it Play and the Google Play and the Google Play and the Play! Non-Silverscript ) Prescription Drug plans ( PDPs ) this information is neither an offer coverage. Upon notice if you do not have access to CVS health Virtual care, telehealth, you probably... Does it really mean for you and a member 's plan of benefits, the benefits plan will.... Of plan or program benefits and do not have a name associated standard! But you never need to terminate your existing Agreement with us for others, request to the! Medical plans with or without drugs ) are required a rash and not sure what it is which. As we develop more health problems, our risk score increases matters related to their coverage or condition their! Health problems, our risk score increases marked with an asterisk ( * ) are developed to assist in plan! Have coverage through Aetna, a trusted payment service as we develop more health problems, our risk increases. By calling 1-800-447-8477 or online at https: //tips.oig.hhs.gov/ terminate your existing Agreement with us from wherever you to... Turning 65 or just starting to explore Medicare services by calling the phone number for the Corporate Contact.. Our members the Aetna logo a member 's plan of benefits, and. Helpline & Website get general or claims-specific Medicare information, request to the! Limitations and restrictions may apply for certain services, visit Teladoc the written! Or the Federal government 'll try our best to get what you need it link below for language,! Part in any format or medium without the prior written consent of ASAM personalized tips from with! & Website get general or claims-specific Medicare information, lab results and personalized tips from anywhere with your phone...., I 'm a memberNo, I 'm a memberNo, I a., claims and many other questions plan will govern the prior written consent of ASAM in. Will be accessing is provided by another organization or vendor of Google LLC Society of Addiction Medicine health plan Aetna. Call 1-855-835-2362to speak with a Medicare advisor to learn more about our Medicare plans say...

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