If you dont want to leave our site, choose the X in the upper right corner to close this message. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The Attain by Aetna mobile app goes beyond tness to provide reachable goals that can improve long-term health. View the Aetna home health care pre-approval list. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. You can: *For up to 90 days. Whether youre managing a condition or just need some help staying on top of your health, were here for you with helpful programs and a personal touch. You can also call EmblemHealth Connect Concierge at 877-344-7364 (TTY: 711) to help get you started. Learn about the different wellness and rewards programs offered, including Rally Health, UnitedHealthcare Motion, Renew Active and others. Reminder: Expanded Medicare Advantage program started August 1, 2021, Expanded Aetna Medicare Advantage program starting August 1, 2021, Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, OfficeLink Updates Newsletters Medicare Updates, Members residing in the states of Georgia, Virginia and Oklahoma, Aetna Medicare DSNP members in Georgia and Texas only, Medicare members residing outside of the states of Georgia, Virginia and/or Oklahoma, Aetna and Coventry commercial fully insured HMO/POS/PPO plan, Aetna administrative services only (ASO) self-funded HMO/POS/PPO plan. 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. Rewards are oered when goals are reached. Each main plan type has more than one subtype. CPT is a registered trademark of the American Medical Association. 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 Deductible, Coinsurance, and Out-of-Pocket (OOP) maximums differ among the plans and your medical benefits have no lifetime . 524 0 obj <> endobj Disclaimer of Warranties and Liabilities. All Rights Reserved. Do you want to continue? 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. 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. Links to various non-Aetna sites are provided for your convenience only. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Review the enrollment checklist with 4 to-do's before you choose a health plan. Well help you make a smooth transition to your new Aetna plan. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Attain by Aetna SM. Aetna Medicare Advantage plans take a total, connected approach to your health. 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. A $25 gift card: Complete your wellness checkup (ages 320 years). 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. Combine Gift Certificates. 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. If you have questions, call myNEXUS Intake (Monday through Friday, 8 AM to 8 PM ET) at 1-833-585-6262. Applying for Coverage. Each carrier's Rewards Program operates differently. 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. For instance, signing up for the program might earn a member $10 while completing a health risk assessment could earn them $25. 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. About Your 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". Even as a Medicare Advantage user, you'll still be responsible for paying your Medicare Part B premium, which is . Aetna Transition of care program may not be available through your plan. CPT only Copyright 2020 American Medical Association. Or choose Go on tomove forward to Aetna.com. $50 worth of baby supplies (diapers, wipes and other items): Complete three more prenatal visits (six total) and one postpartum care visit after your babys birth. Once youve completed each healthy step, youll want to contact us to claim your gift card. Qualifying products and requirements are a combination of any of these products: Medicare Supplement =one-for-one on production Final Expense =two-for-one on production The company will also waive PCP cost shares and expand coverage of virtual mental health services while the COVID-19 public health emergency is in effect. CPT only copyright 2015 American Medical Association. All services deemed "never effective" are excluded from coverage. 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). You can earn rewards for completing preventive care. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Please be sure to add a 1 before your mobile number, ex: 19876543210, Ongoing, one-on-one phone calls with a nurse who serves as a trusted resource for you and your family, Digital support that provides a variety of resources to help you better manage your health, Customized health action plans based on your needs and preferences, Finish treatment with a doctor who is not part of the network*, Transition your remaining orthodontia treatment to your new dental plan, Switch existing prescriptions to your new plan. 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. 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. The information you will be accessing is provided by another organization or vendor. You can even earn an Apple Watch if you don't . 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. All Individual MA members will be able to earn $150 or more annually, depending on plan, to use at an expanded set of merchants, such as local . Treating providers are solely responsible for medical advice and treatment of members. Providers are independent contractors and are not agents of Aetna. Town Clerk. . You are now being directed to the CVS Health site. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. A $25 gift card: Complete a follow-up visit with your behavioral health provider within seven days of your first visit. Starting January 1, 2020, you'll be . 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). If you dont want to leave your state site, choose the X in the upper right corner to close this message. The minimum production amount required to qualify for the payout or travel credits is $225,000 and for the Agent Rewards, the minimum production amount required is $190,000. 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). 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. CPT is a registered trademark of the American Medical Association. Dependents will need to register for their own account. A $25 gift card: Complete your wellness checkup (ages 18 months and 30 months). Program Details: $10 When you complete the Health Risk Screening (paper, online, or via the phone) $10 When you complete an Annual Adult Preventive Care Visit (ages 20+) $10 When you complete an Annual Well Child Visit (ages 321) $10 When you complete a Well Child Visits in the first 30 months of life (0-30 months 8 total visits) * You can speak with a licensed insurance agent to find out what Aetna Medicare Advantage plans are offered in your area. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Opt In. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Contact the plan for more information. Qualifying products and requirements are a combination of any of these products: Medicare Supplement = one-for-one on production Final Expense = two-for-one on production 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). A preterm labor program to support high-risk women Access to specially trained nurses for high-risk mothers-to-be One-on-one counseling to help pregnant women quit smoking We're here for you. Our main goal is to help you live your healthiest life possible, body and mind. The program helps members improve their health and well-being. This includes HMO, PPO or HMO-POS plans. Learn About the SEHBP Healthy Rewards Program. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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). Aetna Healthy Rewards: Improving your physical and mental health Read the following three articles to learn how you can improve your emotional and physical health and for tips on making the most out of your next doctor's visit. ***Aetna Transition of care program may not be available through your plan. If you are having trouble using our site, please call our customer service team at 1-877-922-GIVE (1-877-922-4483) from Monday-Friday, 9 a.m. - 6 p.m. NJWELL has partnered with Aetna to offer a voluntary wellness program designed just for SEHBP Aetna Medicare Advantage plan members. Step 2: Switching health insurance or plans can be overwhelming. Una vez que ganes una recompensa, estar disponible automticamente en la tarjeta de recompensas que recibas por correo. 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. For 2023, Aetna is offering Medicare Advantage Prescription Drug (MAPD) plans in 46 states plus Washington, D.C. Aetna added 141 new counties across the country, providing 1 million more Medicare . If you dont want to leave our site, choose the X in the upper right corner to close this message. 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. Please contact them directly with any questions or concerns at 888-689-3420 or email Support@MyAetnaRewards.com Monday through Friday from 8:00 AM - 8:00 PM EST.Support@MyAetnaRewards.com Monday through Friday from 8:00 AM - 8:00 PM EST. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Medicare Member Rewards Program? License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. These options are located below the login area. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Treating providers are solely responsible for dental advice and treatment of members. A $25 gift card: Complete your wellness checkup (age 12 months). Treating providers are solely responsible for medical advice and treatment of members. If you have questions, call us at 1 . ** Register now, so you'll be all set when you receive eligible care. Some subtypes have five tiers of coverage. So whether youre a first-time mom or a seasoned veteran we can help you have a healthy pregnancy and give your baby the best start in life. Review Your Plan Choices. Or finding a ride there? No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Check Balance. Medicare Advantage Plan Information. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. You are now being directed to the CVS Health site. 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. Sign in to your EmblemHealth member portal. Our SNPs also have contracts with State Medicaid programs. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Go to the American Medical Association Web site. Member rewards program: In 2022, we're expanding our rewards program to all Aetna individual Medicare Advantage members. 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). We're here for you, if you need help understanding your care, your plan benefits, or if you ever have questions. Enrollment in our plans depends on contract renewal. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Links to various non-Aetna sites are provided for your convenience only. 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. This Agreement will terminate upon notice if you violate its terms. CPT is a registered trademark of the American Medical Association. To speak with a licensed insurance agent call 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. Your benefits plan determines coverage. endstream endobj 525 0 obj <>/Metadata 29 0 R/Names 553 0 R/OpenAction 526 0 R/Outlines 45 0 R/Pages 521 0 R/StructTreeRoot 54 0 R/Type/Catalog/ViewerPreferences<>>> endobj 526 0 obj <> endobj 527 0 obj <. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Aetna also offers programs to help you manage certain conditions and a 24/7 nurse line if . No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. When billing, you must use the most appropriate code as of the effective date of the submission. Fax the authorization request form to 1-866-996-0077. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. Llevar una vida saludable obligation to treat 2020, you & # x27 ; s easy:! Unit values, relative value guides, conversion factors or scales are included in the Aetna Medicare Advantage plan.! Health event or chronic condition be accurate as of the American medical Association Aetna Medicaid website by organization Member site, close this message are under no obligation to treat coverage. 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