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Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. The member's benefit plan determines coverage. Be sure to check your email for periodic updates. 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. To continue, please close this message or navigate using the links above. No fee schedules, basic unit, relative values or related listings are included in CPT. Were a health care company. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Achieve your health ambitions with improved health care. Health benefits and health insurance plans contain exclusions and limitations. Please be sure to add a 1 before your mobile number, ex: 19876543210. 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. Each of these gives you access to a range of self-help tools and professional support, carefully chosen to help you take care of your overall well-being in a way that makes most sense to you. The AMA is a third party beneficiary to this Agreement. 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). Choose international health cover for: Welcome to Aetna Well-being: a clear and easy way for you to access health and well-being resources available as part of your health care benefits. Get the information you need, when you need it. Transforming health care, together. Our licensed agents will walk you through your options and answer any questions you have. Some subtypes have five tiers of coverage. Our members get choice, convenience and savings like coverage for exams and frames, a large network of providers, savings, perks and more. Discover discounts Living & working abroad gives you access to Work-life support for help solving every day overseas challenges, such as sourcing local childcare and finding recommended local traders, no matter where you are in the world. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. If your plan is through an employer, your employer's contribution to premiums can also affect costs. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Stay Connected. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Employer Log In. Reprinted with permission. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. Others have four tiers, three tiers or two tiers. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Such members should refer to their benefit plan documents in order to determine coverage and applicable cost share for walk-in clinic benefits and services, as applicable. Tools and services Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. The most common ethnicity at Aetna is White (62%), followed by Hispanic or Latino (14%) and Black or African American (11%). In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. The 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. 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. Links to various non-Aetna sites are provided for your convenience 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. Coverage limits will vary per policy, whether you buy a health plan through Aetna or Blue Cross. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. Quality care a local, doctor-driven network. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". It consists of primary care physicians and specialists ranging from cardiologists, podiatrists, and OB/GYNs to oncologists, ophthalmologists, and orthopedists. All through a simple DNA test they can do at home. 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. Language Assistance:||Kreyl Ayisyen| Franais| Deutsch |Italiano | | || Polski| Portugus| P|Espaol | Tagalog |Ting Vit. Treating providers are solely responsible for medical advice and treatment of members. Our website for federal employees has plan information, rates and resources. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Employers can select what to include in their Aetna policies, which may include medical, dental, health, disability and life coverages. 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. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Applicable FARS/DFARS apply. See our cookie policy for more information on how we use cookies and how you can manage them. Employer health insurance is a health plan offered through your job. Is technology keeping workers healthy or making them ill? Health benefits and health insurance plans contain exclusions and limitations. How organisations can overcome employee health inertia, COVID-19 resources: Support for health, work & life, Remote working & physical distancing support resources. The member's benefit plan determines coverage. 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. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are both within the CVS Health family. 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. Please consult with the respective plan detail page for additional plan terms. * Savings are based on Aetna plans with broad network. Treating providers are solely responsible for medical advice and treatment of 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. 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. Manage benefits Access self-service applications and websites View reports Stay Connected Contact your Aetna representative to learn more! Treating providers are solely responsible for medical advice and treatment of members. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. The average employee at Aetna makes $61,847 per year. If you missed Open Enrollment, please contact your HR representative immediately. Access self-service applications and websites. You can access our plans by following the links below: Your Aetna plan offers extras to help you save money and feel your best. Applicable FARS/DFARS apply. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. If you missed Open Enrollment, please contact your HR representative immediately. All services deemed "never effective" are excluded from coverage. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. This search will use the five-tier subtype. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. As part of the Georgia Right to Shop Act, you can compare in-network provider rates for a particular procedure to get estimated average costs. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. We have one of the largest high-quality health care networks in the world. You are now being directed to the CVS Health site. The Open Enrollment Period is the time of year when you can explore plan options, see if your doctor participates in the plan, apply for financial help and purchase health plan coverage. Through your Aetna member account you can manage claims, view plan details and more. Finally, all of your well-being benefits are in one place. We have combined our businesses to create one market-leading health care benefits company. Visit the secure website, available through www.aetna.com, for more information. If you do not intend to leave our site, close this message. 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. Links to various non-Aetna sites are provided for your convenience only. and in California for Knox-Keene plans . Disclaimer of Warranties and Liabilities. Thanks! Please be sure to add a 1 before your mobile number, ex: 19876543210. 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. 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. Go to the American Medical Association Web site. Others have four tiers, three tiers or two tiers. New and revised codes are added to the CPBs as they are updated. This search will use the five-tier subtype. Learn more about Aetna DNA Aetna offers a wide variety of plans. This information helps us provide information tailored to your Medicare eligibility, which is based on age. This information is neither an offer of coverage nor medical advice. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Treating providers are solely responsible for dental advice and treatment of members. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. You can access our plans by following the links below: Please read the terms and conditions of the Aetna International website, which may differ from the terms and conditions of www.interglobal.com/vietnam. You can also buy an individual or family plan directly from Aetna, the health insurance marketplace or you can get several free quotes with SmartFinancial. Enroll by December 15, 2021 for coverage that starts January 1, 2022. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Go to the American Medical Association Web site. Each main plan type has more than one subtype. Integrated with your employee's health plan, 98point6 is on-demand, text-based primary care that's delivered via secure, in-app messaging. 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. . Aetna is not responsible for services received at MinuteClinic locations. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. The information you will be accessing is provided by another organization or vendor. Mobile assistant app 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). By clicking on I accept, I acknowledge and accept that: Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. Next, Body helps you take care of your physical well-being. 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. 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. Our global medical insurance plans are designed to be flexible, convenient and comprehensive. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. 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. They're just some of the perks of being an Aetna member. Access covered MinuteClinic services seven days a week, including evenings, at no or low cost.*. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Learn more about Aetna Well-being, New and exclusive for Aetna members, Five For Me helps you build healthy habits in five minutes or less. 11% of Aetna employees are Black or African American. 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. InterGlobal is now part of Aetna, one of the largest and most innovative providers of international medical insurance. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Health Plan Variety. Several variables affect health insurance premium rates, including age. We use cookies to give you the best possible online experience. 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). 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. 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). For European, Asia Pacific, Middle East and Africa or Latin American and Caribbean based plans, For U.S./Canada based plans and WorldTraveler plans. The EAP is administered by Aetna Behavioral Health, LLC. Members should discuss any matters related to their coverage or condition with their treating provider. Aetna provides benefits through employers in the United States and internationally, with products and services targeted specifically to small, mid-sized and large multi-site national employers, as well as global health insurance for employees on temporary or permanent foreign assignments. UltraCare policies in Vietnam are insured by Baoviet Insurance Corporation Limited, and reinsured by Aetna Insurance Company Limited, part of Aetna International. You are now being directed to CVS Caremark site. It helps employees improve their vision health, which is key to whole health and improved productivity. Lower cost benefits that save you money. 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. Is technology keeping workers healthy or making them ill? In case of a conflict between your plan documents and this information, the plan documents will govern. To contact our local staff, call671-472-3862oremailGovGuamServices@aetna.com from 8AM5PM (MondayThursday), 9AM5PM (Friday). Individual/family plans and group plans through employers are also offered by each health insurance provider. This includes HMO, PPO or HMO-POS plans. 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. All Rights Reserved. CPT only Copyright 2020 American Medical Association. No fee schedules, basic unit, relative values or related listings are included in CPT. You have been redirected to an Aetna International site. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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). The member's benefit plan determines coverage. It is only a partial, general description of plan or program benefits and does not constitute a contract. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Businesses can purchase Aetna's employer plans and provide them to employees. 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. 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. UltraCare policies in Vietnam are insured by Baoviet Insurance Corporation Limited, and reinsured by Aetna Insurance Company Limited, part of Aetna International. 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. Links to various non-Aetna sites are provided for your convenience only. CPT is a registered trademark of the American Medical Association. . Its packed with educational articles, guides, videos and webinars to help you stay fit and healthy. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Updated annually, the study brings you unique insights that help you bend the curve on health care costs, understand workforce health risk profiles, mould benefits solutions to suit your workforce and more. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Contact us. The dental . For example, take advantage of Wysa a mental well-being app developed by leading clinicians. The Aetna International In-Touch Care and vHealth Service can also help you manage your physical health, by providing direct access to a team of Aetna International nurses and doctors. In case of a conflict between your plan documents and this information, the plan documents will govern. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. CPT only copyright 2015 American Medical Association. Access the tools, resources and support you need to take control of your health care. 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). Enjoy discounts on wellness, convenient MinuteClinic visits, digital tools to manage your care and more. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions. This means we can better serve people who depend on Aetna International and InterGlobal to meet their health and wellness needs. Welcome to Aetna Well-being, a clear and easy way for you to access health and well-being resources available as part of your health care benefits. 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. This Agreement will terminate upon notice if you violate its terms. The ABA Medical Necessity Guidedoes not constitute medical advice. CPT is a registered trademark of the American Medical Association. 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 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. All Rights Reserved. We give you a choice of plans along with extra cover options to tailor a plan thats just right for your business. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Links to various non-Aetna sites are provided for your convenience only. 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