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. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. See the criteria (PDF) Office manual for health care professionals. Call 1-844-362-0934 (TTY: 711), 8 AM to 8 PM, 7 days a week, local time. Log in to search for doctors covered by your plan. 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. How to use this provider directory Providers are listed in sections in this order: Primary Care Providers (PCP) Specialty Providers Hospitals Skilled Nursing Facilities Nursing Facilities Behavioral Health Providers Long-Term Services and Support Ancillary - such as laboratories, radiology, home health, physical therapy In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. So we set time frames for how soon your provider should see you. MCO Directory by Region AETNA - Updated 7/11/2023 AETNA- Health Plan Payer ID: 128VA Updated 7/11/2023 AETNA - Health Plan Payer ID: 128VA Updated 7/11/2023 Mental Health Services Roanoke/Alleghany Southwest Northern/Winchester Consumer Direction Authorizations aetnaconsumerdirection@aetna.com Consumer Direction Authorizations 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". You have the flexibility to receive covered services from network providers or out-of-network providers. Aetna Medicare Preferred Plan (HMO D-SNP)_H4982_008 This directory is current as of 08/15/2022. We are working on a resolution and appreciate your patience. Provider/Facility Name OR Specialty is required to continue, Please enter first and last name of Provider, or the name of the facility, Search for an in-network pharmacy provider thats close to you under "Helpful links". We have a set of criteria for participation in our provider network. 1-888-632-3862 (TTY: 711), Mon. Health benefits and health insurance plans contain exclusions and limitations. I Este listado incluye los proveedores que participan en el programa AetnaNatural Products andServices ProgramSM(Programa de productos y servicios naturales de Aenta) en la fecha de publicacin. If you do not intend to leave Aetna Medicare, close this message. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Louisiana, All Rights Reserved. Others have four tiers, three tiers or two tiers. Your benefits plan determines coverage. Use of any robot, spider or other intelligent agent to copy content from this search tool, extract any portion of it or otherwise cause the search tool to be burdened with unwarranted high access or transaction . Heres how long it should take: Did you find info about a provider thats wrong in a directory or inside the search tool? Any health care professional, regardless of participation status with Aetna, can sign up for our live webinars. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative MinuteClinic services at no cost-share. 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. to see what I needed because I wasn't at home. Applicable FARS/DFARS apply. You can reach us toll-free at1-800-282-5366 ${tty},${hours}. 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. Your Payer Express log in may be different from your Aetna secure member site log in. We can help. Your PCP will issue referrals to participating specialists and facilities for certain services. Look for your county under your plan name. If you do not intend to leave our site, close this message. Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. not required to select a PCP, we encourage you to do so. If you do not intend to leave our site, close this message. Legal notices Make sure you have your member ID card because you'll need it to make your request. 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. You can get care from a quality network of local doctors, specialists and hospitals in your area. Why choose ${company} Medicare Solutions? How to Find Aetna Medicare Providers 2022-2023 - MedicareAdvantage.com Whether youre new to the Aetna network or a long-time participant, you can find the resources you need to stay informed and focus on what you do best: caring for your patients. So, you pay less when you get care. Medicare and Aetna Medicare wont be responsible either. 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). However, we encourage you to do so. In the years that follow your Welcome to Medicare visit, youre eligible for an Annual Wellness Visit. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. PDF NY Cover Page - Aetna Better Health Updates may also be affected by interruptions due to system maintenance, upgrades or unplanned outages. This overview has information about APCN and APCN Plus Networks. Two Aetna Provider Networks The new Aetna health plan has two provider networks. Some subtypes have five tiers of coverage. Provider Directory. We will help you find a provider. This search will use the five-tier subtype. Convenient tools and guidelines to help you manage claims, payments and reimbursements. All Rights Reserved. Employee Assistance Program (EAP) Manual. It has policies, procedures and contact information. Aetna Inc. and itsitsaffiliated 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. To get the most up-to-date information about Aetna Medicare Plan (HMO) (PPO) network providers in your area, you can call our Member Services department at 1-800-282-5366 (TTY: 711), 8 a.m. to 8 p.m., seven days a week. If youd like a printed copy,you can request one. Copyright document.write(new Date().getFullYear()) Aetna Better Health of California, All Rights Reserved. Information is believed to be accurate as of the production date; however, it is subject to change. The member's benefit plan determines coverage. The member's benefit plan determines coverage. Aetna Better Health of New Jersey is not responsible or liable for non-Aetna Better Health content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Enter the provider's first and last name or the name of the facility. ZIP CODE Find a 2023 pharmacy in our network We update our find a pharmacy tool every two weeks. Aetna Better Health of Florida is not responsible or liable for non-Aetna Better Health content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Please feel free tocontact us to provide any new information. I would like to opt-in to receive a Medicare printed directory annually, Dual Eligible Special Needs Plans (D-SNP). 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. Your member ID will contain 12 numeric characters. And I mattered, and I was a person versus a number. Aetna Inc. and itsaffiliated 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. Available online provider directories (PDF): Call a licensed agent at ${dynamicPhone} ${tty},${hours}. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. This Agreement will terminate upon notice if you violate its terms. Treating providers are solely responsible for medical advice and treatment of members. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. It may be different from your Aetna secure member site log in. Find a Medicare Doctor, Dentist, Pharmacy & more | Aetna Medicare Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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). CPT only Copyright 2022 American Medical Association. Like, any questions that I had or just anything. For questions about your ${ProviderDirectoryPlanName} or if you need help selecting a PCP, call us. Members who get Extra Help are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. New and revised codes are added to the CPBs as they are updated. make sure that my insurance was accepted. Links to various non-Aetna sites are provided for your convenience only. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. You are leaving our Medicare website and going to our non-Medicare website. If you still have Medicare questions, please give us a call or visit AetnaMedicare.com to learn more. Most printed directories come with both English and Spanish text included. In some cases, you may get covered services from out-of-network providers, but you may pay more out of pocket. This guide is a reference tool to help contracting delegates and their staff understand how to perform delegated functions to Aetna standards. Under our visitor/traveler program you may receive all plan covered services at in-network cost-sharing when you see a network provider. She actually did give me a list of food pantries, and if I needed help getting to and from the hospital. It contains our most uptodate pharmacy network information. If you'd like a printed copy, you can request one. 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. You can use these links and phone numbers to find in-network providers and pharmacies near you. H6399_32018_2023 Page last updated: 3/8/2023.