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AETNA’S PRIVACY CENTER

 

We value the trust you place in us. Protecting your privacy is important to
Aetna and we take care to safeguard your personal information. Additional
information regarding how we collect, maintain and use your information is
available in our Privacy Center.



Web & mobile privacy statement Text terms of use Notice of privacy practices
Security highlights Frequently asked questions
Web & mobile privacy statement


WEB AND MOBILE PRIVACY STATEMENT

 

Welcome to our web and mobile experience. By using our websites and mobile apps,
you agree to the terms of this Privacy Statement.

 
What does this Privacy Statement cover?

This statement describes how Aetna (“Aetna”, “we” or “us”) may collect
information about you through your interactions with us on our website and
mobile applications (“apps”) that contain a link to this statement
(collectively, the “Services”).

 

If information collected through the Services is member information, please
refer to the Notice of Privacy Practices tab and not this Privacy Policy. If you
are a member covered by an Aetna insured policy, this Notice can be found on
this app, if you are covered through an employer plan which is self funded, ask
your employer for a copy of your Notice. Examples of member information are
information collected when you enroll in an Aetna health plan or access services
related to your health plan.


Who may use the Services?

We do not knowingly collect personal information online from any person we know
to be under the age of 13. We tell users under 13 not to send any information to
us through the online Services without their parents’ consent.


What types of information do we collect?

We may collect two basic types of information:

 

 * Personal information is data that is unique to a person. It may include
   information such as your name, address, Social Security number, email
   address, telephone number and certain personal device information.
 * Non-personally identifiable information is data that doesn’t personally
   identify you. This may include demographic information, aggregated
   information or certain information collected automatically through your
   device. These may include what web browser you use, server log files,
   cookies, pixel tags, web beacons and other tracking methods, and other
   non-personally identifiable information collected by us or provided by you.


How do we collect your personal information?

We collect your personal information when you:

 

 * Sign up or create a personal profile with us
 * Request products, services or information from us

We may also automatically collect certain personal device information. This may
include your device’s physical location, internet protocol (IP) address, battery
information, app activity, data usage, and malware information. This helps us
identify you and your device to prevent fraud and data loss and keep our app
secure.

 

In some cases, and in all cases required by law, you can update the information
you give us. Just send us an email or update your online profile. Please revisit
the specific place in the app where you first gave us your information.

 

Providing personal information for the purposes of seeking health insurance
coverage/enrollment is a voluntary submission of personal information under the
applicable law. If you choose not to provide your personal information to us, we
may not be able to provide you with requested products, services or information.


How do we use your personal information?

We may use your personal information to:

 

 * Confirm it’s you so we can be sure our interactions with you are secure and
   confidential
 * Respond to your questions or requests
 * Deliver web-based products and services to you
 * Send you marketing messages that may interest you

Except during the sale, transfer, merger, or other transaction involving all or
part of our company, we won’t sell, license, or otherwise transfer any rights to
your personal information to a third party unless you expressly authorize it.

 

We may transmit or share your personal information with other parties:

 

 * If required by law, such as to comply with a subpoena, regulatory oversight
   or other legal process
 * When our contractors or vendors need to perform certain services, such as app
   maintenance or to improve performance

 

In all cases, we’ll require the other party to protect the information. They can
use it only for the purpose we provided it.


How do we collect and use your non-personally identifiable information?

We collect and aggregate non-personally identifiable information when you visit
our website or use our apps. It helps us analyze and improve the services we
provide you. Because this information doesn’t personally identify you, we may
use and share it for any purpose permitted by law. We may:

 

 * Automatically collect certain web browser information. Web browsers collect
   and store data about your device and operating system when you use our apps.
   When we collect this information, as well as your device’s media access
   control (MAC) address, we use it to help create a secure and consistent
   connection to you and customize experience and content when you use our apps.
 * Perform page tagging. This is a way to log web page and visitor information
   when you use our apps. "Tagging" does include a JavaScript program running in
   your browser. But it’s limited to providing information about the page you’re
   requesting and the setup of your browser. It won’t read any of your data
   files, extract personal information about you, or run any other programs. You
   can disable JavaScript in your browser to stop tagging, but that may keep you
   from using all the functions on our app.
 * Use tracking pixels or beacons. These electronic files track your activity on
   our apps. They also track your completion of transactions and browsing
   behavior.


Cookies and other technologies enhance your user experience

A "cookie" is a bit of data that we can send to your browser when you link to
our apps. It isn’t a computer program. It can’t get any data or personal
information on your computer. Your browser software can be set to reject or
accept cookies.

 

Our use of cookies allows us to collect and retain certain information about a
website user, such as the type of Web browser you use. Reviewing our Web server
logs and site usage helps us monitor performance. Cookies also help us:

 

 * Enhance web and mobile navigation
 * Personalize your experience
 * Understand how you use our services
 * Diagnose problems
 * Measure the success of our marketing campaigns
 * Deliver online content on services/products that may interest you
 * Otherwise administer our services

 

Collecting IP addresses is also a standard practice and is done automatically by
many websites and apps. We use IP addresses to administer our services, measure
service levels and help diagnose server problems. Your IP address is a number
that is automatically assigned to the computer that you are using by your
Internet Service Provider. An IP address may be identified and logged
automatically in our server log files whenever a user accesses our services,
along with the time of the visit and the page(s) visited.

 

Our Services use tracking technologies to collect and record your activities and
movements across our websites throughout your browsing session, including page
hits, mouse movements, scrolling, typing, out-of-the-box errors and events, and
API calls (“session data”). We use this information to provide us with analytics
and to improve our products, services, and your experience. Such tracking may
also include recorded sessions, which we may play back for these purposes. We
may share session data with our vendors (which may change over time) for these
purposes, who will use the session data solely on our behalf.


Deidentified patient information

As permitted by law, we may also sell or disclose patient or member information
that has been deidentified. This means data that can be used to identify a
patient or member has been removed or changed according to one of the methods
described in the Code of Federal Regulations. These are known as the HIPAA
expert determination and HIPAA safe harbor methods. (See Section 164.514(b)(1)
or (b)(2) of Title 45 of the Code of Federal Regulations.)


How do we protect your information?

We understand that the security, integrity and confidentiality of your
information are very important to you. And we want to protect it. Here’s how:

 

 * We seek to use technical, administrative and physical security measures to
   protect your personal information from unauthorized access, disclosure, use
   or changes.
 * We regularly review our security practices. We test our apps regularly to
   mimic attempts to breach our security. We also have robust disaster recovery
   plans in place. Despite our best efforts, though, note that no security
   measures are perfect or 100 percent secure.


How we advertise to you

We don’t show you third parties’ ads on our apps. But we may use third-party
advertising companies to serve you our ads on other sites based on the web pages
you may have visited or your online activity. These are known as interest-based
or personalized ads. They may also be known as targeted ads.

 

We (Aetna) show you these ads so you can see products and services that might
interest you. We don’t direct ads to children. Or where we know a user is under
13 years old.

 

In order to serve up information related to our Services, the third-party
companies may place or recognize a unique cookie on your browser (including
through the use of pixel tags). We follow the guidelines of the Digital
Advertising Alliance (DAA) Self-Regulatory Principles for Online Behavioral
Advertising. These help you understand and have greater control over the ads you
see based on your online behavior. The DAA has a web site where you can opt out
from getting targeted ads from some or all of the companies in the program. Our
apps don’t respond to “Do Not Track” signals from browsers.

 

We may use analytics providers that use cookies, pixel tags and other, similar
technologies to collect information about your use of the Services and your use
of other websites and online services. Aetna and these other parties use these
details to understand your online activity. We also use it to deliver ads and
web site content based on your interests.

 

This policy doesn’t apply to, and we aren’t responsible for, the cookies or web
beacons, or other tracking methods used by third parties. You can check out the
privacy policies of these other companies to learn more.


You can email us your questions

We welcome the comments and questions you send to the email address given in our
apps. We’ll share them with our Member Services team and other employees who can
best help you.

 

Keep your information safe. Don’t email us information you consider
confidential. If you’re a health plan member, call us at the number on your
member ID card instead. Or call the number in the app you’re using. There are
also some secure areas of our apps to share this type of information.


Other websites and apps

The Services may contain links to, or otherwise make available, third-party
websites, services, or other resources not operated by us or on our behalf
(“Third-Party Services”). We aren’t responsible for the privacy practices,
content or accuracy of websites or apps of the Third-Party Services. We also
don’t review or endorse their content or the products or services they describe.

 

We are not responsible for the privacy or security of any information you
provide to them or their handling of information. We recommend that you review
the privacy policy of any third party to whom you provide personal information
online.

 

In addition, we aren’t responsible for the information, collection, use,
disclosure or security policies and practices of other organizations. These
include companies such as Apple, Google, Microsoft, RIM, or any other app
developer, app provider, operating system provider, wireless service provider,
or device manufacturer.


We may update our Privacy Statement

We may change this Privacy Statement. You can find the date changes were last
made at the bottom of the page. Any changes become effective when we post the
revised Privacy Statement. Your use of our websites or mobile apps following
these changes means you accept the revised version. This isn’t intended to, and
doesn’t create, any contractual or other legal rights in, or on behalf of, any
party.



Privacy Statement update: February 17, 2022

Text terms of use


TEXT MESSAGE ALERT TERMS & CONDITIONS

 

 

Effective date 02/01/2020


 

Read these Terms and Conditions (this “Agreement”) for important information
about our text alert services (“Aetna text alerts”). THIS AGREEMENT CONTAINS A
MANDATORY ARBITRATION OF DISPUTES PROVISION THAT REQUIRES THE USE OF ARBITRATION
ON AN INDIVIDUAL BASIS TO RESOLVE DISPUTES, RATHER THAN JURY TRIALS OR CLASS
ACTIONS.

 

Aetna or one or more of its affiliates offers access to healthcare service
messages via recurring SMS (Short Message Service), MMS (Multimedia Message
Service) text alerts and email alerts. Enrollment in text alerts requires a
member to provide his or her own mobile phone number with an area code within
the 50 United States or the District of Columbia. Enrollment in email alerts
requires member to provide an email address. By enrolling to receive Aetna text
or email alerts, you agree to these terms and conditions, which become effective
upon your enrollment. You may be asked to verify your mobile phone number before
the service will start. This requires responding to a text alert sent to your
mobile phone confirming your enrollment in this Service.

 

You acknowledge that alerts will be sent to the mobile phone number or email
address you provide to Aetna. Such alerts may include personal information about
your health based on the type of information you choose to receive via
electronic communication, and whoever has access to the mobile phone or carrier
account or email address will also be able to see this information. You
acknowledge that if you elect to receive Protected Health Information as defined
in HIPAA via text alerts or e-mail alerts, you are (i) electing to receive such
information through an unencrypted method of communication, and that (ii)
information contained in an unencrypted e-mail and/or text message is at risk of
being intercepted and read by, or disclosed to, unauthorized third parties. Once
you enroll, the frequency of text or email alerts we send to you will vary. You
will typically receive alerts when we have information for you about healthcare
information. Aetna does not impose a separate charge for text alerts; however,
your mobile carrier’s message and data rates may apply depending on the terms
and conditions of your mobile phone contract. You are solely responsible for all
message and data charges that you incur. Please contact your mobile service
provider about such charges. The following carriers are supported: AT&T, Verizon
Wireless, Sprint, T-Mobile, U.S. Cellular, Boost Mobile, MetroPCS, Virgin
Mobile, Alaska Communications Systems (ACS), Appalachian Wireless (EKN),
Bluegrass Cellular, Cellular One of East Central, IL (ECIT), Cellular One of
Northeast Pennsylvania, Cricket, Coral Wireless (Mobi PCS), COX, Cross, Element
Mobile (Flat Wireless), Epic Touch (Elkhart Telephone), GCI, Golden State,
Hawkeye (Chat Mobility), Hawkeye (NW Missouri), Illinois Valley Cellular, Inland
Cellular, iWireless (Iowa Wireless), Keystone Wireless (Immix Wireless/PC Man),
Mosaic (Consolidated or CTC Telecom), Nex-Tech Wireless, NTelos, Panhandle
Communications, Pioneer, Plateau (Texas RSA 3 Ltd), Revol, RINA, Simmetry (TMP
Corporation), Thumb Cellular, Union Wireless, United Wireless, Viaero Wireless,
and West Central (WCC or 5 Star Wireless).

 

You may opt out of Aetna text alerts at any time. To stop receiving text alerts,
text STOP to the number upon which you are receiving text alerts, including
41368, 46716, 49540, 66902, 67954, 72483, 77583, 79720, 90156, or 37046 (or the
number from which you are receiving Aetna alerts). After you submit a request to
unsubscribe, you will receive one final text alert from Aetna confirming that
you will no longer receive text alerts. No additional text alerts will be sent
unless you re-activate your enrollment to the text alert program. For questions
about text alerts, text the word HELP to 41368, 46716, 49540, 66902, 67954,
72483, 77583, 79720, 90156, or 37046. Text alerts may come from any one of these
short codes and Aetna may change, add or remove short codes as necessary.

 

The Aetna text alert programs are offered on an “as is” basis and: (1) may not
be available in all areas at all times; and (2) may not continue to work in the
event of product, software, coverage or other service changes made by your
wireless carrier. Aetna may change or discontinue any of its text alert programs
without notice or liability to you. Aetna and its related companies and each of
their respective officers, directors and employees are not responsible and shall
not be liable for any losses or injuries of any kind resulting, directly or
indirectly, from any Aetna text alert program or from technical failures or
delays of any kind. Aetna reserves the right to cease delivery of text alerts to
any person at any time in its sole discretion.

 


DISPUTE RESOLUTION

 

EXCEPT FOR DISPUTES THAT QUALIFY FOR SMALL CLAIMS COURT, ALL DISPUTES ARISING
OUT OF OR RELATED TO THIS AGREEMENT OR ANY ASPECT OF THE RELATIONSHIP BETWEEN
YOU, ON THE ONE HAND, AND AETNA OR ITS SUPPLIERS OR VENDORS, ON THE OTHER HAND,
WHETHER BASED IN CONTRACT, TORT, STATUTE, FRAUD, MISREPRESENTATION, OR ANY OTHER
LEGAL THEORY, WILL BE RESOLVED THROUGH FINAL AND BINDING ARBITRATION BEFORE A
NEUTRAL ARBITRATOR INSTEAD OF IN A COURT BY A JUDGE OR JURY AND YOU AGREE THAT
AETNA AND YOU ARE EACH WAIVING THE RIGHT TO TRIAL BY A JURY. YOU AGREE THAT ANY
ARBITRATION UNDER THIS AGREEMENT WILL TAKE PLACE ON AN INDIVIDUAL BASIS; CLASS
ARBITRATIONS AND CLASS ACTIONS ARE NOT PERMITTED AND YOU ARE AGREEING TO GIVE UP
THE ABILITY TO PARTICIPATE IN A CLASS ACTION. The arbitration will be
administered by the American Arbitration Association (“AAA”) under its Consumer
Arbitration Rules (currently available at the Consumer Arbitration Rules PDF),
as amended by this Agreement. The arbitrator will conduct hearings, if any, by
teleconference or videoconference, rather than by personal appearances, unless
the arbitrator determines upon request by you or by us that an in-person hearing
is appropriate. Any in-person appearances will be held at a location which is
reasonably convenient to both parties with due consideration of their ability to
travel and other pertinent circumstances. If the parties are unable to agree on
a location, such determination should be made by the AAA or by the arbitrator.
If you are able to demonstrate that the costs of arbitration will be prohibitive
as compared to the costs of litigation, Aetna will pay as much of your filing
and hearing fees in connection with the arbitration as the arbitrator deems
necessary to prevent the arbitration from being cost-prohibitive. The
arbitrator’s decision will follow the terms of this Agreement and will be final
and binding. The arbitrator will have authority to award temporary, interim, or
permanent injunctive relief, or relief providing for specific performance of
this Agreement, but only to the extent necessary to provide relief warranted by
the individual claim before the arbitrator. The award rendered by the arbitrator
may be confirmed and enforced in any court having jurisdiction thereof.
Notwithstanding any of the foregoing, nothing in this Agreement will preclude
you from bringing issues to the attention of federal, state, or local agencies
and, if the law allows, they can seek relief against us for you.

 

With the exception of any of the language above in this Dispute Resolution
provision relating to the waiver of class and representative actions, if a court
decides that any part of this Dispute Resolution provision is invalid or
unenforceable, the other parts of this Dispute Resolution provision shall still
apply. If a court decides that any aspect of the language above in this Dispute
Resolution provision relating to the waiver of class and representative actions
is invalid or unenforceable, then the entirety of this Dispute Resolution
provision shall be null and void. The remainder of the Agreement will continue
to apply and be unaffected by this severability provision.

Notice of privacy practices


PRIVACY NOTICES

 

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule
affords members the right to receive a notice that describes how health
information may be used and disclosed and how to get access to this information.
Aetna is required to send a notice ("Notice of Privacy Practices") to members of
our insured Health and Long Term Care plans and Mail Order Pharmacy customers.

 

Aetna is also required to send a privacy notice ("Notice of Information
Practices") to our insured Life and Disability plan members and to our Large
Case Pension payees.

 


NOTICE OF PRIVACY PRACTICES BY PLAN TYPE

Document name

Language

Medical, Dental, Pharmacy, Managed Behavioral Health and Vision plans Notice of
Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Federal Risk Plans

 * English (PDF)
 * Spanish (PDF)

Aetna Senior Supplemental Health Notice of Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Aetna Student Health Notice of Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Employee Assistance Plan Notice of Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Long-Term Care Notice of Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Aetna Voluntary Notice of Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Aetna International – U.S. Based Plans Notice of Privacy Practices

 * English (PDF)
 * Spanish (PDF)

Document name

Medical, Dental, Pharmacy, Managed Behavioral Health and Vision plans Notice of
Privacy Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Federal Risk Plans

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Aetna Senior Supplemental Health Notice of Privacy Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Aetna Student Health Notice of Privacy Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Employee Assistance Plan Notice of Privacy Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Long-Term Care Notice of Privacy Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Aetna Voluntary Notice of Privacy Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name



Language




NOTICE OF INFORMATION PRACTICES BY PLAN TYPE

Document name

Language

Large Case Pension Notice of Information Practices

English (PDF)

Life and Disability Notice of Information Practices

 * English (PDF)
 * Spanish (PDF)

Life and Disability Privacy Notice for Aetna Voluntary Notice of Information
Practices

 * English (PDF)
 * Spanish (PDF)

Life Privacy Notice for American / Continental Notice of Information Practices

 * English (PDF)
 * Spanish (PDF)

Document name

Large Case Pension Notice of Information Practices

Language

English (PDF)

Document name

Life and Disability Notice of Information Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Life and Disability Privacy Notice for Aetna Voluntary Notice of Information
Practices

Language

 * English (PDF)
 * Spanish (PDF)

Document name

Life Privacy Notice for American / Continental Notice of Information Practices

Language

 * English (PDF)
 * Spanish (PDF)


COMPLAINTS

 

If you think your HIPAA Privacy Rights have been violated, you can contact us
using the toll-free Member Services number on your ID card or you may contact
the Aetna Privacy Office directly at the address below:

 

HIPAA Member Rights Team
Aetna Inc.
P.O. Box 14079
Lexington, KY 40512-4079

 

You also may write to the Secretary of the U.S. Department of Health and Human
Services.

Security highlights


SECURITY HIGHLIGHTS

 

Aetna takes information security seriously and we diligently safeguard your
personal information. Here are some ways Aetna protects your information and
steps you can take to help.

 
Securing health information

A list of steps we take to secure your health information.

 

17 steps for securing health information (PDF)


Social Security numbers


OUR EFFORT TO REDUCE THE USE OF SSNS

 

PROTECT YOUR MEDICAL RECORDS AND IDENTITY

 

Because we’re committed to protecting the privacy of our members, we’re moving
away from the use of Social Security numbers whenever possible. Thieves often
steal Social Security numbers when they hack websites and computers. A Social
Security number is not required for health care services.

 

Here's how you can help

 

If you're a health care professional working with us:

 

 * Collect the patient's member ID number, rather than a Social Security number.
   
 * For your own transactions, use your Employer Identification Number (EIN),
   rather than a Social Security number.
   

 

If you're an Aetna member:

 

 * Give your member ID number -- not your Social Security number -- when you go
   to the doctor, dentist or hospital.

 

If you're an employer working with us:

 

 * Work with your Aetna Contact or Account Rep to reduce the transmission of
   SSNs


Aetna uses encryption to safeguard data

Protecting the privacy and security of sensitive information is one of our
highest priorities. Accordingly, Aetna encrypts all Internet e-mails that
contain member-specific health and financial information -- examples include,
but aren't limited to, personal and demographic information (e.g., name, SSN,
address), employment information, information about payment of benefits,
provider information, diagnostic or treatment information, claims status
information and information related to behavioral health and/or sexually
transmitted disease services.

 

Use of encrypted e-mail enables us to send quick, reliable communications while
maintaining our commitment to protecting the confidentiality of member-specific
information.

 

What is encrypted e-mail?

 

Encrypted e-mail is scrambled by the sender's e-mail program, which renders it
unreadable until it is descrambled or "decrypted" by the recipient. Unencrypted
e-mail is similar to a postcard - the message can be viewed by anyone who picks
it up. Encrypted e-mail is similar to a sealed letter -- the content cannot be
viewed until the envelope is opened - except, in this case, the envelope has a
lock on it to which only the recipient has a key.

 

How does Aetna's use of encrypted e-mail impact recipients?

 

 * Whenever Aetna transmits member-specific health or financial information via
   Internet e-mail, the e-mail includes a message indicating that the content
   has been secured via encryption.
 * Encrypted e-mails from Aetna include instructions on how to decrypt the
   message for viewing - this requires the recipient to perform a few simple
   clicks.
 * Anyone who receives an encrypted e-mail from Aetna is able to send an
   encrypted reply.
 * Third party messages that are sent to Aetna via the "Contact Us" feature on
   Aetna.com are also encrypted.

 

Who can receive member-specific health and financial information?

 

Aetna has strict procedures in place for determining if a third party can
receive member health and financial information i.e., Aetna employees are
required to verify whether a requestor is authorized to receive the information
before it is released.

 

Whom can the recipient of an Aetna encrypted e-mail call with questions?

 

Each encrypted e-mail from Aetna includes instructions on how to open the
message and view the secure content. In the event a recipient receives an error
message while in the process of trying to open an Aetna-generated encrypted
e-mail, the error message provides guidance for troubleshooting the problem. In
addition, the error message includes the following contact information:

 

If you experience any problems, please contact 1-800-237-7476 (TTY: 711), option
4 (Secure Email) during normal business hours; 8AM to 6PM ET.


Medical identity theft


MEDICAL IDENTITY THEFT IS A GROWING PROBLEM

 

Medical identity theft happens when someone steals your personal or health
insurance information. They use it to get medical care, prescriptions, insurance
payouts, even surgery. It’s a lot like regular identify theft. It can damage
your credit rating. Cost you money and take time to clear up. Even hurt your
chances to get some jobs. And it's happening more and more in the United States.

 

HERE ARE A FEW STEPS TO PROTECT YOURSELF

 

Be careful with your member ID card

It could be used to get medical services or drugs. And these will be on your
medical record permanently. If your card is missing, lost or stolen, notify
Aetna Member Services right away.

 

Keep personal information personal

Don’t give out your insurance ID, Social Security or driver’s license numbers on
the phone or by mail to just anyone. Make sure you initiated the contact. And
make sure there is a valid reason for giving out the number.

 

Be on guard even if someone claims to be from Aetna

We avoid asking for your Social Security number. However, there are times we
need it. For example, if you:

 

 * Sent us a form that requested your Social Security number but you didn’t
   provide it or it is not readable, we might call you to ask for it.
 * Left a voice mail for someone at Aetna that did not include enough
   information to identify you, we might ask for additional information when
   returning your call.

 

Review health care information

Take time to read mailed Explanation of Benefits (EOB) statements or online
claims. Even if they are marked, “This is not a bill."  Look for:


 

 * Wrong group or identification numbers
 * Unfamiliar provider offices or hospitals
 * Dates for services on which you did not receive care
 * Prescriptions you did not fill

 

Make sure “free” is free

If you visit a free clinic, make sure it’s free. Don’t show your ID card for any
reason.

 

Check your credit report

Identity thieves can run up medical costs in your name. The bills can be mailed
to another address. You won’t know unless you check your report. Or you get a
call from a collection agency.

 

Find out how you can get a credit report for free visit the Federal Trade
Commission.


Frequently asked questions


HEALTH CARE PRIVACY FAQS

 

Simple, direct answers to common questions about health care privacy.

 

 
Why is health care privacy important?

If you don't believe your health information is protected, you may be less
likely to visit or talk to your doctors and other health care experts about
health issues because you are afraid of who else may learn about your
conditions. This may place you at greater risk: Your doctor needs to know as
much as possible about your health to give you the best possible care.


Is my personal health information private?

The Health Insurance Portability and Accountability Act (“HIPAA”) includes a
privacy rule that require people who manage your health care keep your
information private (other federal and state laws include privacy protections as
well). Health care companies must follow the HIPAA privacy rule as well as
health care providers. Examples of health care companies and health care
providers include:

 

 * Doctors
 * Dentists
 * Psychologists
 * Chiropractors
 * Hospitals
 * Clinics
 * Nursing homes


What sort of health information is considered private?

Here are some examples of protected information:

 

 * Anything your doctors, nurses, and others put in your medical record
 * Conversations your doctor has about your care or treatment with nurses and
   others
 * Information about you in an insurer's computer system
 * Billing information about you at a doctor's office, clinic or hospital
   


What are my rights with regard to my privacy?

You have the right to:

 

 * Know who has your personal health information
 * Request limits on who can see this information
 * Get a copy of this information
 * Be provided with privacy notices that explain our use and disclosure of your
   information
 * Have this information safeguarded
 * Request corrections to your information
 * Decide if you want to give your permission before your information can be
   used or shared for certain purposes, such as for marketing
 * Get a report on when and why your information was shared for certain purposes
 * File a complaint if you feel your right to privacy has been violated


What are Aetna’s responsibilities with regard to my privacy?

We have the responsibility to:

 

 * Put safeguards in place to protect your information
 * Limit the use and disclosure of your information to the minimum needed to
   accomplish our goals
 * Enter into agreements with our contractors and others to make sure they use
   and disclose your information properly and safeguard it appropriately
 * Have procedures in place to limit who can see your information
 * Hold training programs for employees to learn how to protect your information


I am an Aetna member. How do I exercise my privacy rights?

Call us at the number on your member ID card. Tell us what you need. For
example, you may want to:

 

 * Request information on how we may use or share your health information
 * See what health information we have about you
 * Authorize someone else to see your private health information
 * Ask us to refrain from sharing your information under certain circumstances.
   You may need to complete and send in a form depending on your request. Our
   response will depend on the nature of your request.

 

Do you get your health insurance where you work? If so, where you go for privacy
information depends on the kind of plan you joined.

 

There are two kinds of health plans offered by employers. One kind of plan is
called "insured" because an insurance company pays for claims. The other kind of
plan is called "self-insured" because your employer actually pays for claims and
hires another company only to run the systems that support the plan. If you are
a member of a self-insured plan, you may need to work with your employer to
address your privacy concerns.

 

To find out whether to address a privacy issue with your employer or with Aetna,
call the number on your member ID card or talk to your company HR
representative.


What can I do if I think my privacy rights have been violated?

Contact us if you think your rights are being denied or your health information
isn't being protected. Call the number on your member ID card. Or write to:

 

HIPAA Member Rights Team
P.O. Box 14079
Lexington, KY 40512-4079


 

You may also write to the Secretary of the U.S. Department of Health and Human

Services. You will not be penalized for filing a complaint.


How can I change the way Aetna communicates with me?

You have the right to ask us to communicate with you in a certain way or at a
certain location.

 

If you are on someone else's insurance and would like us to send your
Explanation of Benefits statements and other claim information to an address
that's different from the primary subscriber's, please call Member Services at
the number on your ID card.

 

To stop paper mailings of Explanation of Benefits and claim information, log in
to your secure account and use the "Profile" link in the upper right corner to
change your paper saving preferences. Your Explanation of Benefits and claim
information will still be available in your secure account.

 

You also can use the "Profile" link to opt in or out of receiving emails from
us, or to add or change a phone number.

 

Log in or register




RELATED LINKS

 

Main FAQs

Supplier diversity FAQs


LEGAL NOTICES

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).

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APPLIED BEHAVIOR ANALYSIS MEDICAL NECESSITY GUIDE

By clicking on “I Accept”, I acknowledge and accept that:
 

The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine
appropriate (medically necessary) levels and types of care for patients in need
of evaluation and treatment for behavioral health conditions. The ABA Medical
Necessity Guide does not constitute medical advice. Treating providers are
solely responsible for medical advice and treatment of members. Members should
discuss any matters related to their coverage or condition with their treating
provider.

Each benefit plan defines which services are covered, which are excluded, and
which are subject to dollar caps or other limits. 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.

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. The member's
benefit plan determines coverage. Some plans exclude coverage for services or
supplies that Aetna considers medically necessary.

Please note also that the ABA Medical Necessity Guide may be updated and are,
therefore, subject to change.

Medical necessity determinations in connection with coverage decisions are made
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