www.aetna.com
Open in
urlscan Pro
45.223.19.220
Public Scan
Submitted URL: https://click.email.myplanportal.com/?qs=82dfde14c48c1448af5601fd9174d55bd42b5212e4b71a1dc196f6f703b31ab519f53b5bb9fc948c3dd9d09c24fe...
Effective URL: https://www.aetna.com/legal-notices/privacy.html
Submission: On September 12 via api from US — Scanned from DE
Effective URL: https://www.aetna.com/legal-notices/privacy.html
Submission: On September 12 via api from US — Scanned from DE
Form analysis 3 forms found in the DOM
/search-results.html
<form class="searchform--desktop searchformdesktop" action="/search-results.html">
<div class="megamenu__nav--search">
<label for="globalSearch" class="nav__search--text">Search</label>
<button class="nav__search--icon" aria-label="search"></button>
<input type="text" name="query" class="nav__search--input" id="globalSearch" placeholder="Search">
<input type="hidden" name="offset" value="0">
<button class="nav__close--icon clear-input" aria-label="clear search"></button>
</div>
</form>/search-results.html
<form class="searchform--desktop searchformmobile" action="/search-results.html">
<div class="megamenu__nav--search">
<label for="mobileSearch" class="nav__search--text">Search</label>
<button class="nav__search--icon" aria-label="search"></button>
<input type="text" name="query" class="nav__search--input" id="mobileSearch" placeholder="Search">
<input type="hidden" name="offset" value="0">
<button class="nav__close--icon clear-input" aria-label="clear search"></button>
</div>
</form>POST /aem-services/api/gatewayservice/post
<form class="formstyle--fullbox generic-aet-form displaysubmitinline container section sfmform" novalidate="novalidate" method="POST" data-aeth-script="form" aria-live="polite"
data-thankyoupage="https://www.aetna.com/individuals-families/using-your-aetna-benefits/aetna-mobile/health-app/thank-you-aetna-app.html" action="/aem-services/api/gatewayservice/post" data-sfmc-connection="true"
data-use-paginationtext="Step {0} of {1}" data-loaded="true">
<div class="row">
<div class="form__wrapper col-sm-12 col-lg-6 offset-lg-3 ">
<!-- PAYFLEX ERROR SUMMARY -->
<div class="errorSummary hidden" aria-hidden="true">
<div class="summaryTitle">
<span tabindex="-1" class="errorMsg"><strong>Error or missing data. Please check your entries for an error message.</strong></span>
</div>
</div>
<div class="form-body">
<div class="aem-Grid aem-Grid--12 aem-Grid--default--12 aem-Grid--xs--12 ">
<div class="input aem-GridColumn--default--none aem-GridColumn--offset--xs--0 aem-GridColumn aem-GridColumn--xs--none aem-GridColumn--default--12 aem-GridColumn--offset--default--0 aem-GridColumn--xs--12">
<div class="forminput generic-form-input responsive-input
">
<div class="forminput__wrap">
<label for="mobileNumbers" class="forminput__label ">MOBILE NUMBER </label>
<input id="mobileNumbers" type="text" name="mobileNumbers" title="Please enter 11 digits (1 plus your number) without hyphens" pattern="^\d{11}$" aria-describedby="description-mobileNumbers">
<span class="help-text" id="description-mobileNumbers">Please be sure to add a 1 before your mobile number, ex: 19876543210</span>
</div>
</div>
</div>
<div class="hiddenfield aem-GridColumn--default--9 aem-GridColumn aem-GridColumn--default--newline aem-GridColumn--offset--default--0"><input type="hidden" name="subscribe" value="true">
</div>
<div class="hiddenfield aem-GridColumn--default--9 aem-GridColumn aem-GridColumn--default--newline aem-GridColumn--offset--default--0"><input type="hidden" name="resubscribe" value="true">
</div>
<div class="hiddenfield aem-GridColumn--default--9 aem-GridColumn aem-GridColumn--default--newline aem-GridColumn--offset--default--0"><input type="hidden" name="keyword" value="NUMBER">
</div>
<div class="hiddenfield aem-GridColumn--default--9 aem-GridColumn aem-GridColumn--default--newline aem-GridColumn--offset--default--0"><input type="hidden" name="butype" value="comm">
</div>
<div class="hiddenfield aem-GridColumn--default--9 aem-GridColumn aem-GridColumn--default--newline aem-GridColumn--offset--default--0"><input type="hidden" name="sfmcAction" value="/sms/v1/messageContact/MTMwNzo3ODow/send">
</div>
</div>
</div>
<input type="submit" value="Send me a text" class="btn btn--primary">
</div>
</div>
</form>Text Content
Skip to main content
Contact us Español
logo
* Contact us
* Español
Search
Explore Aetna sites
* EXPLORE AETNA SITES
* Individuals & Families
* Affordable Care Act
* Medicare
* Medicaid
* Providers
* Employers
* Agents & Brokers
* Partners
* Careers
* About Us
Explore Aetna sites
* Individuals & Families
* Affordable Care Act
* Medicare
* Medicaid
* Providers
* Employers
* Agents & Brokers
* Partners
* Careers
* About Us
* Who we are
* Our mission
* Diversity and inclusion
* Code of conduct
* About Aetna
* Our history
* Our leadership team
* Facts and subsidiaries
* News & analysis
secondary menu close
* Initiatives
* Corporate responsibility
* Racial & ethnic equity
secondary menu close
* Investors
* Investors
secondary menu close
* Health section
* Access
* Community
* Innovation
* Well-being
secondary menu close
Login
Login
Back
Menu Mobile menu for the website. Navigation Menu Menu Close
Search
* Who we are
* Initiatives
* Investors
* Health section
* Explore Aetna sites
* Contact us
* Español
Login
WHO WE ARE
* Our mission
* About Aetna
* News & analysis
*
INITIATIVES
* Corporate responsibility
* Racial & ethnic equity
*
INVESTORS
* Investors
*
HEALTH SECTION
* Access
* Community
* Innovation
* Well-being
*
* EXPLORE AETNA SITES
* Individuals & Families
* Affordable Care Act
* Medicare
* Medicaid
* Providers
* Employers
* Agents & Brokers
* Partners
* Careers
* About Us
OUR MISSION
* Diversity and inclusion
* Code of conduct
ABOUT AETNA
* Our history
* Our leadership team
* Facts and subsidiaries
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
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" and not this Privacy Statement. 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?
Our websites and mobile applications are designed for general audience and not
directed to children under the age of 13. We do not knowingly collect personal
information online from any person we know to be under the age of 13.
What types of information do we collect?
We want you to know what personal information we may collect about you. Some
examples of the personal information we may collect about you include:
* Contact information including your name, address, email address, telephone
number and certain personal device information
* Your password, if you create an account
* Demographic information, such as your age and date of birth, sex and/or
gender
* Language preferences
* Driver’s license information or Social Security number
* Information collected automatically through your device, such as web browser
information, server log files, cookies, pixel tags and web beacons and other
tracking information
In addition, our mobile apps may ask for your permission to collect/use the
following:
* Your GPS Location, to support searching for nearby providers and services
* Bluetooth, Camera, and Audio, to enable communication with a provider
* Your Calendar, so appointments can be added
* Your Files and Images, to enable the uploading of files when speaking with a
provider
* Your IMEI (International Mobile Equipment Identity) number, which is used to
authenticate your device as part of our security program
How do we collect your personal information?
We collect your personal information when you:
* Sign up or create a personal profile with us
* Enter into a transaction with us
* Request products, services or information from us
* Sign up with or interact with our products or services
* Participate in surveys or quizzes
We may also automatically collect certain 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. It may also help us customize your application or website experience.
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
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?
To respond to you. We use your personal information to deliver services and to
respond to your requests. For instance, we may use it to fulfill your order,
contact you about your order, send you email alerts, send you newsletters, and
to provide you with related customer service.
To send marketing and administrative information to you. For example, we may use
your personal information to manage subscription services, such as your order
management, billing, reorder experience, and account communication. We may also
offer other products and services that may be of interest to you. This could be
done through push notifications in our apps.
To add to your experience. We may use your personal information to personalize
your experience when interacting with us. We may present products and offers
tailored to you. And we may use your details for our business purposes, along
with data analysis, audits, fraud monitoring and prevention, and new product and
service development. We may also use it to gauge the effectiveness of our
campaigns, and to run and grow our business efforts.
For a sale or transfer of business assets. We may share or transfer your
personal information to other parties if some or all of our business, assets or
stock are sold, transferred or used as security. This includes in connection
with any bankruptcy or similar proceeding.
To give information to our businesses. As allowed by law, we may give your
personal information to our affiliated businesses or to our business partners.
They may use it to send you marketing and other communications.
To respond to law enforcement officials. We may share your personal information
if required to do so by law enforcement officials or judicial authorities.
We may use or share your information including without court process, in matters
involving claims of personal, public safety or in a litigation, where the
information is pertinent. This may include use or sharing to allow us to pursue
remedies or to limit the damages we may sustain.
We may also use or share your information to enforce our terms and conditions,
to protect our operations or those of any of our affiliates, or to protect our
rights, privacy, safety or property and/or that of our affiliates, you or
others.
To our service providers. We may disclose personal information to our service
providers, who provide services such as website hosting, data analysis, payment
processing, order fulfilment, information technology and related infrastructure
provision, customer service, email delivery, auditing, and other services.
To look for security breaches. We may use and disclose personal information to
investigate security breaches or otherwise work with authorities in a legal
matter.
To use information that does not identify you. If information does not
personally identify you, we may use and share it for any purpose except as
limited by applicable law. This includes information described in the “Cookies
and other technologies” section. To the extent we are required to treat such
information as personal information under applicable law, then we may use it for
all the purposes we use and disclose personal information.
To combine information. We may combine information that does not personally
identify you with personal information. If we do, we will treat the combined
information as personal information for as long as it stays combined.
Cookies and other technologies enhance your user experience
Like many other websites and online services, we collect traffic and usage
patterns. It helps us analyze and improve the services we provide you. We use
cookies, Web server logs and similar technologies to do this.
We use this information for various purposes:
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
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.
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.
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.
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 statement 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.
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 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.
You can email us your questions
If you have any questions or concerns about this statement, or the way your
information is collected and used, please contact the Aetna Privacy Office at
Privacy.Officer@cvshealth.com.
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.
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 the Services following these changes
means you accept the revised version.
Privacy Statement update: February 25, 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).
Health benefits and health insurance plans contain exclusions and limitations.
See all legal notices
*
*
*
*
*
* AETNA APPS
* CAREERS
* FAQs
* GLOSSARY
* ACCESSIBILITY SERVICES
* PLAN DISCLOSURES
* PROGRAM PROVISIONS
* GRIEVANCE FORM
* NEWS AND ANALYSIS
* HEALTH CARE REFORM
* INVESTOR INFO
* SITE MAP
* TERMS OF USE
* LEGAL NOTICES
* PRIVACY CENTER
* NONDISCRIMINATION NOTICE
* VULNERABILITY DISCLOSURE PROGRAM
©2022 Aetna Inc.
For language services, please call the number on your member ID card and request
an operator. For other language services: Español-Spanish | 中文 | Tiếng Việt |
한국어 | Tagalog | Pусский | العربية | Kreyòl | Français | Polski | Português |
Italiano | Deutsch | 日本語 | فارسی | Other languages ...
YOU ARE NOW BEING DIRECTED TO THE AMA SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW BEING DIRECTED TO THE GIVE AN HOUR SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW BEING DIRECTED TO THE CVS PHARMACY SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW BEING DIRECTED TO THE CDC SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
AETNA IS PROUD TO BE PART OF THE CVS HEALTH FAMILY.
You are now being directed to the CVS Health site.
Continue
YOU ARE NOW BEING DIRECTED TO THE APPLE.COM COVID-19 SCREENING TOOL
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW BEING DIRECTED TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES
SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW BEING DIRECTED TO THE CVS HEALTH COVID-19 TESTING SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW BEING DIRECTED TO THE FIGHT IS IN US SITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
YOU ARE NOW LEAVING THE AETNA WEBSITE
Links to various non-Aetna sites are provided for your convenience only. 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.
Continue
LOGIN
Please log in to your secure account to get what you need.
Continue
YOU ARE NOW LEAVING THE AETNA MEDICARE WEBSITE.
The information you will be accessing is provided by another organization or
vendor. If you do not intend to leave our site, close this message.
Continue
GET A LINK TO DOWNLOAD THE APP
Just enter your mobile number and we’ll text you a link to download the Aetna
Health app from the App Store or on Google Play.
Message and data rates may apply*
Error or missing data. Please check your entries for an error message.
MOBILE NUMBER Please be sure to add a 1 before your mobile number, ex:
19876543210
THIS SEARCH USES THE FIVE-TIER VERSION OF THIS PLAN
Each main plan type has more than one subtype. Some subtypes have five tiers of
coverage. Others have four tiers, three tiers or two tiers. This search will use
the five-tier subtype. 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. Do you want to continue?
back
Continue
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
on a case-by-case basis. 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.
I Accept
AETNA IS PROUD TO BE PART OF THE CVS FAMILY.
You are now being directed to CVS caremark® site.
Continue
ASAM TERMS AND CONDITIONS
By clicking on “I accept”, I acknowledge and accept that:
Licensee's use and interpretation of the American Society of Addiction
Medicine’s 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.
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.
Copyright 2015 by the American Society of Addiction Medicine. Reprinted with
permission. No third party may copy this document in whole or in part in any
format or medium without the prior written consent of ASAM.
I accept
PRECERTIFICATION LISTS
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".
* 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. It does
not mean precertification as defined by Texas law, as a reliable
representation of payment of care or services to fully insured HMO and PPO
members.
* Applies to: Aetna Choice® POS, Aetna Choice POS II, Aetna Medicare℠ Plan
(PPO), Aetna Medicare Plan (HMO), all Aetna HealthFund® products, Aetna
Health Network Only℠, Aetna Health Network Option℠, Aetna Open Access® Elect
Choice®, Aetna Open Access HMO, Aetna Open Access Managed Choice®, Open
Access Aetna Select℠, Elect Choice, HMO, Managed Choice POS, Open Choice®,
Quality Point-of-Service® (QPOS®), and Aetna Select℠ benefits plans and all
products that may include the Aexcel®, Choose and Save℠, Aetna Performance
Network or Savings Plus networks. Not all plans are offered in all service
areas.
* All services deemed "never effective" are excluded from coverage. 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. Visit the secure website, available through
www.aetna.com, for more information. Click on "Claims," "CPT/HCPCS Coding
Tool," "Clinical Policy Code Search."
* The five character codes included in the Aetna Precertification Code Search
Tool are obtained from Current Procedural Terminology (CPT®), copyright 2020
by the American Medical Association (AMA). CPT is developed by the AMA as a
listing of descriptive terms and five character identifying codes and
modifiers for reporting medical services and procedures performed by
physicians.
* 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.
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. No fee schedules, basic
unit values, relative value guides, conversion factors or scales are included
in any part of CPT. 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. Applicable FARS/DFARS apply.
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT®")
* CPT only Copyright 2020 American Medical Association. All Rights Reserved.
CPT is a registered trademark of the American Medical Association. 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. 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. 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. Applications
are available at the American Medical Association Web site,
www.ama-assn.org/go/cpt.
U.S. Government Rights
* 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. 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.
Disclaimer of Warranties and Liabilities.
* 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. No fee schedules, basic
unit, relative values or related listings are included in CPT. The American
Medical Association (AMA) does not directly or indirectly practice medicine
or dispense medical services. The responsibility for the content of this
product is with Aetna, Inc. and no endorsement by the AMA is intended or
implied. 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. The AMA
is a third party beneficiary to this Agreement.
* Should the foregoing terms and conditions be acceptable to you, please
indicate your agreement and acceptance by selecting the button labeled "I
Accept".
* The information contained on this website and the products outlined here may
not reflect product design or product availability in Arizona. Therefore,
Arizona residents, members, employers and brokers must contact Aetna directly
or their employers for information regarding Aetna products and services.
* This information is neither an offer of coverage nor medical advice. It is
only a partial, general description of plan or program benefits and does not
constitute a contract. In case of a conflict between your plan documents and
this information, the plan documents will govern.
I accept
DENTAL CLINICAL POLICY BULLETINS
By clicking on “I accept”, I acknowledge and accept that:
* Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in
administering plan benefits and do not constitute dental advice. Treating
providers are solely responsible for dental advice and treatment of members.
Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to
their coverage or condition with their treating provider.
* While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in
administering plan benefits, they do not constitute a description of plan
benefits. 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. 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.
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). Your benefits plan determines
coverage. Some plans exclude coverage for services or supplies that Aetna
considers medically necessary. If there is a discrepancy between this policy
and a member's plan of benefits, the benefits plan will govern. In addition,
coverage may be mandated by applicable legal requirements of a State or the
Federal government.
* Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly
updated and are therefore subject to change.
* 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.
* Under certain plans, if more than one service can be used to treat a covered
person's dental condition, Aetna may decide to authorize coverage only for a
less costly covered service provided that certain terms are met.
I accept
MEDICAL CLINICAL POLICY BULLETINS
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".
* 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 medical advice and treatment of members.
Members should discuss any Clinical Policy Bulletin (CPB) related to their
coverage or condition with their treating provider.
* While the Clinical Policy Bulletins (CPBs) are developed to assist in
administering plan benefits, they do not constitute a description of plan
benefits. The Clinical Policy Bulletins (CPBs) express Aetna's determination
of whether certain services or supplies are medically necessary, experimental
and investigational, or cosmetic. 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 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). 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. Aetna expressly reserves the right to revise these conclusions as
clinical information changes, and welcomes further relevant information
including correction of any factual error.
* CPBs include references to standard HIPAA compliant code sets to assist with
search functions and to facilitate billing and payment for covered services.
New and revised codes are added to the CPBs as they are updated. When
billing, you must use the most appropriate code as of the effective date of
the submission. Unlisted, unspecified and nonspecific codes should be
avoided.
* 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. If there is a
discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of
benefits, the benefits plan will govern.
* In addition, coverage may be mandated by applicable legal requirements of a
State, the Federal government or CMS for Medicare and Medicaid members.
See CMS's Medicare Coverage Center
* Please note also that Clinical Policy Bulletins (CPBs) are regularly updated
and are therefore subject to change.
* 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.
* 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. In the event that a member disagrees with a
coverage determination, Aetna provides its members with the right to appeal
the decision. 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. However, applicable state mandates will take precedence with respect
to fully insured plans and self-funded non-ERISA (e.g., government, school
boards, church) plans.
See Aetna's External Review Program
* 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). CPT is developed by the AMA
as a listing of descriptive terms and five character identifying codes and
modifiers for reporting medical services and procedures performed by
physicians.
* 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.
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). No fee schedules, basic
unit values, relative value guides, conversion factors or scales are included
in any part of CPT. 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. Applicable FARS/DFARS apply.
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT®")
CPT only copyright 2015 American Medical Association. All Rights Reserved. CPT
is a registered trademark of the American Medical Association.
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.
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.
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. Applications are available at the
American Medical Association Web site, www.ama-assn.org/go/cpt.
Go to the American Medical Association Web site
U.S. Government Rights
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. 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.
Disclaimer of Warranties and Liabilities.
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. No fee schedules, basic unit, relative
values or related listings are included in CPT. The American Medical Association
(AMA) does not directly or indirectly practice medicine or dispense medical
services. The responsibility for the content of this product is with Aetna, Inc.
and no endorsement by the AMA is intended or implied. 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. The AMA is a
third party beneficiary to this Agreement.
Should the foregoing terms and conditions be acceptable to you, please indicate
your agreement and acceptance by selecting the button labeled "I Accept".
The information contained on this website and the products outlined here may not
reflect product design or product availability in Arizona. Therefore, Arizona
residents, members, employers and brokers must contact Aetna directly or their
employers for information regarding Aetna products and services.
This information is neither an offer of coverage nor medical advice. It is only
a partial, general description of plan or program benefits and does not
constitute a contract. In case of a conflict between your plan documents and
this information, the plan documents will govern.
I accept
Opens in a new tab