Medicare plans Are you older than 65? If so, you may be eligible for a Medicare plan, which is a type of health insurance that covers people 65 and older. Medicare also covers certain disabilities in people under the age of 65. To find out if you’re eligible for Medicare, use this ...
Diffuse large B-cell lymphoma (DLBCL) whenallof the following criteria are met: The requested drug is used as subsequent therapy;and The requested drug is used in combination with polatuzumab vedotin-piiq with or without rituximab;and The member is not a candidate for transplant or the requeste...
Elastic support garments (e.g. made of material such as neoprene or spandex [elastane, Lycra]) do not meet Aetna's definition of covered DME because they are not durable (not made to withstand prolonged use). Note: Most Aetna traditional plans cover durable medical equipment (DME) as a st...
Medicare Advantage and Medicare supplement plans, and workers' compensation administrative services. It primarily serves employer groups, labor groups, college students, health care providers, part-time and hourly workers, individuals, health plans, government-sponsored plans, governmental units, and expatri...
Aetna considers tracheostomy medically necessary for those members with the most severe OSA not manageable by other interventions. Requests for tracheostomy for OSA are subject to medical review.Note: Aetna follows Medicare DME MAC rules for the medically necessary quantity of tracheostomy supplies for ...
Policy Scope of Policy This Clinical Policy Bulletin addresses rituximab for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: Precertification of rituximab (Rituxan), rituximab-abbs (Truxima), rituximab-arrx (Riabni), rituximab-pvvr (Ruxien...
Most Aetna benefit plans exclude coverage of hearing aids. Any applicable benefit plan exclusions and limitations for coverage of hearing aids would apply to air conduction hearing aids, implantable hearing aids and semi-implantable hearing aids. Please check benefit plan descriptions for details. ...
This Clinical Policy Bulletin addresses alpha 1-proteinase inhibitors for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note:Requires Precertification: Precertification of alpha 1-proteinase inhibitors (Aralast NP, Glassia, Prolastin-C, and Zemaira) is required of all ...
This Clinical Policy Bulletin addresses aldesleukin (Proleukin) for commercial medical plans. For Medicare criteria, see Medicare Part B Criteria. Criteria for Initial Approval Aetna considers aldesleukin (Proleukin) intravenous medically necessary for the treatment of persons with any of the following cond...
Policy Scope of Policy This Clinical Policy Bulletin addresses hematopoietic colony-stimulating factors (CSFs) for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note:Requires Precertification: Precertification of long-acting granulocyte colony stimulating factor (G-CSF) prod...