Some drugs have coverage rules, such as prior authorization, step therapy and quantity limits. To learn about coverage rules, requesting exceptions to coverage rules and more, visit ourDrug information and resourcespage. Have Medicare coverage through an employer?
Get the Aetna medicare prior authorization form completed. Download your adjusted document, export it to the cloud, print it from the editor, or share it with others via a Shareable link or as an email attachment. Benefit from DocHub, one of the most easy-to-use editors to quickly manage ...
Also known as prior creditable coverage. This term means types of health coverage a person has had. People sometimes need to prove they have had this so they can be fully covered by a new plan. Some examples of acceptable types are: Group or individual coverage Medicare Medicaid Health care...
Aetna partners with Novologix to offer free electronic prior authorization services for specialty drugs on Aetna’s National Precertification List. You can use this service for commercial and Medicare members for all health plans. For questions about Novologix, call 1-866-378-3791 or send them an...
Aetna considers continuation of hCG therapy medically necessary for all members (including new members) requesting reauthorization who meet all initial authorization criteria. Follitropins (e.g., follitropin alfa [Gonal-f]; follitropin beta [Follistim AQ]) Critieria for Initial Approval: Aetna consi...
This Clinical Policy Bulletin addresses the following tocilizumab products for commercial medical plans. For Medicare criteria, see Medicare Part B Criteria.tocilizumab (Actemra) tocilizumab-aazq (Tyenne) tocilizumab-bavi (Tofidence)Note: Requires Precertification:...
This Clinical Policy Bulletin addresses botulinum toxin for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: Precertification of botulinum toxin (Botox [onabotulinumtoxinA]; Daxxify [daxibotulinumtoxinA-lanm], Dysport [abobotulinumtoxinA]; ...
For Medicare criteria, see Medicare Part B Criteria. Note: Requires Precertification: Precertification of octreotide acetate (Sandostatin, Sandostatin LAR Depot), lanreotide (Somatuline or generic), pasireotide diaspartate (Signifor), and pasireotide pamoate (Signifor LAR) is required of all Aetna ...
For Medicare criteria, see Medicare Part B Criteria.Note: Requires Precertification:Precertification of omalizumab (Xolair) is required of all Aetna participating providers and members in applicable plan designs. For precertification of omalizumab call (866) 752-7021 or fax (888) 267-3277. For ...
This Clinical Policy Bulletin addresses infliximab for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: Precertification of an infliximab product (Avsola, Inflectra, Remicade, or Renflexis) is required of all Aetna participating providers and ...