their traditional Medicare coverage to Aetna-run Medicare Advantage to generate cost savings for New York City. Critics claim the shift of 250,000 city retirees to Medicare Advantage supplemental coverage could leave them with higher costs and fewer benefits.nypost.com/2024/06/16/us-ne...Bullish...
A major draw for Medicare Advantage is the supplemental benefit offerings that these private plans can provide, ranging from dental and vision coverage to pharmacy benefits to programs targeting the social determinants of health. And while those benefits have largely grown with the program, payment ra...
Aetna's policy on parenteral and enteral nutrition is similar to Medicare policy. Medicare provides reimbursement under the part-B prosthetic-device benefit for parenteral and enteral nutrition. Consistent with its policy of covering supplies necessary for use of prosthetics, Medicare will generally cover...
Aetna plans exclude coverage of cosmetic surgery and procedures that are not medically necessary, but generally provide coverage when the surgery or procedure is needed to improve the functioning of a body part or otherwise medically necessary even if the surgery or procedure also improves or changes...
For Medicare Part B plans, call (866) 503-0857 or fax (844) 268-7263.Hepatitis B Immune GlobulinCriteria for Initial Approval Aetna considers hepatitis B immune globulin medically necessary for members who have had contact with an individual diagnosed with hepatitis B virus (HBV). Risk groups ...
This Clinical Policy Bulletin addresses remdesivir (Veklury) for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: The criteria outlined in this policy is only applicable to coverage in the outpatient setting. Hospitalized members receiving Veklury for the treatment ...