Get helpful guidance to understand your health plan or find quality coverage for you and your family. Medical providers Join the Aetna network, so together we can give patients access to the most trusted, highest-quality care. Agents and brokers ...
If you’re considering an Aetna plan:If your employer is offering an Aetna pharmacy plan, ask your HR department for the plan name. Ready to search drug info? Follow these steps: Step 1: Choose a plan year Step 2: Choose a plan ...
It will not cover any part of the cost of non-formulary drugs. However, in some instances, a plan may be willing to make an exception. To get one, you need to contact the plan and tell them why the drug is needed. CMS Also known as Centers for Medicare & Medicaid Services. This ...
Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does ...
Please check benefit plan descriptions for details. Gender dysphoria when all of the following are met: The member is able to make an informed decision to engage in hormone therapy; and The member has a diagnosis of gender dysphoria; and The member's comorbid conditions are reasonably controlled...
Precertification of certolizumab pegol (Cimzia) is required of all Aetna participating providers and members in applicable plan designs. For precertification, call (866) 752-7021 or fax (888) 267-3277. For Statement of Medical Necessity (SMN) precertification forms, see Specialty Pharmacy Precertif...
Formulary restrictions may apply. Please check plan benefit description for details. Psychotherapy (if member also exhibits anxiety and/or depression) Psychotherapeutic interventions are covered under the member's behavioral health benefits. Please check benefit plan descriptions. Experimental, Investigational,...
See alsoAetna Non-Medicare Prescription Drug Plan Specialty Pharmacy Clinical Policy Bulletins. Dosage and Administration For dosing recommendations, see prescribing information for individual products. Experimental, Investigational, or Unproven Aetna considers the use of IVIG and SCIG experimental, investigation...
Aetna does not cover vibrators, which have been used in the treatment of FSD because vibrators do not meet Aetna’s contractual definition of covered durable medical equipment (DME). Please check benefit plan descriptions. Coverage of DME is limited to devices that are not normally of use in ...