aetna medicare advantage timely filing 2022

You have the flexibility to receive covered services from network providers or out‐of‐network providers. If you’re enrolled in Aetna Medicare Plan (PPO) If you get routine care from out‐of‐network providers, Medicare and Aetna Medicare won’t be responsible for the costs. You must use network providers, except for: There are exceptions for certain direct access services. You’ll need to get a referral from your PCP for covered, non‐emergency specialty or hospital care, except in an emergency and for certain direct‐access service. For some services, your PCP is required to obtain prior authorization from Aetna Medicare. Your PCP will issue referrals to participating specialists and facilities for certain services. Generally, you must get your health care coverage from your primary care physician (PCP). Medicare and Aetna Medicare won’t be responsible either. If you get coverage from an out‐of‐network provider, your plan won’t cover their charges. If you’re enrolled in a standard Aetna Medicare Plan (HMO) *Some items may require prior authorization from your medical benefit. Insulin needles, pens and syringes (when used for injecting insulin).Individual Medicare Prescription Drug (PDP) and MAPD plans cover diabetic supplies under Part D, including: For more info about your no-cost OneTouch BGM for Aetna ® Medicare plan members, you can visit us online or call 1-87 $ without a prescription.To avoid rejections on Part B-covered supplies like test strips, ensure they are OneTouch brand.Blood Glucose Meters (BGM) and testing supplies - exclusively OneTouch ® by LifeScan.FreeStyle Libre, Dexcom and Medtronic iPro ®ĭownload the DME National Provider Listing (PDF) to view potential suppliers.Continuous Glucose Monitors (CGM) and supplies, including:.Therapeutic shoes* and inserts* for diabetics.Insulin infusion pump and most insulins used in the pump.Medical benefits, diabetic supplies and equipment coverage may include:

Just check your plan’s Evidence of Coverage (EOC) for details and limitations. You can get some diabetic supplies, including durable medical equipment (DME), with your Medicare Advantage (MA) and Medicare Advantage Prescription Drug plans (MAPD).

Aetna medicare advantage timely filing 2022