|
About the Aetna Public Employees Plan
If a member goes to a non-contracted provider, will Aetna cover the visit (with the member paying more, as with UMP) or will claims be denied?
Aetna does not cover services from non-contracted providers, except in the case of an emergency, so the claim would be denied.
Back to Top
Who handles prescription drug benefits for the Aetna Public Employees Plan?
Prescription drug benefits for the Aetna Public Employees Plan are managed by Washington State Rx Services, which contracts directly with the Health Care Authority and is not affiliated with Aetna. Aetna enrollees pay flat copays for prescriptions at retail and mail order. See the Prescription Drug section of the Aetna website at www.aetnahca.com or call Washington State Rx Services at 1-888-361-1612 to find out what your copay would be for your prescription drugs.
Back to Top
How does the Aetna Public Employees Plan coordinate benefits for members who have other insurance that is primary (like Medicare, for example)?
Aetna does coordinate benefits with other plans. If you have other coverage that is primary, in most cases, Aetna will cover the rest of the charges and the enrollee will owe nothing or very little.
Back to Top
Is there a conversion plan for Aetna enrollees whose COBRA period expires?
Yes. Those who live in Washington and most other states can convert to a basic conversion plan offered by Aetna. In a few states where Aetna does not have a basic conversion plan, they will be able to transfer to a conversion plan offered through Uniform Medical Plan. These states are California, Montana, Nevada, New Hampshire, New York, South Dakota and Vermont.
Back to Top
Does Aetna have a health assessment in 2009?
The Health Care Authority does offer a health assessment to Aetna plan enrollees. The Health Counts Health Assessment can be accessed at www.activehealthphr.net/hca. Enrollees who complete the Health Assessment will receive a $30 gift card.
Back to Top
|
