Skip to main content
Doctor Talking with Senior Patient

Medicare

Information and Resources

Important: Medicare Compliance Attestation

All contracted Medicare and Medicaid providers must complete the 2016 Medicare Compliance Attestation. Not complying could affect your participation status.

Aetna or Aetna/Coventry dually contracted Medicare or Medicaid providers

Log in or register with NaviNet to complete the attestation. You’ll find it in the Compliance Reporting section.

Log in or register with NaviNet

Coventry-only Medicare providers and dental contracted providers

Complete the attestation

Nurse comforting patient

Part D prescriber enrollment requirement

Any health care professional who prescribes drugs to patients with Part D plans must now enroll in the Medicare program or opt out. If you do not enroll or opt out, Medicare Part D may no longer cover these drugs as of February 1, 2017. Please try to enroll or opt out by November 1, 2016. This will allow time for application processing and ensure that patients get their prescriptions without disruption.

Get started with Part D enrollment
Enrollment guide

Woman in office staff on phone and holding file

Medicare appeals information

Find what you need to know about submitting a dispute or appealing a decision.

Learn about the dispute process
Medicare appeals for non-participating providers
Appealing a Medicare hospital discharge

Determining Medicare coverage

The Centers for Medicare & Medicaid Services sometimes makes changes to coverage rules. See updated National Coverage Determinations (NCDs) that may affect patient coverage.

See National Coverage Determinations
(Note: scroll to the bottom of the page to see NCDs)

Supplemental retiree medical coverage

The Aetna Supplemental Retiree Medical Plan is a fully insured, non-network-based commercial retiree group health product. In all states but Florida and Minnesota, it is offered as a supplementary medical plan, not a Medicare plan. In Florida and Minnesota, it is approved as a group Medicare Supplement product.

This coverage is offered only to retirees and their eligible dependents who are enrolled in Medicare. 

Get claims processing information and other details about this plan

Doctor listening to patients

For non-participating Aetna Medicare PPO providers

We are expecting an increase in membership for our Medicare Advantage preferred provider organizations. You are likely to see more patients with these health plans.

Here’s what you need to know
Apply to join our network

Part D pharmacy participation

We welcome pharmacies to the Aetna Medicare Part D pharmacy network. The network includes retail and non-retail pharmacies, both independent and chain.

Learn how to participate in our Part D network 

 

Transition of coverage for Part D

Members who are taking Part D drugs that are not on the plan’s formulary, or that are subject to utilization management requirements, can get a transition supply of their drug under certain circumstances. They can work with you to complete a successful transition and avoid disruption in treatment.

Read about our transition process

Prescription drug coverage

Find formularies, prior authorization criteria and step-therapy criteria for our Medicare prescription drug plans.

Find prescription drug information
Find Part D prescription drug prior authorization and exception forms

 

JavaScript is required

In order to have the best experience on Aetna.com, Javascript needs to be enabled.
Learn how to change your browser settings to enable Javascript.

You are now leaving the Aetna website

Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.

Continue >