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