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Expansion of Dual Eligible Special Needs Plans (DSNPs) beginning January 1, 2019

 

We’ve expanded our 2019 Dual Eligible Special Needs Medicare Advantage HMO Plans. These plans are available to individuals who are dual eligible for Medicare and Medicaid coverage and live within a DSNP county.

 

Since the DSNP network is available in a limited number of counties, check your participation status using the provider search tool on either the Aetna or Coventry website.

 

DSNP members should show the following cards to your office staff:

  • DSNP member ID card
  • State-issued Medicaid (or MSP) card (varies by state and month of eligibility)


Prior authorizations

 

Participating providers can submit preauthorization requests through our provider portal, by fax or by calling the Provider Service Center.

 

Other important information

 

  • Primary care physician selection is required for all members.
  • Pharmacy Part D coverage is included for DSNPs.
  • No out-of-network benefits exist for these plans unless the member follows the approval process by contacting Member Services directly.

 

View our DSNP information by checking our provider manual on aetna.com.

 

Questions and/or to verify eligibility

 

To verify member and provider eligibility, view claims submission information and access our websites, view our 2019 Dual Eligible Special Needs Medicare Advantage HMO Plans. You can also use the phone number listed there to speak to a representative.