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Preventive care includes vaccines, well exams and routine screenings. Vaccines help protect you and others from harmful disease. Screenings check for medical issues early when they’re easier to treat. Together, it’s a powerful pair for overall health and wellness.
Most plans cover eligible preventive care services for $0 out of pocket. Check your plan documents to learn if your plan covers a service. You can also call us at the number on your member ID card.
We’ve gathered helpful info from trusted sources about vaccines and health screenings. Be sure to talk with your doctor about what may be right for you.
Vaccines help your immune system create antibodies that protect you from disease. With your Aetna® benefits plan, you’re covered for a flu shot. Plus, non-seasonal vaccines, like RSV, pneumonia, shingles and Tdap. Check vaccine details.* We’re bringing together what matters most to you.
Consider a vaccine schedule to help your kids stay protected.
Protect yourself and those you love. It’s easy to find a provider and schedule your flu shot visit.
Looking for a simple way to check in on your health? Routine screenings check for diseases or conditions before there are signs or symptoms. This can help you get early treatment or even avoid a health issue.
Find guidelines by age. We follow grade A and B recommendations.
Find preventive care guidelines for women’s health and well-being.
Find mental health screening and preventive care info.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Aetna® and CVS Pharmacy® are part of the CVS Health® family of companies.
Health benefits and health insurance plans contain exclusions and limitations.
Flu shots and vaccines may not be available in all pharmacies at all times. Call for availability and to make an appointment, if needed. Most vaccines require a prescription (except for the flu shot).
The flu shot and many vaccines to treat common illnesses are generally covered under the Affordable Care Act by non-grandfathered group health plans and non-grandfathered individual and group health insurance coverage typically with no cost sharing if provided by an in-network provider, consistent with specified dosage limits and satisfaction of age and other vaccine specific requirements. Other restrictions may apply. Check with your health plan if you have any questions about your benefits.
Pharmacy benefits are administered by an affiliated pharmacy benefit manager, CVS Caremark®.
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Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
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Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
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Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?
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The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.
Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.
The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.
Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change.
Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law.
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Copyright 2015 by the American Society of Addiction Medicine. Reprinted with permission. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM.
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Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliates are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its affiliated 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.
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