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General Aetna® disclaimers
Policies and plans are insured and/or administered by Aetna Life Insurance Company or its affiliates (Aetna). Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Refer to Aetna.com for more information about Aetna® plans.
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, Aetna Health of California Inc., and their affiliates (Aetna).
Health plans are offered or underwritten or administered by Aetna Health of California Inc., Coventry Health Plan of Florida, Inc., Aetna Health Inc. (Florida), Aetna Health Inc. (Georgia), Aetna Life Insurance Company, Aetna Health of Utah Inc., Aetna Health Inc. (Pennsylvania), or Aetna Health Inc. (Texas) (Aetna) Aetna is part of the CVS Health® family of companies.
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, Aetna Health Inc. and Aetna Better Health of Washington (Aetna) and their affiliates.
Product, program and third-party disclaimers
In Florida, policies are insured by Aetna Health Inc. and/or Aetna Life Insurance Company. In Iowa by Aetna Health of Iowa Inc. and/or Aetna Life Insurance Company. In Utah and Wyoming, by Aetna Health of Utah Inc. and Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. For all other states, policies are insured by Aetna Health Inc., Aetna Health Inc. of Pennsylvania, Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Inc. of Maine, Aetna HealthAssurance Pennsylvania Inc., Aetna Health Insurance Company and/or Aetna Life Insurance Company. Each insurer has sole financial responsibility for its own products.
Health information programs provide general health information and are not a substitute for diagnosis or treatment by a health care professional.
In Florida, you pay the PCP copay when you visit any network PCP, regardless of whether it is your selected PCP.
Care management nurses/24 Hour Nurse Line/Informed Health®
While only your doctor can diagnose, prescribe or give medical advice, the care management nurses can provide information on a variety of health topics.
Managed Choice and Open Access Managed Choice are not available on a fully insured basis in Missouri.
In Texas, PCP is known as physician (primary care).
In the State of Washington, PCP refers to primary care provider.
Missouri members in insured plans are not required to have or select a PCP, or to obtain a referral from a PCP to see a specialist.
Open Access Managed Choice and Managed Choice are not available in Missouri.
Aetna HMO plans issued to a Missouri-based plan sponsor or individual policyholder do not have a deductible.
Missouri members in insured plans receive the same cost sharing as a network PCP for in-network services rendered by a physical or occupational therapist.
Missouri members in insured plans have coverage for at least two outpatient sessions per calendar year for the purpose of diagnosis or assessment of mental health by an in-network or out-of-network mental health provider.
Cost estimating tools
Estimated costs are not available in all markets or for all services. We provide an estimate for the amount you would owe for a particular service based on your plan at that very point in time. It is not a guarantee. Actual costs may differ from an estimate for various reasons including claims processing times for other services, providers joining or leaving our network or changes to your plan. Health maintenance organization (HMO) members can only get estimated costs for doctor and outpatient facility services.
Coverage anywhere in the world
No coverage based on U.S. sanctions: If U.S. economic or trade sanctions consider you a blocked person, the plan cannot provide benefits to you. If your health care provider is a blocked person or is in a sanctioned country, we cannot pay for services from that provider. For example, if you receive care while traveling in another country and the health care provider is a blocked person or is in a sanctioned country, the plan cannot pay for those services. Learn more information about U.S. trade sanctions.
DMO plans are insured by Aetna Life Insurance Company, Aetna Dental Inc., Aetna Dental of California Inc. and/or Aetna Health Inc. (Aetna). Each insurer has sole financial responsibility for its own products.
Dental policies and plans are insured and/or administered by Aetna Life Insurance Company (Aetna). Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Refer to Aetna.com for more information about Aetna® plans.
Not all services are covered. See plan documents for a complete description of benefits, exclusions and limitations of coverage. Plan features and availability may vary by location and are subject to change.
State laws vary with regard to out-of-network benefits. In Illinois, DMO plans provide limited out-of-network benefits. However, in order to receive maximum benefits, members must select and have care coordinated by a participating primary care dentist. Illinois DMO is not an HMO.
DNO (Dental Network Only) in Virginia is not an HMO. To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with in-network providers.
In Texas, the dental Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN).
Dental plans and vision benefits are insured by Aetna Life Insurance Company (Aetna). Certain vision claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care ("EyeMed"), LLC.
Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Refer to the Aetna Dental Direct website for more information about Aetna® dental plans.
Policies and plans are insured and/or administered by Aetna Life Insurance Company (Aetna). Certain claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care (“EyeMed”), LLC. Providers in the Aetna Vision network are contracted and credentialed through EyeMed Vision Care, LLC according to EyeMed’s requirements. EyeMed and Aetna are independent contractors and not agents of each other. Provider participation may change without notice. Refer to Aetna.com for more information about Aetna® plans.
Aetna Life Insurance Company, located at 151 Farmington Avenue, Hartford, CT 06156, 1-877-698-4825 ${tty}, is the Discount Plan Organization.
Student health insurance plans are insured by Aetna Life Insurance Company (Aetna). Self-insured plans are funded by the school and administered by Aetna Life Insurance Company.
Aetna Student Health℠ is the brand name for products and services provided by Aetna Life Insurance Company, Aetna Health and Life Insurance Company and their affiliates.
Aetna provides access to the travel assistance program offered and administered by On Call International, LLC (OnCall). AD&D coverage offered through OnCall is underwritten and insured by third parties as set forth in the policy. Aetna and OnCall are independent contractors and are not agents of each other. Aetna accepts no liability for the services provided through On Call.
For more information, visit AetnaStudentHealth.com.
The Student Assistance Program (SAP) is administered by Aetna Behavioral Health, LLC. All SAP calls are confidential, except as required by law. SAP educators and participating providers are independent contractors and are not agents of Aetna. Aetna does not oversee or control the services provided by these persons and does not assume any liability for their services.
DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge on products and services offered by third party vendors and providers. Aetna makes no payment to third parties. You are responsible for the full cost. Check any insurance plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts.
Not available to NY policyholders.
Discount vendors and providers are not agents of Aetna and are solely responsible for the products and services they provide. Discount offers are not guaranteed and may end at any time. Aetna may get a fee when you buy these discounted products and services.
Hearing products and services are provided by Hearing Care Solutions and Amplifon Hearing Health Care.
Vision care providers are contracted through EyeMed Vision Care. LASIK surgery discounts are offered by the U.S. Laser Network and Qualsight.
Natural products and services are offered through ChooseHealthy®, a program provided by ChooseHealthy, Inc. which is a subsidiary of American Specialty Health Incorporated (ASH). ChooseHealthy is a registered trademark of ASH and is used with permission.
Other discounts are offered through the LifeMart® member discount program, offered by LifeCare, Inc. LifeMart® is a registered trademark of LifeCare, Inc. and is used with permission.
If you have questions about any of the discounts, call the number on the back of your ID card. For HMO members, any complaints about these discount offers may be submitted using the process described in your Evidence of Coverage.
Talk to your doctor first about whether this is right for you.
Incentive-based activity awards are not available to California HMO members.
Aetna Behavioral Health refers to an internal business unit of Aetna. Administrative services are provided by Aetna Behavioral Health, LLC.
Aetna does not recommend the self-management of health problems. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a health care professional.
There may be fees associated with a health savings account ("HSA"). Please see the HSA fee schedule online.
Investment services are independently offered through a third-party financial institution. By transferring funds into an HSA investment account, you will also be exposed to a number of risks, including the loss of principal, and you should always read the prospectuses for the mutual funds you intend on purchasing to familiarize yourself with these risks. The prospectus describes the funds, investment objectives and strategies, their fee and expenses, and the risks inherent to investing in each fund.
The HSA investment account is an optional, self-directed service and Inspira Financial™ does not provide investment advice. Mutual funds and brokerage investments are not FDIC-insured and are subject to investment risk, including fluctuations in value and the possible loss of the principal amount invested. System response and account access times may vary due to a variety of factors, including trading volumes, market conditions, system performance, and other factors.
The amount due shown in your account is reported to us by the insurance carrier. Any adjustments to this amount may result in overpayments or underpayments. You may have to work directly with your provider or insurance carrier to make any necessary adjustments. If a refund check is sent to you by your provider, what you do with those funds may have tax consequences.
MasterCard® is a registered trademark of MasterCard International Incorporated.
This card is issued by UMB Bank pursuant to a license from MasterCard International Incorporated.
HSA Advantage is powered by The Karis Group’s Kare360 program. Kare360 is not insurance and does not provide funds to pay for bills. This is a best-efforts service. Despite Kare360’s diligent efforts on member’s behalf, some providers refuse to make accommodations to help resolve outstanding medical bills.
HRAs are currently not available to Florida members.
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). Pharmacy benefits are administered through an affiliated pharmacy benefit manager, CVS Caremark®. Aetna® is part of the CVS Health® family of companies. Aetna® and CVS Specialty® are part of the CVS Health® family of companies. CVS Caremark® Mail Service Pharmacy, CVS Specialty® and Aetna are part of the CVS Health® family of companies.
CVS Caremark® Mail Service Pharmacy and Aetna® are part of the CVS Health® family of companies.
Maintenance Choice is not available in all states and is not permitted for Minnesota and Oklahoma residents.
For a complete list of other participating pharmacies, log in to Aetna.com and use our provider search tool.
Aetna Resources For Living℠ is the brand name used for products and services offered through the Aetna group of companies (Aetna). The EAP is administered by Aetna Behavioral Health, LLC. and in California for Knox-Keene plans Health and Human Resources Center, Inc.
The EAP is administered by Resources For Living, LLC.
All EAP calls are confidential, except as required by law. EAP instructors, educators and participating providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Refer to Aetna.com for more information about Aetna® plans.
This material provides a general overview of the topic. Information is not meant to replace the advice of tax, financial or legal advisors.
Information is not a substitute for diagnosis or treatment by a professional. Contact a professional with any questions about specific needs.
There may be other explanations for any or all of the above behaviors, characteristics and/or symptoms. This information is not a complete list of all signs concerning such behaviors, characteristics and/or symptoms and should not be used as a stand-alone instrument.
Consult your company’s human resources, legal and other professionals to properly assess your observations and apply your company’s policies regarding harassment and bullying.
SIGNAL System® Assessment Tool complements a provider’s own assessment of a patient’s progress and the strength of the therapeutic alliance but does not replace the provider’s independent professional judgment.
This search provides information. It does not endorse or recommend providers. You will need to contact providers to verify location information and ensure availability. While every effort is made to maintain current provider information, providers in your community may change without notice.
Services are provided and managed by Lifecare, an independent third party. Aetna does not oversee or control the services provided by or recommended by Lifecare and does not assume any liability for their services.
Services are provided and managed by MyStrength, an independent third party. Aetna does not oversee or control the services provided by or recommended by MyStrength and does not assume any liability for their services.
No protected health information will be sent to you through text. SMS, as a technology, is not a secure messaging platform. If Aetna needs to send you a message that involves protected health information or personally identifiable information, the information will be sent securely by encrypted e-mail.
Case studies are composites of real situations. All names and other identifying information are fictional.
ZP Challenge program is developed by ZP Group, Inc., an independent third party.
[DIGITAL MATERIALS ADA COMPLIANCE STATEMENT]
Resources For Living strives to continuously improve our digital experiences to meet or exceed universal design best practices and web accessibility standards. We have adopted Web Content Accessibility Guidelines (WCAG) 2.0 A/AA Guidelines as our corporate standard.
Resources For Living® is the brand name used for products and services and is administered by Resources For Living, LLC ("RFL"). RFL is an independent company and is not owned or operated by Wal-Mart. Information is not a substitute for diagnosis or treatment by a professional. Contact a professional with any questions about specific needs. All calls are confidential, except as required by law.
The EAP is administered by CARE/Solutions For Life. All EAP calls are confidential, except as required by law. EAP instructors, educators and participating providers are independent contractors and are not agents of CARE. Provider participation may change without notice.
Services are provided by ActiveHealth Management, Inc.
Our programs, care team and care managers do not diagnose or treat members. We assist you in getting the care you need and our program is not a substitute for the medical treatment and/or instructions provided by your health care providers.
The CareEngine® is a proprietary technology platform developed by ActiveHealth Management, Inc. In conjunction with clinicians, the CareEngine continuously analyzes claims and other data against evidence-based best practices and alerts the members and their physicians about possible care gaps and other inconsistencies. Information is not a substitute for diagnosis or treatment by a health care professional.
In case of emergency, call 911 or your local emergency hotline, or go directly to an emergency care facility.
Aetna Funding Advantage℠ plans are self-insured by the employer and administered by Aetna Life Insurance Company.
Network providers are independent contractors and are not agents of Aetna. Provider participation may change without notice.
Aetna Signature Administrators is the brand name 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®, CVS Pharmacy, Inc., which owns CVS® HealthHUB™ locations, and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics), Signify Health and Oak Street Health are part of the CVS Health® family of companies.
For a complete list of other participating pharmacies log in to your member website to use our provider search tool.
For your best health, we encourage you to have a relationship with a primary care physician or other doctor. Tell them about your visit to MinuteClinic, or MinuteClinic can send a summary of your visit directly to them.
FOR 20% OFF BENEFITS: The 20% savings is restricted to items purchased for the member, spouse or dependents. Excludes prescriptions, lottery tickets, postage stamps, gift cards, money orders, pre-paid cards, photofinishing, CVS.com purchases, and are not valid on other items reimbursed by a governmental program.
FOR LOW COST/NO COST MINUTECLINIC: Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states and on indemnity plans.
For California residents only: Telehealth services are also available with your dentist, primary care provider (PCP) or specialist. If you use services from a telehealth vendor, your medical records will be shared with your dentist, PCP or specialist. If you want to opt out, please notify your telehealth vendor during your visit. In-network cost sharing will apply for all services received through the third-party corporate telehealth provider and all out-of-pocket costs will accrue to the applicable deductible and/or out-of-pocket maximum.
CVS Virtual Care
CVS Virtual Care services are only available in the USA. Limitations may apply based on services and location. Controlled substances not prescribed.
Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive services at no cost-share.
Adolescent mental health services are limited to counseling only. Mental health medication management and psychiatry services remain available only for adults 18+.
Teladoc®
Teladoc® is not available to all members. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. Visit Teladoc.com/Aetna for a complete description of the limitations of Teladoc services. Teladoc, Teladoc Health and the Teladoc Health logo are registered trademarks of Teladoc Health, Inc.
bswift®
bswift is the brand name for products and services offered by bswift, LLC, an affiliate of Aetna.
98point6
98point6 is a registered trademark of 98point6 Inc. Access to 98point6 is not included in all plans.
98point6 and 98point6 physicians are independent contractors and are not agents or employees of Aetna. Using the 98point6 app does not replace the primary care physician and does not guarantee that a prescription will be written. 98point6 physicians will not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Physicians reserve the right to deny care for potential misuse of services.
Members enrolled in qualified high-deductible health plans must meet their deductible before receiving services at no cost-share. However, such services are covered at negotiated contract rates.
Healthwise®
Healthwise® Knowledgebase – This online database is the cornerstone of our information resources. Developed by Healthwise, Inc., it was created specifically for the program’s care counseling approach. The database contains health information on over 6,000 topics and 500 support/self-help groups. Nurses can print information from the database and mail it to members as follow up to phone calls. Healthwise Knowledgebase is also available online to members.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information is not intended to replace the advice of a doctor. Aetna and Healthwise are not responsible for the decisions you make based on this information. If you have specific health care needs or would like more complete health information, please see your doctor or other health care provider.
Apple
Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc.
Google Play and the Google Play logo are trademarks of Google LLC.
Mastercard®
MasterCard® is a registered trademark of MasterCard International Incorporated.
Morningstar
Morningstar, Inc., Morningstar, the Morningstar logo and Morningstar.com are registered trademarks of Morningstar, Inc.
Quest
Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics.
Other third-party trademarks
All trademarks and logos are the intellectual property of their respective owners.
Legal notices
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).
Health benefits and health insurance plans contain exclusions and limitations.