Aetna® Medicare coverage decisions, appeals and grievances
What do you need help with?
Do you want to know if we will pay for a service or treatment? Or do you have a question about your care? Whatever it is, we want to help. You can also call us at the number on your member ID card.
Medicare coverage decisions
Wondering if your plan will cover a medical service or prescription drug? You can ask us for a coverage decision. We’ll let you know if your plan will cover it.
Medicare appeals
Did you already ask us to cover a medical service or prescription drug? If the answer was no, you can file an appeal. This asks us to change our decision.
Medicare grievances
Do you have a concern with a service or your care? If so, you can file a grievance. A grievance is like a complaint. It can be about your doctor or another provider, a pharmacy or something else.
You have the right to suggest changes in the plan’s policies and services, including our Member Rights and Responsibilities policy.