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Accessing Aetna® Medicare Benefits During a Disaster or Emergency

What you need to know about your Medicare coverage

What you need to know about your Medicare coverage

You'll have access to your Aetna Medicare benefits during a public health emergency or disaster. When one of these events is declared, and until it ends, Aetna Medicare will:
 

  • Temporarily reduce out-of-network facility cost sharing amounts to in-network amounts 
  • Waive referral requirements, where applicable
  • Make changes that benefit you effective immediately, without the required 30-day notice
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Who declares a disaster or public health emergency?


The Centers for Medicare & Medicaid Services (CMS) states that a declaration of disaster may be made by:
 

  • A presidential declaration of disaster or emergency under either:
    • The Stafford Act
    • The National Emergencies Act
  • A secretarial declaration of a public health emergency under Section 319 of the Public Health Service Act
  • A declaration of emergency or disaster by the governor of your state or territory

If the president declares a disaster, the Secretary of Health and Human Services may also authorize waivers or modifications under Section 1135 of the Public Health Service Act.

 

When does a disaster or public health emergency end?

When does a disaster or public health emergency end?

The public health emergency or state of disaster ends 30 days after any of these occur:

  • The source that declared the public health emergency or state of disaster says it's over
  • CMS declares that the public health emergency or state of disaster is over
  • Thirty days have passed since the public health emergency or state of disaster was declared and no end date was given, or
  • 30 days have passed after a declaration end date is provided

We'll let CMS know if we can’t resume normal operations by the end of the public health emergency or state of disaster.

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CMS also requires us to:

  • Explain your payment terms and conditions if you live in a disaster area and get care from an out-of-network health care provider during a declared emergency or disaster
  • Notify you each year of any special requirements that are in effect during a disaster or emergency
  • Share these special requirements with you on our website
 

Need help with Medicare enrollment?

Call a licensed Aetna agent at 1-844-979-3435 ${tty}, ${hours}.

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