We want you to have the access you need
Are you worried about a public health emergency or disaster? You'll still have access to your Aetna Medicare benefits.
Which events count?
To count, the event must:
- Be officially declared by the government
- Disrupt access to health care
This is called a qualifying declared public health emergency or disaster.
When one of these events is declared, and until it ends, we will:
- Reduce out-of-network facility costs to in-network amounts
- Waive the need for referrals in some cases
- Make the changes that you need effective immediately, without the required 30-day notice
Who declares a disaster or public health emergency?
The Centers for Medicare & Medicaid Services (CMS) tells us how they can be declared. Here’s how:
- A U.S. president can declare a disaster or emergency under one of these Acts:
- The Stafford Act
- The National Emergencies Act
- The U.S. Health Secretary can declare a public health emergency under Section 319 of the Public Health Service Act.
- The governor of your state or territory can declare an emergency or disaster.
If the president declares a disaster, the Health Secretary may also allow waivers or changes under section 1135 of the Public Health Service Act.
When does either event end?
A qualifying declared public health emergency or state of disaster ends 30 days after any of these occur:
- The source that declared the event says it’s over.
- Access to health care is no longer disrupted.
- CMS declares that the event is over.
- The event is declared and no end date is given:
- This includes when the declaration expires.
- This also includes when any renewal of the declaration expires.
- Or if an end date is given for the emergency.
We’ll let CMS know if we can’t get back to normal operations by the end of the public health emergency or state of disaster.
How your plan must help you
Here’s how else we can help at these times:
For care from an out-of-network provider
What if you need to get care out of network during a disaster or emergency? If you live in a disaster area, we must explain your payment terms and conditions to you.
To keep you informed
Each year, we have to tell you about any special requirements that are in effect during a disaster or emergency. And we have to share them 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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