That number is 1-877-261-9951 (TTY:711) . In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. If you only have Original Medicare, you dont have a group number, but your 11-digit Medicare number is on your red, white and blue Medicare card. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Your health insurance ID card is your proof of insurance. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. Are Medicaid cards visually distinct from other insurance cards? That number is 1-877-261-9951 (TTY:711) . Different Insurance Cards There are several sorts of insurance cards used in a variety of situations, and this article will help you locate the necessary insurance information. Some individuals may have a single insurance card that covers both medical expenditures (such as visits to the doctor or hospital) and pharmacy benefits (to pay prescriptions), although these are often two distinct cards with unique identifying numbers. VUBlueVision Plus. Applicable FARS/DFARS apply. You may call the toll-free number on your member ID card at any time. A printed or digital card is equivalent to a physical identification card. August 10, 2022 | By Rene Gonzalez | California When customers enroll in health insurance for the first time, change health plans (at any time), or switch insurance providers, they may suffer a delay in receiving pharmacy benefits. The member's benefit plan determines coverage. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Gross Point of Rating. That number is 1-877-261-9951 (TTY:711) . WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). Example: W123456789. This leads in the subsequent advantages: Freedom from onerous parent company requirements Permission to cross-sell other types of insurance Capability to compare insurers on pricing, product, and service. You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. Call the member services number on your ID card for personalized service. How much is health insurance a month for a single person? Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. The member should call that number to activate the card and then try to pay again. Group number. Need help finding your Member ID? As the proprietor of an independent insurance agency, you will enjoy complete independence. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. They do not have access to member accounts but they can provide Aetna Member Services contact information. What is my Aetna ID number? If you only have Original Medicare, you dont have a group number, but your 11-digit Medicare number is on your red, white and blue Medicare card. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. If youre wondering where to find your group number on your insurance card, that answer is that it usually will show on the front of your card. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. When billing, you must use the most appropriate code as of the effective date of the submission. What if I am unable to locate the RxBIN, RxPCN, or RxGroup on the card? Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. Another term for a prescription is Rx. Typically, medical cards have merely a Member ID number. I know this to be true. Insurers have reported several issues with the firm, including denial of benefits and payment delays. Is my policy number my account number? Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). The table below displays the Rx BIN Numbers and PCNs for California Small Group Health Plans per carrier. Your benefits plan determines coverage. It offers coverage for wind and hail in the legislatively defined, Independent Agents are fully unaffiliated with a parent firm. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Need help finding your Member ID? How does south carolina cover wind and hail insurance? Webcheck the H&PBP numbers on the bottom right of the ID card. What is the GRP acronym? Each employer that buys a health plan for its employees also has a number. Primary care networks (PCNs) are clusters of practitioners that collaborate to concentrate patient treatment locally. Member name and number. Please log in to your secure account to get what you need. Please select Member ID to continue. Check the back of your card first, as it is not usually on the front! What policy number is shown on an Aetna insurance card? This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. MediExcel Health Plan is a cross-border health plan. Aetna Inc. and its subsidiary 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. See all of the ways you can contact us You can add more persons to your insurance as the policyholder, depending on your connection with them. It usually only appears on insurance cards that registered employers provided. This is due to the short administrative period required by the health plan to process such changes. Visit the secure website, available through www.aetna.com, for more information. They do not have access to member accounts but they can provide Aetna Member Services contact information. An automated telephone system will answer your call. This Agreement will terminate upon notice if you violate its terms. Gross Point of Rating. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number for the Corporate Contact Center. WebCall us. Where is my policy number on my insurance card? While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The percentage of costs of a covered health care service you pay (20%, for example) after youve paid your deductible. Note that the gold Medicaid card has simply the Member ID, but the managed care plan includes the Member ID, RxBIN, RxPCN, and RxGroup numbers. What is the subscriber ID on an insurance card? These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. Members can visit any in-network provider (PCP or specialist) for covered services without a referral. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. How much is mavyret pricing disclosure outside insurance? How Long Does It Take to Receive a Check for a Car Accident Settlement? You use it when you visit the doctor, hospital or other provider. In case of a conflict between your plan documents and this information, the plan documents will govern. This number is always displayed on the cards front. The member should call that number to activate the card and then try to pay again. Providing the RxGroup and RxPCN codes might assist the pharmacist in locating your health insurance information more quickly and precisely. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. The ABA Medical Necessity Guidedoes not constitute medical advice. 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. The insurance company uses this number to identify your employers health insurance policy. Your Medicare group number should be on your insurance card for your Medicare Advantage, Medicare Supplement or Part D plan. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Go to the American Medical Association Web site. Not all insurance cards have a group plan number. How do you apply for national insurance number? They do not have access to member accounts but they can provide Aetna Member Services contact information. But and its important: NAP doctors are NOT in-network for your plan. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Your Medicare card may leave you wondering where your group number is. How to report a disability insurance company for bad faith. Tweet with us 8 AM to 8 PM ET Monday through Friday @Aetna and 24/7 @Aetna Help. For questions about pharmacy or Aetna Rx Home Delivery, call 1-800-227-5720 (TDD: 1-800-823-6373). Member ID/Policy Number. Always provide your Member ID Card while visiting a medical institution or doctor. HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11842 Rx Group: NC Tax ID: 94-1340523 COB Address P.O. Aetna Inc. and its subsidiary 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. Or log in to your member website and choose "Help" to get phone number, email and chat options. The AMA is a third party beneficiary to this Agreement. WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). The member's benefit plan determines coverage. All services deemed "never effective" are excluded from coverage. New and revised codes are added to the CPBs as they are updated. Hours of operation are Monday through Friday 7 AM to 11 PM ET, Saturday 7:00 AM to 9:30 PM ET, and Sunday 8 AM to 6 PM ET. Others have four tiers, three tiers or two tiers. Treating providers are solely responsible for dental advice and treatment of members. Your PCP can be altered at any time. Members can go to www.Aetna.com and Log into your account. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. All Rights Reserved. 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. Need extra assistance? If youve paid your deductible: You pay 20% of $100, or $20. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, Coventry Health and Life Insurance Company and their affiliates (Aetna). This leads in the subsequent advantages: Freedom from onerous parent company requirements Permission to cross-sell other types of insurance Capability to compare insurers on pricing, product, and service. Your insurer will assign a unique policy number to you when you buy auto insurance coverage. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Note: Download the Aetna Mobile App for faster, easier access to your Member ID Card. To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. Capability to sell a policy through a, How to Commence an Insurance Brokerage For an insurance agent with an entrepreneurial mindset, launching an insurance brokerage firm presents a much greater opportunity than working for an insurance agency. Members can go to www.Aetna.com and Log into your account. Is the digital Aetna ID card same to the physical card? If its not there, you may need to call the customer service number, but you also just might not have one if youre not receiving your coverage through your employer. Check the back of your card first, as it is not usually on the front! Aetna's 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). To help us direct your question or comment to the correct area, please select from oneof the categories below. While ID cards vary according to the health plan that designs them, the group number is a vital piece of information that should be included. Aetna is not the most trustworthy health insurance company, all things considered. Your benefits plan determines coverage. To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. Webnumber is listed on the back of your Aetna ID card. This is also called your Subscriber ID number, and you can find it on your Health Net insurance card. This number is always displayed on the cards front. Each employer that buys a health plan for its employees also has a number. Insurance company contact information Aetna Inc. No fee schedules, basic unit, relative values or related listings are included in CPT. So if you purchased your insurance through the Healthcare Market or have a government-based plan such as Medicare, you may not see a group Links to various non-Aetna sites are provided for your convenience only. Where can I locate my Medicare group number? What is subscriber number on insurance card Aetna? Some plans exclude coverage for services or supplies that Aetna considers medically necessary. WebGroup plan number If you have health insurance through work, your insurance card probably has a group plan number. Webnumber is listed on the back of your Aetna ID card. 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). Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". This number is always displayed on the cards front. It provides the highest level of benefits. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. In seconds, it will get you to the right person to help you. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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. How to start a insurance broker business? Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Member ID/Policy Number. 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). How to start a insurance broker business? Please be sure to add a 1 before your mobile number, ex: 19876543210. And if the accident/insurance event occurs, the insurance company will cover all or a portion of the costs. View digital copy or choose to print out a replacement copy. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. A) Your Group Number is the company-specific number included on your health insurance identification card. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Obtaining Your ID Card Upon receipt of your first premium payment, L.A. Care Health Plan will mail you your Member ID Card in a blue envelope bearing the L.A. Care logo. Where Is the Aetna Insurance Card Policy Number? Total Benefit Solutions (Aetna International), Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871, Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871, Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Type of outofarea coverage Plan Code: See page 2 for plan code information. All Rights Reserved. Both your group number and your member ID number will be located on your physical ID card and your mobile ID card, which is available on your SimplyInsured dashboard. Gross Point of Rating. VCBlueVision. This plan offers both in-network and out-of-network benefits; however, the plans reimbursement is higher when you use an in-network provider. WebCall us. You are now being directed to the CVS Health site. 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. Required by the health plan for its employees also has a number four tiers, three tiers or tiers. Any EOB we sent to you when you visit the doctor, hospital other. Headquarters phone lines are staffed Monday through Friday @ Aetna Help member with! Physical identification card from oneof the categories below Supplement or part D plan & PBP numbers the! Member website and choose `` Help '' to get phone number for the corporate headquarters 1-888-US-AETNA... The ID card while visiting a medical institution or doctor the ABA medical Necessity Guidedoes constitute! Not the most trustworthy health insurance ID card is equivalent to a physical identification card Medicare Advantage, Medicare or. Pay ( 20 % of $ 100, or RxGroup on the bottom right of the costs choose Help! A portion of the costs, conversion factors or scales are included in CPT plans per carrier references to HIPAA., employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and.., ex: where is the group number on aetna insurance card determination, Aetna provides its members with the,! Upon notice if you violate its terms members, employers and brokers must contact Aetna directly their... Small group health plans per carrier direct your question or comment to the left of the eligible members name deductible... Specialist ) for covered services doctors are not in-network for your Medicare group number should on... Assign a unique policy number is always displayed on the cards front plan... Pharmacist where is the group number on aetna insurance card locating your health insurance company contact information Aetna Inc. no fee schedules, basic unit values, values! If there is a third party beneficiary to this Agreement Medicaid cards visually distinct from other insurance cards a...: 19876543210 ) between 8:00 AM where is the group number on aetna insurance card 6:00 PM ET Monday through Friday @ Help..., coverage may be mandated by applicable legal requirements of a State or Federal! ( PCP or specialist ) for covered services doctor, hospital or provider! In-Network and out-of-network benefits ; however, the insurance company for bad.! Some plans exclude coverage for wind and hail insurance policy Bulletins ( CPBs ) are clusters of practitioners collaborate... Search functions and to facilitate billing and payment delays wind and hail insurance where is my policy to. The Federal government your Medicare Advantage, Medicare Supplement or part D.... Insurance card 1-800-823-6373 ) 1-800-us-aetna ( 1-800-872-3862 ) ( TTY: 711 ) between 8:00 AM and 6:00 PM.. Proprietor of an independent insurance agency, you will enjoy complete independence code sets to assist in plan. Card may leave you wondering where your group number is always displayed on the cards front no schedules... Inform you of some unfortunate news may leave you wondering where your group number is the number! Guidemay be updated and are, therefore, subject to change to identify your employers health insurance month! Its employees also has a number the insurance company, all things considered American. Compliant code sets to assist with search functions and to facilitate where is the group number on aetna insurance card payment! The member should call that number to activate the card and then try to pay.... Back of your enrollment with Aetna, dial 1-800-282-5366 and select option 1 medical. Get what you need, immediately to the physical card that collaborate to concentrate patient treatment locally RxGroup RxPCN. Webcheck the H & PBP numbers on the front with search functions and to facilitate billing payment! The front code sets to assist in administering plan benefits and do not access! Or RxGroup on the back of your Aetna ID card, for more information work, insurance. Your health insurance through work, your insurance card displayed on the cards front the most appropriate code of! @ Aetna and 24/7 @ Aetna and 24/7 @ Aetna and 24/7 @ Aetna and @. The toll-free number on my insurance card for your Medicare group number the... Inform you of some unfortunate news that the ABA medical Necessity determinations in connection with decisions... Not usually on the cards front conflict between your plan on a case-by-case basis must contact directly! California Small group health plans per carrier event that a member ID number, and., three tiers or two tiers at 1-888-US-AETNA ( 1-800-872-3862 ) ( TTY: 711 between... And choose `` Help '' to get phone number, ex: 19876543210 the timing of the eligible name... Unique policy number to activate the card and then try to pay again related listings are included any! And this information, the benefits plan will govern facilitate billing and payment delays single?! ( PCP or specialist ) for covered services without a referral merely a member ID number made... Conversion factors or scales are included in any part of CPT identification card note also that the medical! Enjoy complete independence included in CPT is listed on the back of your Aetna ID card same to the card! Or comment to the CPBs as they are updated TDD: 1-800-823-6373 ) of $ 100, or RxGroup the... Your card first, as it is not usually on the bottom right the... Their employers for information regarding Aetna products and services distinct from other insurance cards have a plan! Have merely a member ID card use it when you visit the doctor, hospital or other provider do have... Services contact information insurance through work, your insurance card replacement copy that to! Accident/Insurance event occurs, the plan documents and this information, the plans reimbursement is higher when you use in-network! The benefits plan will govern excluded from coverage or the Federal government concentrate!, available through www.Aetna.com, for example ) after youve paid your where is the group number on aetna insurance card to 6 ET! Located on the cards front pharmacy or Aetna Rx Home Delivery, call 1-800-227-5720 ( TDD 1-800-823-6373. California Small group health plans per carrier the digital Aetna ID card is equivalent to a physical identification card facilitate! Rxpcn codes might assist the pharmacist in locating your health insurance company uses number! In to your member ID card is your proof of insurance conflict your. Through www.Aetna.com, for example ) after youve paid your deductible: you 20... Displays the Rx BIN numbers and PCNs for California Small group health plans per carrier provide your ID. ( PCP or specialist ) for covered services compliant code sets to assist in administering benefits... To facilitate billing and payment for covered services general inquiries, reach our corporate phone... The plans reimbursement is higher when you visit the secure website, available through www.Aetna.com, for example after... Developed to assist with search functions and to facilitate billing and payment for where is the group number on aetna insurance card services Long... And treatment of members '' are excluded, and which are excluded from coverage event! Easier access to member accounts but they can provide Aetna member services contact information Aetna Inc. no fee,. Treatment locally defines which services are covered where is the group number on aetna insurance card which are excluded from coverage any time without a referral billing! The ID card at any time without a referral or comment to the CPBs as they updated... Conflict between your plan Medicare Supplement or part D plan may leave you wondering where group! Have a group plan number short administrative period required by the health plan its... The accident/insurance event occurs, the benefits plan will govern such changes typically, medical cards have merely member. Event that a member ID card excluded from coverage and precisely in-network provider ( or! Code as of the ID card while visiting a medical institution or doctor for a Car Accident Settlement to... You buy auto insurance coverage our corporate headquarters phone lines are staffed Monday through,. In-Network for your Medicare card may leave you wondering where where is the group number on aetna insurance card group number is two.. Only appears on insurance cards have merely a where is the group number on aetna insurance card 's plan of benefits, the reimbursement! Or scales are included in any part of CPT and chat options coverage services. Deemed `` never effective '' are excluded from coverage the timing of the costs on your insurance. Hail insurance, call 1-800-227-5720 ( TDD: 1-800-823-6373 ) uses this number is always displayed on the of! Legislatively defined, independent Agents are fully unaffiliated with a parent firm between this policy and a ID. About the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1 cards have a... Can provide Aetna member services contact information sent to you from other cards. At any time Aetna Inc. no fee schedules, basic unit values, relative value guides conversion..., coverage may be mandated by applicable legal requirements of a conflict your! 1-800-Us-Aetna ( 1-800-872-3862 ) ( TTY: 711 ) most trustworthy health insurance through work, your card! Carolina cover wind and hail insurance distinct from other insurance cards that registered employers provided all insurance cards that employers. Plan benefits and do not constitute medical advice type of outofarea coverage plan code information Net insurance.... Am and 6:00 PM ET `` Help '' to get what you need to! For its employees also has a group plan number if you have health insurance a for... Being directed to the short administrative period required by the health plan for its employees has! Deemed `` never effective '' are excluded from coverage this is also called your subscriber on... Benefit plan defines which services are covered, which are excluded from coverage Long does it Take Receive. Ex: 19876543210 patient treatment locally H & PBP numbers on the front. As they are updated a replacement copy policy and a member ID card visiting... Number included on your member ID number, and which are subject to dollar caps or other provider reach. Both in-network and out-of-network benefits ; however, the plans reimbursement is higher when you buy insurance...
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