UTAH SMALL GROUP
ENROLLMENT GUIDE
Your Destination for Small Business Solutions
SM1
Table of Contents
Employee Assistance Program
3
Aetna Navigator
®4
Personal Health Record
5
Urgent Care
6
Special programs for women
7
Informed Health
®Line/Aetna Fitness
SMdiscount program
8
Aetna Vision
SMDiscounts
9
Aetna Natural Products and Services
SMdiscount program
10
HearPO
®12
Wellness and prevention programs
14
Life and disability overview
16
DocFind
®17
Aetna Health Care Transparency tools
18
How to complete the employee application
19
Health care is a journey. Aetna Avenue
SMprovides you and your family a
direct route to valuable discounts and programs designed specifically to meet
your health care needs. At Aetna Ave, we provide you the latest information
and a holistic approach to health so you maximize your benefits and make
informed decisions.
This brochure provides an overview of the member discount programs and
services available to you as an Aetna member. You may access a variety
of Aetna’s member tools and resources that put you and your family in
the driver’s seat of your health and well-being. From finding a doctor to
scheduling a “web visit” to maintaining your personal health record so it goes
where you go, Aetna Ave keeps you on track to effectively navigate the
ever-changing world of health care.
Welcome to Aetna!
3
Aetna’s Employee Assistance Program is a confidential program that gives employees and members of their household access to useful services and support to help them manage the everyday challenges of work and home. The EAP is available at no additional charge to members and their family members and includes:
n Choice — They’ll find a range of resources to help them balance their personal and professional lives.
n Easy access — Small Group EAP can be reached anytime toll-free at 866-672-5417 or on the Web at Aetnaeap.com.
n Professional assistance — Our workplace-trained specialists provide confidential phone support, assessing needs and recommending an appropriate course of action. Employees and their household members receive three phone consultations per member in a calendar year.
Employers can also take advantage of EAP Resources:
n Management and Human Resources assistance — Employers get unlimited phone consultations with workplace-trained clinicians who can provide help in dealing with complex employee issues that may arise.
n Online tools — Employers can also get online tools and materials to encourage employees to use the EAP by visiting Aetnaeap.com (enter your company ID and select the “Promotional Materials” link).
Employee Assistance Program* (EAP)
Aetna Navigator
member self-service website
When you need up-to-date information about your health insurance plan or want information about a particular health condition, here’s where you’ll find it! Aetna members can turn to Aetna
Navigator, our member self-service website that provides you with a single source for online health and benefits information. It’s convenient, and easy to use:
1. Go to Aetna.com 2. Click on Aetna Navigator 3. Register as a new user, or log on
using your secure password
4. Find a wealth of credible health care information and self-service functions — available to you anytime of the day or night — from wherever you have Internet access
Our secure connection lets you:
n View information about who is covered on your plan
n Search for a participating provider on our DocFind® online provider directory
n Check the status of a claim or review an Explanation of Benefits (EOB)
n Contact Member Services with benefits questions (also available in Spanish)
Use Aetna Navigator’s online tools to manage your benefits and help you make more informed health decisions:
■ Doctors’ Rates — view physician-specific rates by specialty for up to 30 of the most common services and procedures.
n Hospital Comparison tool — compares hospital outcome information about medical care provided by hospitals in your area, based on criteria important to you.
■ Medical Procedure by Facility Cost
tool — provides facility-specific and managing physician costs for more than 30 common medical procedures, from admission through discharge.
n Price-A-DrugSM tool* — helps you estimate the cost of prescriptions before you buy
n Estimate the Cost of Care tool — provides estimated average in-network costs and out-of-network fees for certain procedures based on your geographic search.
n Pharmacy benefits summary — allows you to locate retail pharmacies; order prescriptions through Aetna’s mail-order pharmacy, Aetna Rx Home Delivery®; search and learn about
medications; and review the medications available in Aetna’s formulary
And, if you’re interested in learning more about a particular health condition, Aetna Navigator provides credible health information resources.
n Aetna InteliHealth® website, our award-winning and interactive consumer website for credible health, dental and wellness information provided by Harvard Medical School
n Healthwise® Knowledgebase, look up information about thousands of medical topics with this user-friendly online tool; available in English and Spanish.
n Interactive and streaming videos about topics such as asthma and heart health
Aetna Navigator —
Your gateway to managing your health
4
Included with your plan
are important tools and
resources that make it
easier to use your
benefits and help you
make more informed
health care decisions.
Aetna.com
Put your Personal Health
Record to work and make
history!
Members with Aetna medical coverage can now use Aetna’s Personal Health Record.
Your Personal Health Record is a secure online tool that makes it easy to:
n keep your health information in a single, safe place
n track doctor visits, prescriptions and more for you and your family
n give your doctor a more complete health history
n receive timely, personalized health alerts and preventive care reminders
Much of your health information is ready for you to see now.
Information from your Aetna health claims automatically appear in your Personal Health Record. And, you can easily add more information. List your allergies, your family history and more. It’s up to you. The more you enter, the better picture you and your doctors will get of your overall health.
Use it to talk to your doctors with ease.
The Personal Health Record can help you team up with your doctors. You can share your Personal Health Record online with individual doctors by making it available through a secure website many doctors already use. You also can print your Health Summary to share at office visits or to help you fill out medical forms when you see a new doctor.
Stay safe and healthy with alerts and reminders.
Personal Health Records helps you get the care you need. If you’re due for a checkup or other important screening, you might see a reminder when you log on. You may also receive a message if there’s an alternative treatment that may improve your care. And, if you give Aetna permission, you can get e-mails telling you that a new alert or reminder is in your secure Personal Health Record.
Portability ensures your personal health records go where you go
Aetna’s relationship with Microsoft provides our members portability of their personal health information. You can transfer a copy of your Aetna PHR from Aetna Navigator directly to Microsoft HealthVault at http:// www.healthvault.com/personal. Your information will be stored on this secure, web-based consumer health platform and remains available if you change jobs or health plans.
You can also print and save a PDF copy of your health record for your own files through the same Navigator location.
Print your personalized Emergency Card
You can print an Emergency Information Card that pulls information from several sections of your Personal Health Record. It provides first responders your emergency contact’s name and phone number, your insurance details, any medications you are taking, allergies if you have any and if you have a living will or have designated your organs for donation. All this detail in a printout that folds and fits in your wallet. Be sure the information in these sections is accurate and up-to-date, and start using your Aetna Personal Health record today!
* The Aetna Personal Health Record should not be used as the sole source of information about health conditions or medical treatment.
It’s easy to get started.
Visit your Personal Health Record today or use our Walk Me Through guide to explore
how this resource works on your own. Visit http://www.aetna.com/showcase/phr/
for answers to the most common questions from our members.
A convenient solution
for care on the go
Urgent Care
Looking for a convenient way to get medical care? Consider an urgent care clinic. It’s a convenient alternative to the doctor’s office. If you aren’t feeling well and have trouble getting an appointment with your doctor, it’s your answer to non-emergency care right away.
For care that is not minor, such as fractures, sprains or other urgent injuries, we contract with urgent care centers to offer you an economical alternative to visiting an emergency room. Urgent care sites are staffed with physicians to handle urgent medical needs, whereas walk-in clinics are staffed by nurse practitioners to care for minor ailments. Some urgent care centers offer evening and weekend hours with no appointments needed.
Check your Plan Design and Benefits Summary to get more information about coverage and costs to visit an urgent care center. Use DocFind through Aetna.com to find the closest clinic or care center near you.
Follow these simple steps to locate a care center:
Step 1
Start your search in DocFind.
Step 2
Complete all the category selections — note there are required fields to complete. n Decide how you’d like to search for a
provider — by zip code, city or county
n Under PROVIDER CATEGORY, select
Facilities (such as lab and X-ray)
n Under PROVIDER TYPE, select Urgent
Care Facilities
n Finally, under PLAN, select your plan
Step 3
Click START SEARCH for a listing of all the Urgent Care centers in the geographical area you selected.
7
Ongoing health management
Work, family, friends. Too much to do, too little time to do it. That’s today’s woman. Add health needs that change over time, and you’ll know why we offer services and information to help you manage your health.
Prevention programs for women
Our preventive programs can help women benefit from:
n Preventive screening reminders for breast and cervical cancer
n Culturally focused initiatives to help reduce health disparities among women of diverse ethnic backgrounds
Women’s health online
Go to Womenshealth.aetna.com for information on women’s health issues — from heart health, breast cancer and pregnancy to baby care and other topics important to women, as well as: n An interactive body mass index n A pregnancy guide
n Food pyramid recommendations n Information on diet and nutrition
For ob/gyn care, no referrals
needed
†For an annual well-woman exam, unlimited visits for gynecological problems and routine maternity care, women may schedule an appointment with participating obstetrical, gynecological or women’s health care professionals.
Special maternity care
From the start of pregnancy to birth, our maternity management program offers expectant mothers services and educational materials to help give their newborns a healthy start. Moms-to-be receive: n Educational materials, available in
English or Spanish, that cover: > Prenatal care
> Labor and delivery > Newborn and baby care > Breastfeeding
> Postpartum depression
n A pregnancy risk survey and nurse care coordination for high-risk pregnancies n A program to help you stop smoking
Beginning Right
SMmaternity
program
Aetna’s Beginning Right maternity program offers information and services to expectant mothers including care coordination by obstetrical nurses experienced in preterm labor education, breastfeeding support and more. We want to make sure expectant mothers have the information needed to make informed decisions about health care while pregnant or planning a pregnancy. Members enrolled in both our medical and dental plans, as well as our Beginning Right maternity program, may receive enhanced dental benefits (additional cleaning or treatment of periodontal (gum) disease, fully covered with no deductible) during pregnancy.
† Direct access applies to general ob/gyn care and basic infertility care only, not subspecialty care/
treatment such as additional infertility specialist care, perinatology care or gynecologic/oncologic care.
Special programs
Informed Health
®Line
Access to a registered nurse —
24/7!
With Aetna’s Informed Health Line,
you can talk to a registered nurse
anytime, day or night. Just call our
24-hour toll-free number (available
upon enrollment). While only your
doctor can diagnose, prescribe or
give medical advice, the Informed
Health Line nurses can provide
information on thousands of health
topics. They can also assist you on
how to ask the right questions and
describe health symptoms more
effectively during your next visit
to your doctor. Remember, always
contact your doctor first with any
questions or concerns regarding your
health care needs.
Regular exercise helps you stay healthy, and can make you look and feel better. The Aetna FitnessSM discount program
is automatically included with your health benefits or health insurance plan, so you can save money, too!
You’ll save on fitness club memberships, exercise videos and home exercise equipment like treadmills and elliptical trainers — everything you need to get fit for less today.
Pick a club — join a club
You’ll enjoy preferred rates on fitness club memberships* within the GlobalFit™ network. With nearly 10,000 locations** (and growing every day), it’s easy to find one close to where you live or work. And with features like a FREE guest pass*** and flexible membership options, you can get started today!
Step #1: Visit Globalfit.com/fitness for a current list of participating clubs
Step #2: Select a club and follow the directions to get your FREE guest pass (available at most clubs) - It’s your “sneak peek” at club culture, services and equipment
Step #3: Join a club today - Enroll online, or call GlobalFit toll free at 800-298-7800
More reasons to join a club
n Flexible membership options — including the Commit (48-week) and Non-Commit (month-to-month) memberships
n Convenient billing options through your bank account or major credit card
n Guest privileges at participating clubs for when you travel (Commit memberships only) n Transfer your membership to another person (Commit memberships only) or to another participating fitness club
n Freeze your membership for up to two months in a calendar year (Commit memberships only)
n Plus, family members on your health benefits or health insurance plan are eligible, too!.
Save on home exercise
equipment and supplies
Rather get fit in your own home? You’ll also save on exercise videos and home exercise equipment like elliptical trainers and treadmills.
Lifestyle programs beyond
the fitness club
Starting a fitness program is just the start to a healthier you. The fitness discount program also offers access to at-home weight-loss programs and one-on one health coaching* to help you quit smoking, lower stress, lose weight or meet another health goal.
*Provided by WellCall, Inc., through GlobalFit.
Good health
can mean
more than visiting the doctor
*Participation in GlobalFit is for new club members only. Membership to a club of which you are currently a member may not be available.
**GlobalFit website,
www.globalfit.com/fitness, 1/08.
9
See better … for less
Save 5 to 40 percent off the retail price* of eye exams, eyeglasses, contact lenses and solutions, accessories and more, with our Aetna Vision Discounts program. The discounts are instant — there are no forms or claims.
You can use your discount over and over again … you save each and every time you purchase a product or service from a participating location.
Here’s how you do it:
n Book — Schedule an eye exam, or visit any participating location. From Aetna.com, log on to our DocFind directory and select Aetna Vision Discounts to find a participating professional. Or, call 1-00-793-616.
n Browse — Choose from hundreds of fashionable frames and the latest in lens technology.
n Save — Show your Aetna ID card for on-the-spot savings.
Special savings on LASIK
eye surgery
Have you been hearing about LASIK eye surgery and wondering if you can afford it? With Aetna Vision Discounts, you can get up to 5 to 15 percent off the doctor’s usual fee* for surgery.** To learn more, call 1-800-422-6600.
*EyeMed Services and Compensation Schedule, 7/06. Prices are subject to change. ** LASIK surgery discounts are offered by U.S. Laser Network. Providers are independent
surgeons and are not agents or representatives of Cole Vision Corporation, Aetna and/or their affiliates.
PRODUCT OR SERVICE
Eye Exams
n Comprehensive eye exam
n Standard contact lenses fit & follow up n Specialty contact lenses fit & follow up
(e.g. Toric, Bifocal, Gas Permeable) Lenses per Pair (uncoated plastic)
n Single Vision n Bifocal n Trifocal
n Standard Progressive (no-line bifocal) Eyeglass Frames (retail prices)
Lens Options per Pair (add to lens price above) n Standard polycarbonate (includes UV
coating and scratch-resistant coating) n Scratch-resistant coating
n Ultraviolet (UV) coating n Solid or gradient tint
n Standard antireflective coating n Glass
n Photochromic Glass Contact Lenses
Get a 15% discount (5% on disposables) off retail prices. Mail-Order Contact Lens Replacement Program
Call 1-800-391-LENS (5367) to order replacement contact lenses. (Mail-order contact pricing is not subject to the discounts received at participating locations.)
Additional Vision-Related Items
Visit any participating location to receive a 20% discount off retail prices. LASIK Procedure
Save up to 5% to 15% off the surgeon’s fee through the U.S. Laser Network.
WHAT YOU’LL PAY
$42
$40 (plus $42 exam fee)
$10 off retail (plus $42 exam fee)
$40 $60 $80 $120
40% off retail prices
$40 $15 $15 $15 $45 20% off retail 20% off retail
This is a brief listing of the savings* you can receive through the Aetna VisionDiscounts program.
An eye-opening way
to healthy vision
10
Aetna membership has its
perks! You automatically get
the Aetna Natural Products
and Services discount
program when you join any
one of our health insurance
plans.
Aetna Natural Products
and Services
SMDiscount
Program
The path to healthy living comes in all shapes and sizes. That’s why the Aetna
Natural Products and Services discount program gives you great savings on
complementary health care services and natural products through American Specialty Health (ASH) Incorporated, a recognized leader in this market, and its subsidiaries. It’s a smart way to save on items not typically covered by insurance,1
such as massage therapy and over-the-counter vitamins. Plus, it’s a great way to encourage your body’s natural health abilities.
No referrals, no claims — and no waiting for reimbursement
Simply contact a natural therapy professional, book an appointment, and save! There are four money-saving services available:
1. Massage therapy
Massage can relieve stress and improve your overall wellbeing. So rest your achy muscles with relaxing massage therapy — and pay less!
2. Acupuncture
Pinpoint your pain or stress points with this 5000-year old stress reliever, and save.
3. Chiropractic care
Get “realigned” with savings on regular chiropractic visits.
4. Dietetic counseling
Get sound dietary advice from registered dieticians on the foods you should eat to feel healthier, look leaner and improve your overall health!
Two easy steps to greater savings:
1. Schedule an appointment. To find a location near you, visit DocFind at Aetna.com or call the toll-free number on your ID card, which you’ll get after enrollment.
2. Pay the discounted fee at the time of service. There are no claims to file and no waiting for reimbursement.
1 Check your plan documents to see if
chiropractic and acupuncture benefits are available under your plan.
A cost-effective way to relax,
recharge and save
Save on massage
therapy, acupuncture,
natural products and
more.
11
Did you know?
If you’ve ever taken Vitamin
C to ward off a cold or
practiced yoga to destress,
then you’re already familiar
with complementary health
care. Now, you get great
savings just for doing it!
Save on healthy lifestyle
products, too!
Get your daily dose of Vitamin C — at a discount. Other over-the-counter vitamins, too! Or, stock up on aromatherapy, yoga equipment, nutritional and herbal supplements, and more.
And with thousands of health-related products available, it’s easy to order by mail, phone, fax or the Web. It’s just what the doctor ordered for your healthy lifestyle.
Once you’re an Aetna member,
12
A great way to hear what
you’ve been missing
You don’t have to live in a world of muted sound. We’ve teamed with HearPO, a national hearing benefits provider, to give you 30 to 40 percent off the retail price* of hearing exams and hearing services.** And you’ll save 4 to 62 percent off the retail price* on hearing aids. It’s what you need to make your world sound clearer.
This program is not insurance …
meaning no referrals or claims. It’s a simple, convenient way to take a little
off the top of your expenses.
n Save on many styles, from complete canal to behind-the-ear hearing aids.
n Save on the newest technology, including programmable and digital instruments. n Choose from over 1,800*** participating
locations nationwide.
n Get discounts on hearing aid repairs. n Enjoy free follow-up service for one year.
Three steps to savings:
1. Find a nearby provider. Call HearPO at 1-888-HEARING, or visit our DocFind directory online through Aetna.com.
2. Make an appointment with your selected provider.
3. Get your discount at the point of purchase.
*HearPO Compensation Contract, 7/06. ** Read your plan documents for additional
hearing benefits that may be available to you under the plan. *** HearPO website,
Hearpo.com/aetna, 7/06.
14
Good health begins with
prevention. So we’ve
developed an array of
wellness programs and
services to help you and
your family stay healthy
through all the stages of
your life.
Preventive care
Member health education
reminders
To help prevent, detect and monitor problems early on, we mail women age 40 and over reminders encouraging them to schedule an annual mammogram. We also send important health
information, a chart of recommended preventive care guidelines and a tear-off wallet card to schedule and track this important information.
Aetna Health Connections
smdisease management —
This program features Aetna nurses and programs, including MedQuery®, and is an
important part of our new Aetna Health Connections health and wellness portfolio. Our newly redesigned capabilities support more than 30 conditions and integrate care for members with multiple conditions. The program includes cutting-edge technology to help improve patient safety, doctor communication and more.
This integrated, holistic approach using capabilities unique to Aetna, delivers premiere medical management for our members that no one in the industry can match. It includes innovative and individualized clinical programs, information and support for totally integrated health management that optimizes our members’ state of health. Members are viewed holistically — considering multiple diseases or conditions across all benefit plans— to deliver customized programs based on their individual needs and preferences.
Prevention programs —
helping you and your family stay healthy
Good health begins with
prevention.
14
Vascular
■ Heart Failure
■ Diabetes — Adult & Pediatric ■ Coronary Artery Disease (CAD) ■ Peripheral Artery Disease (PAD) ■ Hypertension — Adult & Pediatric
(High Blood Pressure)
■ Cerebrovascular Disease/Stroke (CVA) ■ Hyperlipidemia (High Cholesterol)
Pulmonary
■ Asthma — Adult & Pediatric
■ Chronic Obstructive Pulmonary Disease (COPD)
Orthopedic / Rheumatologic
■ Osteoporosis ■ Osteoarthritis (OA)* ■ Rheumatoid Arthritis (RA) ■ Chronic Lower Back Pain
Gastrointestinal
■ Gastro Esophageal Reflux Disease (GERD) ■ Peptic Ulcer Disease
■ Inflammatory Bowel Disease (IBD) (Crohn’s Disease) ■ Chronic Hepatitis
Neuro-Geriatric
■ Geriatrics ■ Migraines ■ Seizures ■ ParkinsonismCancer
■ General Cancer ■ Breast Cancer ■ Lung Cancer ■ Lymphoma/Leukemia ■ Prostate Cancer ■ Colorectal CancerRenal
■ Chronic Kidney Disease ■ End Stage Renal Failure
Other
■ Weight Management — Adult & Pediatric ■ Cystic Fibrosis — Adult & Pediatric ■ HIV
■ Hypercoagulable State
■ Sickle Cell Disease — Adult & Pediatric ■ Depression**
Aetna Health Connections
SMDisease Management Program
Conditions/Clinical Content
1
*Not scored by Clinical Stratification and Identification (CSID) identification process **Addressed as a comorbid condition
16
Nothing is more reassuring
than knowing financial
resources are available
when you need them most.
Aetna’s Group Term Life
and Disability Insurance
provide you and your
dependents financial
support when it counts.
Protection for the future
Having options is essential to choosing the appropriate benefits package. You’ll be glad to know that your employer has selected Aetna to offer you a variety of life insurance products, and with more than 150 years industry experience, your future is in good hands.
Basic Term Life
The building block of financial security. You get company-sponsored protection with flexible benefit schedules and guaranteed coverage up to a designated amount.
Dependent Term Life
Financial protection for your spouse and dependent children.
AD&D Ultra
®This leading-edge product provides you better financial security than typical accidental death and dismemberment plans and then some. That’s because AD&D Ultra includes coverage for education or dependent child-care expenses upon the death of the insured.
Guard against the
unexpected
Suffering a disabling illness or injury doesn’t have to deprive you of financial security. Your employer has selected Aetna’s Group Disability Insurance to offer you an affordable way to protect your income in the event of an injury or sickness. Beyond providing partial replacement of lost income, our plans offer support services to help improve your health and well-being. Our goal is to provide the assistance you need to return to health and back to work.
Short Term Disability
Protects a portion of your income and offers peace of mind if you have become ill or injured and require a temporary absence from work.
Long Term Disability
Protects you from the financial impact of catastrophic illness or injury, usually picking up where short-term disability policies leave off.
Aetna’s Group Life
and Disability Insurance
for Small Group Employees
Aetna’s Life and
Disability plans protect
you from financial loss.
S T E P 2 :
Complete all the category selections — note there are required fields to complete.
n
Decide how you’d like to search for a provider — by zip code, city, or county or use QUICK SEARCH if you already have a provider’s name.
n
Next, select your personal search parameters:
> Provider category includes doctors, dentists, hospitals, etc.
> Provider type includes specialist and primary care providers.
> The Aetna plan that you enrolled in.
> Check ADDITIONAL SEARCH CRITERIA for an enhanced search that includes criteria such as gender and language spoken.
S T E P 1 :
Start your search at www.aetna.com. Below
the Shortcuts column on the right, select FIND A DOCTOR and I ACCEPT. First-time Aetna members can register with either their Aetna Member ID or Social Security number or conduct a general search. To reach DocFind if you are already enrolled in an Aetna plan, simply log in to Aetna Navigator.
S T E P 3 :
Click START SEARCH for a listing of all the providers in your geographical area.
How will I
find a
Doctor
or
Specialist
?
Use our improved DocFind
site to find a provider,
primary care physician or
dentist.
Aetna.com/docfind
You also can call us at
888-702-3862 to request
provider information.
And call 877-238-6200 to
find a dentist.
1
Since 2005, Aetna has empowered members with our industry-leading suite of member tools. You can make more informed health care decisions by using our online transparency tools before visiting a doctor or hospital.* Our transparency tools allow you to: ■ view and compare rates for
participating doctors
■ lookup costs for medical procedures at facilities in select locations around the country
■ use at your convenience since the information is available 24/7 through Aetna Navigator, our secure member website, and DocFind, our online directory of doctors and facilities
Aetna’s Health Care Transparency tools
Understanding the
true cost for health
care puts you in the
driver’s seat.
Follow these steps to access our online Health Care
Transparency tools:
1. Once registered, log on to Aetna Navigator and access the Cost of Care page from your Aetna Navigator home page
2. From the Cost of Care page, you can access a number of tools:
■ Search for doctors’ rates by:
> Search for your doctor/specialist using DocFind’s Search by Name function — > Click Provider Detail
> Access the tabs at the top of the Provider Detail screen linking to View Rates for Aetna Members
■ Look up costs for medical procedures at hospitals and other facilities by selecting Compare actual cost ranges by facility
■ Get estimated average costs for other procedures and services to compare in- and out-of-network costs
* Always consult your doctor about your health care decisions. Members cannot view rates for dentists, vision providers or certain types of health care professionals with these tools.
19
Now that I’ve selected a plan,
how do I enroll?
Please be sure
to complete your
application
thoroughly.
The sections noted
below are frequently
overlooked.
Check the medical and dental plan in which you are enrolling.
For each enrollee, include a
Social Security Number, as well as Height and Weight information.
Sign here if you are waiving
coverage for yourself or any dependents.
Sign and date here to complete the application. List all prior coverage
and attach appropriate
documentation.
19
Additional information, including precertification number for mental health and substance abuse services.
Your member ID card
After you enroll, you will receive ID cards that look like this. Make sure to present your Aetna ID card when receiving care from participating providers or when accessing emergency care. Your ID card identifies you as an Aetna member.
Plan in which you are enrolled. Call this number
to speak with a Member Services representative.
000000-000-00000
If you need this material translated into another language, please call Member Services at 1--9-AETNA (1--92-362).
Si usted necesita este documento en otro idioma, por favor llame a Servicios al Miembro al 1--9-AETNA (1--92-362).
This material is for information only and is neither on offer or invitation to contract. The models depicted are not Aetna members. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care of guarantee access to health services. Health insurance plans and life and disability insurance plans/policies contain exclusions and limitations.
Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. HealthEquity, Inc. is the custodian of health saving accounts and independently offers Investment services.
Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions.
Information is believed to be accurate as of the production date and is subject to change. For more information about Aetna plans, refer to aetna.com..
Review the material in this brochure and
speak with your employer or human
resources representative about the choices
available to you.
We look forward to welcoming you and
your family as our newest members!
©2009 Aetna Inc. 14.02.140.1-UT B (03/09)
