It is the policy of Aetna to treat you with respect. We also care about keeping a high level of confidentiality with respect for your dignity and privacy. As a member, you have certain rights, to learn more view our member materials to view the Evidence of Coverage, Notice of Privacy Practice and multi-language insert.
Our plan has people and free language interpreter services available to answer questions from non-English speaking members. We can also give you information in Braille, in large print, or other alternate formats if you need it. If you are eligible for Medicare because of a disability, we are required to give you information about the plan’s benefits that is accessible and appropriate for you. It's free. To get information from us in a way that works for you, please call Member Services 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week. The call is free.
Our plan must obey laws that protect you from discrimination or unfair treatment. We do not discriminate based on a person’s race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability, or geographic location within the service area.
If you want more information or have concerns about discrimination or unfair treatment, please call the Department of Health and Human Services’ Office for Civil Rights at 1-800-368-1019 (TTY: 1-800-537-7697) or your local Office for Civil Rights.
If you have a disability and need help with access to care, or if you have a complaint, such as a problem with wheelchair access, call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week.
As a member of our plan, you have the right to choose a primary care provider (PCP) in the plan’s network to provide and arrange for your covered services (Chapter 3 in the Evidence of Coverage explains more about this). Please call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week to learn which doctors are accepting new patients. You also have the right to go to a women’s health specialist (such as a gynecologist) without a referral.
As a plan member, you have the right to get appointments and covered services from the plan’s network of providers within a reasonable amount of time. This includes the right to get timely services from specialists when you need that care. You also have the right to get your prescriptions filled or refilled at any of our network pharmacies without long delays.
Federal and state laws protect the privacy of your medical records and personal health information. We protect your personal health information as required by these laws.
How do we protect the privacy of your health information?
You can see the information in your records and know how it has been shared with others
You have the right to look at your medical records held at the plan, and to get a copy of your records. We are allowed to charge you a fee for making copies. You also have the right to ask us to make additions or corrections to your medical records. If you ask us to do this, we will work with your health care provider to decide whether the changes should be made.
You have the right to know how your health information has been shared with others for any purposes that are not routine.
If you have questions or concerns about the privacy of your personal health information, please call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week.
As a member of Aetna, you have the right to get several kinds of information from us. You have the right to get information from us in a way that works for you. This includes getting the information in languages other than English and in large print or other alternate formats. It's free.
If you want any information, please call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week. The call is free.
You have the right to get full information from your doctors and other health care providers when you go for medical care. Your providers must explain your medical condition and your treatment choices in a way that you can understand.
You also have the right to participate fully in decisions about your health care.
Learn more about your rights in the Evidence of Coverage.
If you have any problems or concerns about your covered services or care, the Evidence of Coverage tells what you can do. It gives the details about how to deal with all types of problems and complaints. What you need to do to follow up on a problem or concern depends on the situation. You might need to ask our plan to make a coverage decision for you, make an appeal to us to change a coverage decision, or make a complaint. Whatever you do – ask for a coverage decision, make an appeal, or make a complaint – we are required to treat you fairly.
You have the right to get a summary of information about the appeals and complaints that other members have filed against our plan in the past. To get this information, please call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week.
If it is about discrimination, call the Office for Civil Rights
If you believe you have been treated unfairly or your rights have not been respected due to your race, disability, religion, sex, health, ethnicity, creed (beliefs), age, or national origin, you should call the Department of Health and Human Services’ Office for Civil Rights at 1-800-368-1019 (TTY: 1-800-537-7697), or call your local Office for Civil Rights.
Is it about something else?
If you believe you have been treated unfairly or your rights have not been respected, and it’s not about discrimination, you can get help dealing with the problem you are having:
There are several places where you can get more information about your rights:
To end your membership in our plan, you simply enroll in another Medicare plan. However, if you want to switch from our plan to Original Medicare but you have not selected a separate Medicare prescription drug plan, you must ask to be disenrolled from our plan. There are two ways you can ask to be disenrolled:
Generally, your membership will end on the last day of the month after we get your request to switch to Original Medicare or another plan.
Have questions about ending your coverage? You can call us at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week.
Use your Evidence of Coverage to learn what is covered for you and the rules you need to follow to get your covered services.
Please call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, 7 days a week to let us know.
We are required to follow rules set by Medicare and Medicaid to make sure that you are using all of your coverage in combination when you get your covered services from our plan. This is called “coordination of benefits” because it involves coordinating the health and drug benefits you get from our plan with any other health and drug benefits available to you. We’ll help you coordinate your benefits.
Show your Aetna® membership card and your Medicaid card whenever you get your medical care or Part D prescription drugs.
We expect all our members to respect the rights of other patients. We also expect you to act in a way that helps the smooth running of your doctor’s office, hospitals, and other offices.
As a plan member, you are responsible for these payments:
If you are going to move, it’s important to tell us right away. Call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, 7 days a week.
You must file Form 1040, US Individual Income Tax Return, along with Form 8853, “Archer MSA and Long-Term Care Insurance Contracts” with the Internal Revenue Service (IRS) for any distributions made from your Medicare MSA account to ensure you aren’t taxed on your MSA account withdrawals. You must file these tax forms for any year in which an MSA account withdrawal is made, even if you have no taxable income or other reason for filing a Form 1040. MSA account withdrawals for qualified medical expenses are tax free, while account withdrawals for non-medical expenses are subject to both income tax and a fifty (50) percent tax penalty.
Tax publications are available on the IRS website or from 1-800-TAX-FORM (1-800-829-3676).
We also welcome any suggestions you may have for improving our plan.
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