From out-of-network doctors to ongoing orthodontia, you have options to make your transition a smooth one.
Some treatments can’t or shouldn’t be stopped
It’s easy to see the cost savings of using quality doctors in our networks. But when you’re a new member, you may need to finish treatment with a doctor who is not part of the network. Our Transition of Care program can help.
This program lets you continue a course of treatment with an out-of-network doctor for up to 90 days* at the same cost share as if your doctor was in the network. This gives you time to finish your treatment, or transition to a network doctor.
To qualify, you must be in an active course of treatment. For instance:
You’re in the second or third trimester of pregnancy, including post-partum care.
You’re getting treatment for certain acute or chronic conditions such as chemotherapy or kidney dialysis.
You’re actively engaged in an acute inpatient or outpatient rehabilitation program for a condition within 21 days of your plan’s effective date.
You’re in the hospital on the plan’s effective date.
Some conditions don’t qualify for Transition of Care include routine exams, stable chronic conditions such as diabetes or asthma, minor illness such as colds or sore throats and elective scheduled surgeries.
To apply, you and your doctor will need to complete a Transition of Care form.
* Coverage length varies by state law and by your condition. We'll advise you if your request is approved and how long it will last.
You can transition your remaining orthodontia treatment to your new dental plan
If your child has braces and you have a treatment plan, you have options.
Has your dentist proposed a treatment plan that will finish in the upcoming year? Did your previous health plan approve a pre-treatment estimate from your dentist? If so, send it to us with a completed Aetna claim form.
IT’S EASY TO SWITCH YOUR EXISTING PRESCRIPTIONS TO THE NEW PLAN
Just share your new member ID card with your pharmacist the first time you pick up your prescription after the effective date. In most cases, as long as your pharmacy is in the Aetna network and your prescription has not expired, you will not need to get a new prescription. Your pharmacist will know how to submit your prescription to Aetna.
TRANSITION YOUR MAIL-ORDER PRESCRIPTION TO AETNA RX HOME DELIVERY® SERVICE
If you are currently receiving your medication by mail, you will need to submit a new prescription to Aetna Rx Home Delivery.
Please contact your doctor and request two prescriptions:
The first for a short-term supply (30 days) that you can get at a retail pharmacy after the effective date
The second for a long-term supply (31 to 90 days) that you can get through home delivery
It generally takes 10 – 14 days to receive your home delivery prescription.
Once you become an Aetna member you can download a copy of the Aetna Rx Home Delivery order form from your secure member website. Call the Aetna Health Concierge at 1-855-496-6289 if you need help.
Need help? Talk to an Aetna Health Concierge at 1-855-496-6289
Monday through Friday, 8 a.m. to 6 p.m. your local time. Or, send us an email.