Find the right doctor quickly and easily
DocFind® Online Directory
When you need to find a doctor,
start with DocFind. It’s quick,
easy and online 24/7.
Our online directory can help you find
almost any type of doctor, facility or
pharmacy. So whether you’re looking for
a new doctor or checking if your doctors
are in our network, you’ll find what you
need. DocFind does the work for you!
Make the best choice
There are many ways to find a
doctor with DocFind. Search by:
You can get key information about
a doctor:
■■
Plans accepted
■■
Office locations
■■
Maps and driving directions
■■
Medical schools attended
■■
Board certification
■■
Languages spoken
You can even see which facilities
specialize in:
■■
Transplants
■■
Children’s heart surgery
■■
Name
■■
Bariatric procedures
■■
City, state, zip
■■
Orthopedic procedures
■■
Specialty
■■
Hospital affiliation
■■
Gender
They’re included in the Institutes
of Excellence™/Institutes of
Quality® network.
Look for these extras
DocFind also tells you about many
programs your doctor may work with,
including:
Aexcel® designation*
This Aetna program for specialists means
that a doctor has met certain care and
cost standards.
ePrescribing
With this service, doctors can use a
computer to write your prescription. They
can also check for harmful drug problems
and suggest safer treatment options.
ational Committee for Quality
N
Assurance (NCQA) recognition
This program helps you find doctors who
meet NCQA standards of care. NCQA is a
non-profit group that works to improve
health care quality.
We update DocFind six times a
week so you have the latest on
participating doctors and facilities.
*Aexcel is not available with HMO plans.
11.03.300.1 K (8/11)
1
Try DocFind now
Need a paper directory?
You’re mobile, so are we
If you’re an Aetna member, register for
your secure Aetna Navigator® website.
Once you do, you’ll get a personalized
version of DocFind. Each time you sign
on your plan name and zip code are
already filled in. That makes your search
even easier!
If you’re a member, just call the tollfree Member Services number on
your member ID card. If you’re not
yet a member, call 1-888-87-AETNA
(1-888-872-3862).
Find our most popular tools on
any mobile phone with web access.
There’s so much you can do on the go!
Just type “Aetna.com” into your mobile
internet browser to look for a doctor,
dentist or facility. As an Aetna member,
you also can:
If you’re not an Aetna member,
go to www.aetna.com. Click on
“Find a Doctor.”
¿Necesita DocFind en
español?
¡No hay problema! Simplemente haga
clic en el botón “Versión en español”
en la parte superior de la página principal
de DocFind para cambiar a la version
en español.
■■
Visit Aetna Navigator
■■
View your member ID card
■■
Look up claims and more
To learn more, go to www.aetna.com.
The Aetna companies that offer, underwrite or administer benefits coverage include
Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of
New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company. In
Arizona and Texas, in-network and out-of-network referred benefits are underwritten
by Aetna Health Inc. or Aetna Life Insurance Company. For self-funded accounts, benefits
coverage is provided by your employer with administrative services only provided by
Aetna Life Insurance Company (Aetna). In Maryland, by Aetna Health Inc., 151 Farmington
Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own
products.
If you need this material translated into another language, please call Member Services at
1-888-98-AETNA (1-888-982-3862).
Si usted necesita este documento en otro idioma, por favor llame a Servicios al Miembro al
1-888-98-AETNA (1-888-982-3862).
This material is for information only and is not an offer or invitation to contract. An application must be
completed to obtain coverage. Providers are independent contractors and are not agents of Aetna. Health
information programs provide general health information and are not a substitute for diagnosis or treatment
by a physician or other health care professional. Provider participation may change without notice. Aetna does
not provide care or guarantee access to health services. Health benefits and health insurance plans contain
exclusions and limitations. Aexcel designation is only a guide to choosing a physician. Members should confer
with their existing physicians before making a decision. Designations have the risk of error and should not be
the sole basis for selecting a doctor. Information is believed to be accurate as of the production date; however,
it is subject to change. For more information about Aetna plans, refer to www.aetna.com.
Policy forms issued in Oklahoma: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER
08/07, GR-23 and/or GR-29 /GR-29N.
©2011 Aetna Inc.
11.03.300.1 K (8/11)
www.aetna.com
2
Pharmacy plan
Aetna Three Tier, Open Formulary
Helping you get the right prescription
at the right cost
What’s inside …
> How your plan works
> What drug coverage
reviews are
> How to save money,
and more
05.03.308.1 K (8/11)
3
Understand your plan and costs
This booklet gives a general idea of how your Aetna prescription drug
benefits and insurance plan works and how to get the most out of it.
Looking for your exact
copay amounts?
Or what the plan covers
and doesn’t cover?
Check your Plan Design and
Benefits summary. This should
be in your enrollment kit. Ask
your employer if you do not
have one.
What the terms mean
What you pay
Your Aetna plan is a Three Tier, Open
Formulary plan.
The amount you pay (your copay)
differs depending on what your
doctor prescribes.
Three Tier means three payment levels.
Open Formulary means your plan
covers most prescription drugs. It may
not cover some drugs. Again, check the
plan documents from your employer for
your plan’s details.
Tier 1
You pay the lowest copay for drugs
in this tier level.
Tier 2
You pay a higher copay for drugs
in this tier level.
Tier 3
You pay the highest copay for drugs
in this tier level.
Searching for drugs by tier
level is easy
See the next section: “Ask your doctor
to help you save money.”
Health benefits and health insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc., Aetna
Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Maryland, by Aetna
4
Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
Use the plan to your advantage
Ask your doctor to help
you save money
Work with your doctor
on drug coverage reviews
Go to a network
pharmacy — and pay less
Make sure your doctor knows that you
pay more for Tier 3 drugs. Your doctor
can consider this before writing a
prescription.
One or more of these programs* may be
part of your plan:
Pharmacies in our network contract
with us to offer reduced rates. That
means lower drug prices.
Find the Tier level online
You and your doctor can search for a
drug, find out if it is covered and see
what payment level it falls under.
■■
Go to www.aetna.com/formulary.
■■
■■
■■
recertification** — Some drugs
P
have to be approved by Aetna before
your plan covers them.
tep therapy — Your doctor may need
S
to prescribe certain drugs first before
another drug will be covered.
And that can mean lower costs
for you:
■■
uantity limits — Some drugs have a
Q
limit on how many doses you can get.
■■
■■
■■
■■
P ull down Three Tier Open Formulary
in the drop-down box.
Click on Medication Search.
T ype in the drug’s name and click
Submit Search.
You will also see if there are any less
costly alternatives available. And if any
special policies apply (see next section on
drug coverage reviews).
They may at first seem burdensome
or unnecessary. But they can actually
help you and your doctor find safe
drugs and keep costs low.
Note: Doctors can ask for an exception
if they believe a certain drug on one of
these lists is medically necessary for you.
No access to the Internet?
copay is either a flat fee that you pay
A
the pharmacist — or a percentage of
the prescription’s price. If your copay is
a percentage, then your copay will be
lower if you go to a network pharmacy.
L et’s say your plan includes a
deductible. This is a set amount that
you need to pay before the plan begins
to share the cost. Take advantage of
lower prices. Go to a network
pharmacy and you’ll save money.
Find a network pharmacy
Go to www.aetnapharmacy.com
to find one near you.
Note: If you go to a pharmacy not in
our network, you will pay full price for
the drug. And you will need to fill out
and submit a claim form to request
reimbursement.
Get a printed directory of network pharmacies,
or a guide listing drugs and their tier level.
Call the toll-free number on your Aetna ID card.
**These drug coverage review programs may not apply in all service areas and all plans. Refer to your plan documents or call Member Services
with any questions. For example, precertification, step therapy and quantity limits do not apply to fully insured HMO members in Indiana. Step therapy is
also not available to fully insured members in New Jersey. However, these programs are available to self-funded plans in New Jersey and Indiana.
5
**In Texas, this approval is known as “pre-service utilization review.” It is not “verification” as defined by Texas law.
Get medications by mail — and save
Do you take medicine on a regular basis
for conditions like arthritis, asthma,
diabetes or high cholesterol?
Do you take specialty medications*
for conditions like multiple sclerosis,
rheumatoid arthritis, anemia or cancer?
Smart tools for
comparing drug costs
Use our Price-A-DrugSM tool
■■
Use Aetna Rx Home
Delivery® services
■■
■■
et up to a 90-day supply sent
G
to your home.
P ay less for that larger supply,
depending on your plan.
Use Aetna Specialty
Pharmacy® services
■■
■■
et free delivery that is reliable, secure
G
and sent anywhere you choose.
T ake advantage of extra help when
you need it — like injection training
and side-effect monitoring.
■■
■■
F ind out how much a drug may cost
at a network pharmacy — and how
much your copay would be.
S ee how much that same drug
would cost if you used Aetna Rx
Home Delivery.
ompare the costs of generic and
C
brand-name drugs.
It’s on your Aetna Navigator®
member website
Go to www.aetnapharmacy.com.
Register for your Member Secure Log In
after you enroll in the plan. Then log in
anytime.
Get a smarter pharmacy plan.
One that connects you with programs and tools
that can help you save money on prescriptions.
www.aetnapharmacy.com
Or try it out on your
mobile phone
You can log in and use the tool on any
mobile phone with web access!
*Specialty medications through Aetna Specialty Pharmacy and the Specialty Pharmacy Network
may not be available to California HMO members. Talk to your doctor about the appropriate
way to get the specialty medications you need. Doctors may have agreed to dispense and
administer these drugs to you themselves. Or they may write a prescription so you can fill them
at any participating retail or mail-order pharmacy.
If you require language assistance from an Aetna representative, please call the Member Services
number located on your ID card, and you will be connected with the language line if needed;
or you may dial direct at 1-888-982-3862. (140 languages are available. You must ask for an
interpreter.) TDD 1-800-628-3323 (hearing impaired only).
Si requiere la asistencia de un representante de Aetna que hable su idioma, por favor llame
al número de Servicios al Miembro que aparece en su tarjeta de identificación y se le
comunicará con la línea de idiomas si es necesario; de lo contrario, puede llamar directamente al
1-888-982-3862. (140 idiomas disponibles. Debe pedir un intérprete.) TDD 1-800-628-3323 (sólo
para las personas con impedimentos auditivos).
This material is for information only and is not an offer or invitation to contract. An application must be
completed to obtain coverage. Rates and benefits vary by location. Health benefits and health insurance
plans 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.
Aetna’s Preferred Drug List is subject to change. Aetna receives rebates from drug manufacturers that
may be taken into account in determining its Preferred Drug List. Rebates do not reduce the amount a
member pays the pharmacy for covered prescriptions. Medications on the precertification, step-therapy
and quantity limits lists are subject to change. Aetna Rx Home Delivery and Aetna Specialty Pharmacy refer
to Aetna Rx Home Delivery, LLC and Aetna Specialty Pharmacy, LLC, respectively. Aetna Rx Home Delivery
and Aetna Specialty Pharmacy are licensed pharmacy subsidiaries of Aetna Inc. that operate through mail
order.
Information is believed to be accurate as of the production date; however, it is subject to change. For more
information about Aetna plans, refer to www.aetna.com.
Policy forms issued in Oklahoma include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS
RIDER 08/07, GR-23 and/or GR-29/GR-29N.
©2011 Aetna Inc.
05.03.308.1 K (8/11)
www.aetna.com
6
Pharmacy PLAN
Aetna Rx Home Delivery®
Your pharmacy — as near as your mailbox
Learn about:
> Our mail-order pharmacy may
save you time and money.
> And standard shipping is
always free!
05.02.308.1-PB A WEB (2/11)
7
Enjoy the benefits of your
mail-order pharmacy
Do you have a chronic condition like
arthritis, asthma, diabetes, high
blood pressure or high cholesterol?
Do you take medications every
month to treat these kinds of
conditions or diseases?
Aetna Rx Home Delivery can fill and refill
these maintenance medication
prescriptions for you.
Quality service
■■
■■
Step 1
■■
et up to a 90-day supply sent to your
G
home or any location you choose.
epending on your plan, you may pay
D
less by using this service.
■■
Fill out the attached Order Form.
■■
rescription #1: Is for a one-month
P
supply. Fill it at a local retail pharmacy.
With this short-term supply you will
have enough of your medication on
hand to see you through until your first
Aetna Rx Home Delivery order arrives.
rescription #2: Is typically for a 90P
day supply (with three refills). Send
this one to Aetna Rx Home Delivery.
ail it with your prescriptions and
M
payment to Aetna Rx Home Delivery.
Use the envelope provided. Or find the
address on the Order Form.
OR
■■
Ask your doctor to write TWO
prescriptions.
Greater supplies, lower
copayments
Step 2
S hipping is quick and confidential.
Standard shipping is always free.
Place your first order today
■■
■■
P harmacists check all prescriptions for
accuracy and can answer questions
anytime, day or night.
ave your doctor fax your prescriptions
H
and completed Order Form. The fax
number is on the Order Form.
Note: Write your date of birth and
Aetna member ID on all documents,
including your prescriptions.
■■
ake sure that you complete the
M
method of payment section on
the order form. We need to know
what credit card to charge or debit
card to deduct from. You can also
use your Health Savings Account or
Flexible Spending Account as a form of
payment.
Health benefits and health insurance plans are offered, underwritten or
administered by Aetna Health Inc., Aetna Health of California Inc., Aetna Health
Insurance Company of New York, Aetna Health Insurance Company and/or Aetna
Life Insurance Company (Aetna). In Maryland, by Aetna Health Inc., 151 Farmington
Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its
8
own products.
Ordering refills is easy
Questions and answers
Shipping, costs and returns
You can order refills:
Who can I call if I have any
questions?
How long does it take to receive
my prescription through the
mail?
1. Online
Log in to www.aetnanavigator.com to
order refills, track your order and more.
2. By phone
Call Aetna Rx Home Delivery toll-free at
the number on the Order Form. Have
your Aetna member ID number, your
prescription number, and your credit card
number ready.
3. By mail
Send in the reorder form that you
received with your last order. Mail
it back with your payment. The reorder
form will also tell you when you can
place your next refill order.
For questions about your pharmacy
benefits plan, call the Member Services
number on your Aetna ID card.
For Aetna Rx Home Delivery questions,
call the toll-free number on your Order
Form. Customer service representatives
can answer questions, check the status of
an order or place a refill order. Pharmacists
are also available to help.
What prescriptions do I send to
Aetna Rx Home Delivery?
Aetna Rx Home Delivery fills prescriptions
for chronic (long-term) medications. These
are drugs that you need to take on a regular
basis for arthritis, asthma, diabetes, heart
disease, high cholesterol and other chronic
conditions.
Please allow 10 to 14 days to process and
ship your order. There may be a delay if we
need to contact your physician. To avoid
delays: Make sure you fill out your forms
completely, and that you send payment in
full at the time you place your order.
Where can I find Order Forms?
There is one included with this brochure.
You can also get forms online at
www.aetnanavigator.com.
How much do I owe for a
prescription?
There are two ways to check on your costs:
■■
When should I use a retail
pharmacy?
If you have an acute condition like an
infection, your doctor will prescribe a
drug that you will take for a short
amount of time.
■■
L og in to your Aetna Navigator®
member website through
www.aetnanavigator.com Use the
Price-A-DrugSM tool to see your cost at
a participating pharmacy — and through
Aetna Rx Home Delivery.
all Member Services at the toll-free
C
number listed on your Aetna ID card.
Take this type of prescription to a local
pharmacy. We recommend that you use
Aetna participating pharmacies. Check
DocFind® at www.aetnapharmacy.com
to find one near you.
How much are the shipping
charges?
Can I fill a prescription for a
controlled substance medication
at mail-order?
Can medications be returned?
Yes. State and federal laws requires that
you mail in a written prescription from
your doctor for this type of drug.
Standard shipping is always free. There is
a shipping charge if you need quicker
delivery.
We cannot accept returned medications.
If you have any questions about our
order return policy, call the toll-free
number on your Order Form. Our
customer service representatives are
available to answer your questions.
9
About your prescriptions
Are 90-day supplies the
standard amount sent through
the mail?
That depends on your doctor and your
plan. You may only get medications in
the amount that your doctor prescribes.
If your doctor writes a prescription for a
30-day supply with three refills, you will
only get one 30-day supply at a time.
Do prescriptions expire?
Most prescriptions, including refills,
expire within one year (sometimes
sooner) from the day they are written. If
this happens, you must get a new
prescription from your doctor — even if
your prescription label still shows refills
remaining.
What is your policy on generic
substitution?
Talk to your doctor about generic drugs.
Generics have been approved by the FDA
as safe and effective. They contain the
same active ingredients in the same
amounts as brand-name drugs.
And they cost a lot less!
Pharmacy law allows generic substitution.
We may substitute a generic for a
brand-name prescription, unless your
doctor indicates not to. If you want to
receive the brand drug, ask your doctor
to write your prescription for brand only.
Check with your doctor to see if he or she
can write a 90-day supply. Also, check
with your plan. Call Member Services to
see what the maximum day supply is. The
toll-free number is on your Aetna ID card.
Note: Depending on your plan, you may
pay more for a brand-name drug.
Health benefits and health insurance plans contain exclusions and limitations.
Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC. Aetna Rx Home Delivery is a licensed pharmacy
subsidiary of Aetna Inc. that operates through mail order.
When you provide a check as payment, you authorize us to use information from your check either to make a
one-time electronic fund transfer from your account or to process the payment as a check transaction. When
we use information from your check to make an electronic fund transfer, funds may be withdrawn from your
account as soon as the same day you make or we receive your payment. You will not receive your check back
from your financial institution.
Information is believed to be accurate as of the production date; however, it is subject to change. For more
information about Aetna plans, refer to www.aetna.com.
©2011 Aetna Inc.
05.02.308.1-PB A WEB (2/11)
www.aetna.com
10
Make the most of all your plan offers
Aetna Navigator® Secure Member Website
Aetna Navigator is your secure
member website. It’s where you
go to:
Find doctors, dentists,
pharmacies and hospitals
■■
■■
ake sure your doctor is in our
M
network before you go
L ook for a new doctor near your
home or work
Get an ID card
■■
Print a temporary card
■■
Order a new card
Check your coverage
■■
Check who is on your plan
■■
Check what your plan covers
Keep track of health care
costs
■■
■■
■■
■■
Save time, avoid
guesswork, do what
you need to do easily
heck what a procedure may cost in
C
your area
L ook up a health savings account*
or health fund balance
S ee how much you’ve paid so far and
how much you have left to pay
heck the price of a drug before you
C
go to the pharmacy
Look up a claim
■■
■■
heck to see what your doctor billed,
C
how much your health benefits and
insurance plan paid and what you
have to pay
Find out how claims work
You’re mobile. So are we.
■■
se any mobile phone with web
U
access to log in to Aetna.com and try
some great tools. Or if you have a
smartphone, check out our apps!
Use Ann, Aetna’s virtual
assistant, to:
> Help you register and log in
> Answer questions
> Find tools and information
*HSAs are currently not available to HMO members in IL and CA.
Health benefits and health insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc.,
Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Maryland, by
Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
13
11.03.312.1 K (8/11)
Health info
on the go
Aetna Mobile
Visit Aetna Navigator anytime,
anywhere. You can log in using any
mobile phone with web access. It’s
fast, easy and so convenient.
www.aetna.com
It’s personalized for you and
your family
What you see is based on:
■■
■■
■■
Your Aetna health plan
ealth history or claims information you
H
entered
Look what else you can do
There’s so much you can do on Aetna
Navigator! Just log in to your plan and:
■■
■■
Your zip code
It’s easy to get started
If you’re a new member, go to
www.aetna.com and “Register” today.
Already signed up for Aetna Navigator?
Log in now to take advantage of the
features and tools.
■■
ave medicines you take every day sent
H
to your home
et a summary of your doctor visits,
G
medical tests, prescriptions and other
health activities
P rint records of preventive shots and
checkups
■■
Look up health topics
■■
Complete a Health Assessment
■■
Get healthy living tips
■■
Sign up for a wellness program
This material is for information only and is not an offer or invitation to contract. An application must be
completed to obtain coverage. Rates and benefits vary by location. The availability of Aetna Navigator’s key
features may vary by plan. Health benefits and health insurance plans 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. Providers are independent
contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not
provide care or guarantee access to health services. The Health Assessment is used in a variety of ways to
support Aetna products and services that help you manage your health. Aetna will use your Health
Assessment information in compliance with all applicable state and federal laws, including the Health
Insurance Portability and Accountability Act (HIPAA) privacy and security rules. For more information, view
Aetna’s Notice of Privacy Practices, located at the bottom of Aetna’s website; or call the number on the
back of your ID card. Information is believed to be accurate as of the production date; however, it is subject
to change. For more information about Aetna plans, refer to www.aetna.com.
Policy forms issued in Oklahoma include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS
RIDER 08/07, GR-23 and/or GR-29/GR-29N.
©2011 Aetna Inc.
11.03.312.1 K (8/11)
www.aetna.com
14
Your health information now has an
online home
Personal Health Record
Keeping track of your health information
can be a challenge. Let your Personal
Health Record to do the work for you.
One place, one record
Your Personal Health Record is where
much of your important health
information is stored. This includes your:
■■
Family health history
■■
Immunizations
■■
P rescription and over-the-counter
medicines
■■
Doctors
■■
Allergies
■■
■■
lood pressure, weight, blood sugar
B
and cholesterol numbers
Tests, procedures and more
When you visit the doctor or fill a
prescription your plan covers, the
information goes right into your Personal
Health Record. You can add other health
information yourself. This may include
family history or over-the-counter
medicines you take. You will have a more
complete picture of your health as you fill
in more details. This makes your Personal
Health Record more useful to you and
your doctors.
How your Personal Health
Record can help you
There are many ways to use your
Personal Health Record.
■■
■■
■■
■■
eep track of when you are due for
K
important checkups. Use it to
remember when to get preventive
screenings like a mammogram or
colonoscopy.
S tay on top of your care. Based on
your health profile, you may get alerts
that spot potential medical problems,
possible drug interactions or ways to
improve your care.
T rack important health numbers. See
how your blood pressure, blood sugar,
weight and other health markers
change over time in clear, easy-tounderstand graphs and charts.
S hare it with your doctor. The Health
Summary is your “home page.” It’s
your health information at a glance.
You decide what goes into your
summary and what you share with
doctors. Print it out and take it with
you or share it securely online before
your visit.
Health benefits and health insurance plans are offered, underwritten or administered by: Aetna Health Inc., Aetna Health of California Inc., Aetna
Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Maryland, by Aetna
Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own Products.
00.03.384.1 C (8/11)
15
It’s easy to get started
Members can visit www.aetna.com
and create a user name and password on
our secure Aetna Navigator® member
website.
The Personal Health Record is here to
help you better manage your health.
Keep it up-to-date and share it with your
doctors. Together you can make the best
decisions about your health.
Your information is secure
You control who sees your information
because you need your user name and
password to access your Personal Health
Record. You can choose to share it with
family members and caregivers, in
addition to your doctors.
Manage your family’s health
information, too
The Personal Health Record is available to
employees who enroll in an Aetna health
benefits or health insurance plan. Your
covered family members have separate
Personal Health Records. As the plan
subscriber, you can access and add
information to the Personal Health
Record of any covered family members
under age 18. You can give your covered
spouse this access, too.
To make the most
of your Personal
Health Record, keep
it up to date.
Take it with you
If you change coverage, change jobs or
your employer stops offering the Personal
Health Record, it’s easy to transfer your
information to Microsoft® HealthVaultTM.
Take advantage of the many tools and
resources it offers. You can also save
a copy your information to a computer
as a PDF file. E-mail it to caregivers or
relatives, as you choose.
This material is for information only and is not an offer or invitation to contract. An application must be
completed to obtain coverage. Rates and benefits vary by location. Health information programs provide
general health information and are not a substitute for diagnosis or treatment by a physician or other health
care professional. The Aetna Personal Health Record should not be used as the sole source of information
about the member’s medical history. For more information about Aetna plans, refer to www.aetna.com.
Policy forms issued in Oklahoma include: HMO/OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS
RIDER 8/07, GR-23 and/or GR-29/GR-29N.
©2011 Aetna Inc.
00.03.384.1 C (8/11)
www.aetna.com
16
Personal attention for your health
conditions and risks
Disease Management Program
Ready to be your
healthiest you?
A program that’s about you,
not your condition
Only your doctor can decide on the best
care for you. But your health coach is by
your side with tips and ideas to help.
You can get solid support managing your
condition with the disease management
program. And it’s included with your
Aetna health benefits and insurance plan,
so you can start living healthier today.
Your condition isn’t unique. But you sure
are. So this program is designed to help
you control your condition in ways that
work for you.
Manage your condition with
online programs
You’ll learn how to:
■■
Manage your condition
■■
Lower your risks for new conditions
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Work better with your doctor
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You can:
■■
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Take your medicine safely
F ind helpful online and community
resources
■■
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Support for more than
35 conditions
…including diabetes, heart disease, cancer,
low back pain and digestive conditions.
Your condition is likely covered, too.
To learn more, log in to your secure
member website at www.aetna.com.
Then choose “Health Programs,” then
“Disease management.”
T ake online disease management
programs, if available, to boost your nurse
coaching sessions
Program topics include:
■■
General condition management
Interact with the program online, by
e-mail, or by phone
■■
Lower back pain
■■
Diabetes
all our dedicated disease management
C
line toll-free, 24/7
■■
Pain management
■■
High cholesterol
■■
High blood pressure
Work one on one with a
registered nurse
Your employer can let you know if these
programs are offered.
An Aetna nurse will act as your personal
health coach. You choose why, when or
how often to speak with them.
You can work with your coach:
■■
■■
■■
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45.02.300.1 D (8/11)
ork with a nurse when it fits your
W
schedule
You may have access to online disease
management programs, too. They can
highlight the progress you’re making with
your nurse. And they’re available 24/7.
hen you need help losing weight or
W
lowering your cholesterol
Before or after your doctor’s visit
hen you’re looking for healthier
W
lifestyle choices
T o understand your doctor’s treatment
plans
17
Technology that works for
your health and safety 24/7
You benefit from smart technology
that keeps scanning your health plan
records. So if you visit the doctor or pick
up a prescription, the system “knows”
you did it.
It also scans information you or your care
team entered into your online personal
health record. Then it compares that
information with current care guidelines
to help you be safer and healthier.
What’s the program like?
How to start the program
Let’s say you have diabetes. Here’s how
a nurse would work with you to manage
your condition today — and going forward.
If you have a condition, or think you’re
at risk, you can get in touch with us:
He or she would:
■■
■■
■■
■■
This technology can:
■■
Find gaps or errors in your care
■■
Remind you to get preventive care
■■
■■
S earch for drug interactions that could
be dangerous
otify your doctor to stop a treatment
N
or try a procedure
■■
■■
T each you about diabetes, and answer
your questions
S end you information by mail, or point
you to online resources
o over your doctor’s treatment plan
G
with you
E xplain possible side effects of your
medicine
ive you access to our 24-hour disease
G
management phone line
■■
P ut in a request through your secure
member website at www.aetna.com.
Call us at 1-866-269-4500.
Get health support —
in ways that work
for you.
The disease
management
program can help.
You may also get a call or letter,
depending on the situation.
Health benefits and health insurance plans are offered, underwritten and/or administered by: Aetna Health Inc., Aetna Health of California Inc.,
Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Maryland, by
Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
This material is for information only. Health information programs provide general health information and are not a substitute for diagnosis or treatment by
a physician or other health care professional. Health benefits and health insurance plans contain exclusions and limitations. Not all 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 group size. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer
to www.aetna.com.
Policy forms issued in Oklahoma include: HMO/OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 8/07, GR-23 and/or GR-29/GR-29N.
©2011 Aetna Inc.
45.02.300.1 D (8/11)
www.aetna.com
18
Aetna discount programs
Programs to help you be well
and save money
Savings on:
> Gym memberships
> Eyeglasses and contacts
> Weight-loss programs
> Chiropractic visits and more
PLUS — no referrals, claims or limits
00.02.333.1 D (8/11)
19
Stay healthy with savings that come with
your Aetna health plan
Aetna VisionSM discount
program
Aetna FitnessSM discount
program
Save on seeing sharper
Save on gym memberships
Pay less for eye exams, contact lenses
and prescription and non-prescription
eyeglasses. Even most designer frames!
Get preferred rates at your choice of over
10,000** gyms in the GlobalFit network.
You also get:
Save at:*
■■
FREE guest pass at most gyms
■■
JCPenney® Optical
■■
Flexible membership options
■■
LensCrafters®
■■
Optical®
■■
Target
■■
Sears Optical®
■■
Pearle Vision®
■■
Plus many doctors in private practice
To find one near you, visit
www.aetna.com.
Great rates on eye exams
Routine checkups help your eye doctor
find problems in your eyes and body
early, for earlier treatment. You pay only
$42 for eye exams. Even if your health
benefits and health isnurance plan covers
your first exam, you can get another for
the same low price.
■■
■■
■■
■■
S avings on LASIK eye surgery, including
a FREE consultation
Freezing and travel*** privileges
Build your home gym with discounts on
elliptical trainers and treadmills. Plus
resistance bands, mats, yoga accessories
and more.
More healthy perks
Save and lose weight
Lose weight, feel great and save on
today’s most popular weight-loss
programs and meal plans.
Save on eDiets®
You can choose an online diet plan, or a
meal delivery plan with food shipped
right to you door.
You get:
■■
■■
■■
■■
■■
0% off online monthly plan
3
membership dues
0% off an online annual plan when
2
you upgrade from a monthly plan
5% off the cost of food for a 5- or
1
7-day Meal Delivery Plan
5% off products in the eDiets Online
1
Store
Customized menus, diet tools and more
Getting fit is just the start to a healthier
you. You can also:
■■
ontact lens replacement — delivered
C
to your door
embership transfer to another gym or
M
person***
Save on home exercise
equipment
More eye-opening perks
■■
E asy billing through your bank account
or credit card
Aetna Weight
ManagementSM discount
program
■■
T ry out an at-home weight-loss
program
et one-on-one health coaching†
G
to help you quit smoking, lower stress,
lose weight and more
0% off eye care items like sunglasses,
2
contact cleaners and eyeglass chains
*EyeMed Select Network and Provider List, 1/11.
**GlobalFit website, www.globalfit.com/fitness, 4/11.
***Not available for month-to-month memberships.
†By WellCall, Inc., through GlobalFit.
20
To start saving on everything in this brochure, log in to
www.aetna.com as soon as you’re an Aetna member.
Save on Jenny Craig®
Sensible weight-loss programs that help
you lose the weight for good.
■■
■■
Start with a free 30-Day Trial Program††
T hen get 25% off a Jenny Craig
Premium Program†† when you sign up
through:
> Participating Jenny Craig Centres
> Jenny Craig At Home
■■
P lus, get weekly one-on-one
consultations, 24/7 online support
and more
Save on Nutrisystem®
Over 150 single-serve food choices that
are tasty and easy to make.
You get:
■■
■■
■■
■■
2% off on any 28-day weight-loss
1
meal plan†††
Aetna Natural Products
and ServicesSM discount
program
Save on good health, naturally
You get at least 25 percent off the
normal fee on these services through
the ChooseHealthy® program:‡
■■
Massage therapy
■■
Acupuncture
■■
Chiropractic care
■■
Dietetic counseling
Get discounts on health and
wellness products
Save 15 percent on over 2,400 products
like over-the-counter vitamins, yoga
equipment, homeopathic remedies and
more through the ChooseHealthy
program.‡
Save on medical consultations
online
Other available offers when you sign up
Get natural remedies for many conditions
from medical doctors in the Vital Health
Network. You’ll get 30 percent off your
first online consultation. Then 50 percent
for each one after that. Topics include
headache, joint paint, allergies and more.
††For
Save on hearing aids and exams
You have two options to meet your
hearing needs.
With Hearing Care Solutions, you get:
■■
■■
n even bigger discount with AutoA
Delivery†††
F ood delivered right to your door, free
online membership and more
Aetna HearingSM discount
program
■■
■■
p to 63% savings on a large choice of
U
hearing aids
two-year supply of batteries (up to 96
A
cells), with mail-order discount after
In-office service for one year
F ree cleanings, checks and battery-door
replacements for the life of your
hearing aid
With HearPO, you get:
■■
■■
■■
S avings on many styles of hearing aids,
including programmable and digital
hearing aids from leading makers
two-year supply of batteries (up to
A
160 cells per hearing aid)
0% off the retail cost of hearing
4
exams
■■
Discounts on hearing aid repairs
■■
Free follow-up services for one year
these plans: Basic, Silver, Diabetic, Vegetarian or NutriSystem SelectTM, not Nutrisystem Flex. The Aetna discount does not apply to any program in which
you are already enrolled. To receive the discounted rate, you must wait until your current program ends. If you are enrolled in Auto-Delivery, you must cancel it
and then re-enroll to receive the discounted rate. With Auto-Delivery you receive a 10 percent discount off Nutrisystem’s regular 28-Day Program price and free
shipping to Continental U.S. only. Auto-Delivery offer is good on new 28-Day Auto Delivery programs only.
†††Food, and if applicable, shipping is not included. Offer applies to initial membership fee only and is valid at participating centres in the U.S., Canada and Puerto
Rico, and through Jenny Craig At Home. Each offer is a separate offer and can be used only once per person. Restrictions apply.
‡The ChooseHealthy program is made available through American Specialty Health Networks, Inc. (ASH Networks) and Healthyroads, Inc., subsidiaries of
21
American Specialty Health Incorporated (ASH). ChooseHealthy is a federally registered trademark of ASH and used with permission herein.
More healthy savings
Enhance your healthy lifestyle with even
more discounts.
Save on:
■■
■■
■■
■■
■■
■■
S onic toothbrushes and water-jet
flossers from Waterpik®
um, toothpastes and mouth rinses
G
from Epic dental
n automatic Home Blood Pressure
A
Monitor with ComFitTM Cuff
ZAGAT.com memberships
ooks and other items from the
B
American Cancer Society Bookstore and
MayoClinic.com Bookstore
How to save with every
program
1. Log in to your secure member website
at www.aetna.com once you’re an
Aetna member.
2. Choose “Health Programs,” then
“Discounts.”
3. Follow the steps for each program you
want to use.
Get well, stay well
and save.
Log in to your secure
member website at
www.aetna.com
to start.
There are no referrals, claims or limits on
how much you can save. And your family
members can enjoy the savings, too!
oga DVDs, books and online videos
Y
through Pranamaya
Health benefits and health insurance plans are offered, underwritten or administered by Aetna
Health Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company
and/or Aetna Life Insurance Company (Aetna). In Maryland, by Aetna Health Inc., 151 Farmington
Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
This material is for information only and is not an offer or invitation to contract. An application must
be completed to obtain coverage. Discount programs provide access to discounted prices and are NOT
insured benefits. The member is responsible for the full cost of the discounted services. Aetna may receive
a percentage of the fee you pay to the discount vendor. Health benefits and health insurance plans contain
exclusions and limitations. Information is believed to be accurate as of the production date; however, it is
subject to change. For more information about Aetna plans, refer to www.aetna.com.
Policy forms issued in Oklahoma include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS
RIDER 08/07, GR-23, GR-29 and/or GR-29N.
©2011 Aetna Inc.
00.02.333.1 D (8/11)
www.aetna.com
22
An online way to make lasting, lifelong
health changes
Simple Steps To A Healthier Life® Program
Learn how to fit healthy choices into every day
How to get started
Yes, it’s possible to reach your own path to good health. The tricky part is getting there
in a way that works for you. Try Simple Steps To A Healthier Life.
First, answer a few health questions
online.
You’ll get online wellness coaching programs that are included with your health benefits
and insurance plan — so it won’t cost you a penny. And you’ll learn strategies to fit
healthy living into your busy life. In simple steps, at your own pace.
3 easy steps:
Online programs* to help you reach your health goals
Manage your weight: Reach your
goal weight, and boost how active you
are with Balance™.
Sleep better: Beat sleepless nights
with strategies from Overcoming™
Insomnia.
Deal with stress: Find out where your
tension comes from, and get proven
strategies to stay calm under pressure
with Relax™.
Quit smoking: Get a quit plan that
uses your strengths to help you get
past old roadblocks with Breathe™.
Eat healthier: Get counseling one on
one to learn better eating habits for life
with Nourish™.
Be happier: Whether you have the
blues or its more serious, you can get
confidential help that gets results with
Overcoming™ Depression.
1. Log in to your secure member website
at www.aetna.com. New to the site?
Just click “Register.”
2. Click on “Health Records,” then
“Health Assessment.”
3. Choose the health assessment link —
and go!
Your responses are confidential. And you
can easily finish in one sitting. But if you
need to come back later, you can. The
system will save your answers.
*Available through HealthMedia®.
00.03.329.1 J (8/11)
23
What questions to expect
It’s all about you
You’ll see questions on your health
history. Like any conditions you have
or your last blood-pressure reading.
These online coaching sessions can
help you get healthy. And help you
find strategies that fit your life so you
can keep up the good work.
You’ll also see questions about your
modifiable health risks. These are the
health habits you can do something
about. Like eating more fruits and
vegetables. Or wearing SPF when
you’re in the sun.
Your answers can help you:
■■
■■
■■
■■
Here’s how:
■■
■■
nderstand your health needs
U
and goals
P ick an online wellness program
that fits your needs
Better manage your health risks
S hare your health information with
your doctor
■■
ou’ll get a personalized plan.
Y
It’s created just for you, based on
information you’ve shared at the
start of the program.
Make health changes
that last a lifetime.
Log on to
www.aetna.com to
start a program.
ou’ll get tools, tips and features
Y
to help you succeed. And have fun
at the same time! You can download
your new exercise routine to your iPod.
Or find healthier versions of your
favorite foods.
ou’ll get online coaching sessions
Y
that fit your schedule. Never the
other way around. So you can work
on one — or many — at the same time.
The choice is yours.
Health benefits and health insurance plans are offered, underwritten and/or administered by
Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New
York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In
Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has
sole financial responsibility for its own products.
The information provided by the Simple Steps To A Healthier Life program is not meant to be either a
recommendation for medical treatment or a diagnosis of medical condition. Participants should consult
their health care provider for the advice and care appropriate for their specific medical needs. This material
is for information only and is not an offer or invitation to contract. Health benefits and health insurance
plans contain exclusions and limitations. Health information programs provide general health information
and are not a substitute for diagnosis or treatment by a physician or other health care professional.
Information is believed to be accurate as of the production date; however, it is subject to change. For more
information about Aetna plans, refer to www.aetna.com.
Policy forms issued in Oklahoma include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS
RIDER 08/07, GR-23, GR-29 and/or GR-29N.
©2011 Aetna Inc.
00.03.329.1 J (8/11)
www.aetna.com
24