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3 forms found in the DOM

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/search-results.html

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    * Health coverage
       * ACA individual and family health plans
       * Health plans through an employer
       * Options without employer coverage
       * Student plans
       * International plans
   
    * Dental, vision and supplemental
       * Dental plans
       * Find a dentist
       * Vision plans
       * Find an eye doctor
       * Supplemental plans
   
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       * Get pharmacy plan information
       * Find a pharmacy
   
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       * Medicaid plans
       * Find a doctor
   
   secondary menu close
 * Member support
    * Account management
       * Log in to your member website
       * Find a form
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       * View coverage opens in secure site
   
    * The health guide
       * All health resources
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       * Understanding health care
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    * Additional resources
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accuracy, or privacy practices of linked sites, or for products or services
described on these sites.


 
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MOBILE NUMBER Please be sure to add a 1 before your mobile number, ex:
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THIS SEARCH USES THE FIVE-TIER VERSION OF THIS PLAN

 

Each main plan type has more than one subtype. Some subtypes have five tiers of
coverage. Others have four tiers, three tiers or two tiers. This search will use
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APPLIED BEHAVIOR ANALYSIS MEDICAL NECESSITY GUIDE

By clicking on “I Accept”, I acknowledge and accept that:
 

The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine
appropriate (medically necessary) levels and types of care for patients in need
of evaluation and treatment for behavioral health conditions. The ABA Medical
Necessity Guide does not constitute medical advice. Treating providers are
solely responsible for medical advice and treatment of members. Members should
discuss any matters related to their coverage or condition with their treating
provider.

Each benefit plan defines which services are covered, which are excluded, and
which are subject to dollar caps or other limits. 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.

The 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) for a particular member. The member's
benefit plan determines coverage. Some plans exclude coverage for services or
supplies that Aetna considers medically necessary.

Please note also that the ABA Medical Necessity Guide may be updated and are,
therefore, subject to change.

Medical necessity determinations in connection with coverage decisions are made
on a case-by-case basis. 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.

 
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