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Frequently asked questions

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Managing my costs

To submit a claim for reimbursement, please download, complete and submit the forms below. Each form includes submission instructions and when you can expect to receive reimbursement.

 

Prescription drug claim form

 

Fitness claim form

 

Medical, dental, vision and vaccine claim form

There are certain steps you need to follow to request coverage for a medical service or prescription drug. The process for each is different. We’ve put together a framework to help you find the right process for your request.

 

Learn about coverage decisions

An appeal is a formal way of asking us to review and change a coverage decision we made. The appeals process can differ depending on what type of medical service you’re appealing. You can learn more about how to appeal a coverage decision for medical coverage or prescription drugs at our Appeals and Grievances Center.

 

Learn about appeals

The Medicare Extra Help program is for those with limited income and resources. Extra Help from Medicare can help you pay for your prescriptions if you qualify.

 

Learn more about Extra Help

Managing my plan

If you’re moving to a new address or getting a new phone number, please let us know right away. Just call Member Services at the number on your ID card. Based on where you move, you may need to enroll in a new plan.

 

Do you get Medicare coverage through an employer, union or retiree plan? If so, you may need to contact your benefits administrator to update your address or phone number.

Need a new, duplicate or additional ID card? You can view and print one within your secure member website. A digital or printed card is identical to a plastic ID card. If you’re unable to log in or do not have an account, just call Member Services. They can help you log in or replace a lost card.

 

Log in to replace your ID card

There are two main time periods when you can change or leave your Medicare Advantage (Part C) or prescription drug (Part D) plan. In addition, some people may qualify for a special enrollment period (SEP). This means the Centers for Medicare & Medicaid Services (CMS) gives you a chance to change your plan outside of these two main enrollment periods.* 


1. During Medicare's annual enrollment period (AEP): 10/15 through 12/7

Medicare annual enrollment goes from October 15 through December 7 each year. During this time, you can decide to keep your current plan or select a new plan. If you choose to make a change during AEP, your new coverage won’t begin until January 1.


2. During Medicare’s open enrollment period (OEP): 1/1 through 3/31

Medicare’s OEP goes from January 1 through March 31 each year. During this time, you can:

 

  • Switch to another Medicare Advantage plan. (You can choose a plan that covers prescription drugs or one that does not cover prescription drugs.)
  • Disenroll from a plan and get coverage through Original Medicare.


3. During a special enrollment period granted to you for certain situations

In certain situations, you can change your Medicare plan outside of Medicare’s AEP. Some examples include if you:

 

  • Move out of your plan’s service area
  • Lose other creditable prescription drug coverage
  • Live in a long-term care facility (like a nursing home)
  • Have Medicaid

If you get coverage from an employer or group health plan, review the information they provide. It can show you what options are available to you.

 

Generally, your membership in your current plan will end on the last day of the month after we get your request to switch to Original Medicare or another plan.

 

*FOR CHANGES OUTSIDE MAIN ENROLLMENT PERIODS: There may be other times when you can join or leave a plan. See Medicare’s full list of special situations.

Managing care

Some Allina Health | Aetna Medicare plans have a home delivery option through the CVS Caremark® Mail Service Pharmacy. To get started with home delivery, please visit the CVS Caremark® Mail Service Pharmacy page.

 

If you qualify, you may complete the forms below to enroll.

 

Mail Service Order Form

 

Mail Service Order Form (Spanish)

 

Please mail the forms to:


CVS Caremark 

PO BOX 659541

SAN ANTONIO, TX 78265-9541

 

Learn more about your options

If you need help with a one-time issue, you can give us your permission by phone. We can speak with that person during the call.

 

If you want to appoint someone to act as a long-term care manager or authorized representative, you can. You’ll need to mail us an Authorization for Release of Protected Health Information (PHI) form. It lets this person access your personal health information. They can also speak with us on your behalf about benefits, coverage, claims, bills and more.

 

Open and print the PHI form

 

Return the completed form to us at the address or fax number shown on the form.

 

It’s important to know:

 

The PHI form doesn’t override Medicare Power of Attorney documents. You don’t need to complete the PHI form if you have a Power of Attorney (POA).

 

The PHI form is only good for one year. You need to complete a new form each year for a representative to continue to assist you.

 

You need to complete a separate form (see below) if you need help filing:

 

  • An initial request for coverage
  • A grievance or an appeal

Appointment of Representative CMS Form

 

Appointment of Representative CMS Form (Spanish)

You have a few options when filing a complaint. You can:

 

We’ll get back to you within 30 days (24 hours if you request a faster response). To send a complaint to Medicare, complete the Medicare Electronic Complaint form

You can select or change your PCP online through the secure member site. Or you can call us at the number on your ID card. You may need to choose your PCP from your plan’s network.

 

Log in to change your doctor

Allina Health | Aetna Medicare Medication Therapy Management (MTM) programs help you and your doctor manage your medications safely. Visit our MTM information page to learn more about Allina Health | Aetna Medicare MTMs and see if you qualify.

 

More about Medication Therapy Management (MTM) programs

1There may be other times when you can join or leave a plan. See Medicare’s full list of special situations.

 

Still have questions?

Talk to an Allina Health | Aetna Medicare representative at ${membersPhone} ${tty}, ${membersHours}.