Allina Health | Aetna is an affiliate of Allina Health and Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Allina Health | Aetna.
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Referrals and prior authorizations
Looking for referral and pre-approval requirements? Check your plan's Evidence of Coverage.
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Flu shot coverage
Medicare coverage changes
The Centers for Medicare and Medicaid Services periodically issues National Coverage Determinations. They issue these when a service's or drug's coverage rules change.
Coverage during a disaster or emergency
We want to make sure you can access your benefits even during urgent situations — like a public health emergency or state of disaster.
Additional coverage information
We help you get medically necessary health care services in the most cost-effective way under your health plan. And we work with you and doctors to evaluate services for medical appropriateness, timeliness and cost.
- Base our decisions on appropriateness of care, service and plan coverage
- Use nationally recognized guidelines and resources to make changes
- Don’t pay or reward providers, employees or others for denying coverage or care
- Focus on reviewing the risks of members who aren’t fully using certain services
Doctors and health care companies continuously develop new technologies. This can include anything from a new procedure to a new way to use a device.
If you’re enrolled in an Allina Health | Aetna Medicare Plan (PPO)
You have flexibility to receive covered services from network providers or out-of-network providers. Out-of-network/non-contracted providers are under no obligation to treat Allina Health | Aetna Medicare members, except in emergency situations. Please call us or see your Evidence of Coverage for more information, including the cost share for out-of-network services.
Although you don’t have to choose a primary care provider, we encourage you to do so. If you receive covered services from an out-of-network provider, it’s important to confirm that they:
- Accept your PPO plan
- Are eligible to receive Medicare payment
Telehealth — or telemedicine — means virtual care you can get at home or away. These visits are live, video conferences between you and a provider by phone, computer, or tablet. Consider using telehealth when you have a time sensitive medical need or can’t get to the doctor in person.
Your plan covers certain telehealth visits with in-network
- Primary care providers
- Physician specialists
- Mental health providers, and
- Urgent care facilities
Not all provider visits can be handled through telehealth. You can view and download a list of potentially covered telehealth services here. Ask your provider whether they offer these services via telehealth and how to schedule a visit.
Telehealth visits with out-of-network providers are not covered. Please refer to your provider directory to find an in-network provider.
Note: Certain services may require a prior authorization (pre-approval). See your Evidence of Coverage for details.
Allina Health | Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.
See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.
You can request a copy of your 2024 Evidence of Coverage or Formulary if you need one.
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