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See a list of covered drugs for your plan

Find your drug list

 

Referrals and prior authorizations

Looking for referral and pre-approval requirements? Check your plan's Evidence of Coverage.

View a list of services and drugs that require prior authorization

 

Check your claims

Log in to review your claims and payment status

 

Flu shot coverage

Learn about your flu shot benefit

 

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.

View a list of coverage determinations

 

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.

Finding care during a disaster or emergency

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.

 

Specifically, we:

 

  • 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 our customer service number or see your Evidence of Coverage for more information, including the cost-sharing 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 doctor, 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 doctor over a computer or smart phone. 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 doctors
  • 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 doctor 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 2023 Evidence of Coverage or Formulary if you need one.

 

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Need answers or information? Just send us an email and we'll get back to you as soon as we can. 

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