[PDF] Directory - Aetna Medicare

Health Insurance Portability andAccountability ActNote: The following information is provided to inform you of certain provisions contained inthe Group Health Plan and related procedures that may be utilized by you in accordance withFederal law.Request for Certificate of CreditableCoverageIf you are a member of an insured plan sponsor or amember of a self insured plan sponsor who havecontracted with us to provide Certificates of PriorHealth Coverage, you have the option to request acertificate. This applies to you if you are a terminatedmember, or are a member who is currently active butwho would like a certificate to verify your status. As aterminated member, you can request a certificate forup to 24 months following the date of yourtermination. As an active member, you can request acertificate at any time. To request a Certificate of PriorHealth Coverage, please contact Member Services atthe telephone number listed on your ID card.Health benefits and health insurance plans are offeredby: Aetna Health Inc., Aetna Health of California Inc.,Aetna Health of Illinois Inc. and/or Aetna LifeInsurance Company. For self-funded accounts, benefitscoverage is offered by your employer, withadministrative services only provided by Aetna LifeInsurance Company. Providers are independentcontractors and are not agents of Aetna. Providerparticipation may change without notice. Aetna doesnot provide care or guarantee access to healthservices. If you are in a plan that requires the selectionof a primary care physician and your primary carephysician is part of an integrated delivery system orphysician group, your primary care physician willgenerally refer you to specialists and hospitals that areaffiliated with the delivery system or physician group.Information subject to change.The NCQA Accreditation Seal is a recognized symbolof quality. The seal, located on the front cover of yourprovider directory, signifies that your plan has earnedthis accreditation for service and clinical quality thatmeets or exceeds the NCQA's rigorous requirementsfor consumer protection and quality improvement. Thenumber of stars on the seal represents theaccreditation level the plan has achieved.Providers who have been duly recognized by theNCQA Recognition Programs are annotated in theprovider listings section of this directory. Providers, inall settings, achieve recognition by submitting data thatdemonstrates they are providing quality care. Theprogram constantly assesses key measures that werecarefully defined and tested for their relationship toimproved care, therefore, NCQA provider recognition issubject to change. Providers are independentcontractors and are not agents of Aetna. Providerparticipation may change without notice. Aetna doesnot provide care or guarantee access to health services.For up-to-date information, please visit our DocFind ®directory at www.aetna.com or, if applicable, visit theNCQA's new top level recognition listing athttp://web.ncqa.org/tabid/58/Default.aspx.If you need this material translated into another language, please call Member Services at 1-800-282-5366.Si usted necesita este documento en otro idioma, por favor llame a Servicios al Miembro al 1-800-282-5366.www.aetna.comXXV