Directory - Aetna Medicare

■ If the notice is given more than 2 days before thecoverage ends, the request should be made nolater than noon the day before the date theMedicare coverage ends.■ If the QIO decides that the decision to terminatecoverage was medically appropriate, you will beresponsible for paying the SNF, HHA or CORFcharges after the termination date on the advancewritten notice you received from the provider.■ If the QIO agrees with you, then the plan willcontinue to provide coverage for the SNF, HHA orCORF services for as long as medically necessary.If you do not request the QIO to do a fast track appealof the discharge by the deadline, you can ask the planfor an Expedited/72-Hour review under the MedicareAdvantage Expedited Appeals Process.Member Rights & ResponsibilitiesYou have the right to receive a copy of our MemberRights and Responsibilities Statement. This informationis available to you online athttp://www.aetna.com/about/MemberRights/.You can also obtain a print copy by contactingMember Services at the number on your ID card.Member ServicesTo file a compliant or an appeal, for additionalinformation regarding copayments and other charges,information regarding benefits, to obtain copies ofplan documents, information regarding how to file aclaim or for any other question, you can contactMember Services at the toll-free number on your IDcard, or e-mail us from your secure member website,Aetna Navigator at www.aetna.com. Click on“Contact Us” after you log in.When you require assistance from an Aetnarepresentative, call us during regular business hours atthe number on your ID card. Our representatives can:■ Answer benefits questions■ Help you get referrals■ Find care outside your area■ Advise you on how to file complaints and appeals■ Connect you to behavioral health services (ifincluded in your plan)■■Find specific health informationProvide information on our Quality Managementprogram, which evaluates the ongoing quality ofour servicesInterpreter/Hearing ImpairedInterpreterAetna can help explain benefit and providerinformation in up to 140 languages! If you requireSpanish speaking assistance, please contact us at thetoll free number located on your ID card and followthe prompts. If you require assistance in a languageother than Spanish please call us at the toll freenumber that is located on your ID card and ask for aninterpreter.Hearing ImpairedTDD: 1-800-628-3323 (hearing impaired only)Quality Management ProgramsCall Aetna to learn about the specific quality effortswe have under way in your local area. Ask MemberServices for the phone number of your regionalQuality Management office. If you would likeinformation about Aetna Behavioral Health’s QualityManagement Program, ask Member Services for thephone number of your Care Management CenterQuality Management office.Privacy NoticeAetna considers personal information to beconfidential and has policies and procedures in placeto protect it against unlawful use and disclosure. By“personal information,” we mean information thatrelates to your physical or mental health or condition,the provision of health care to you, or payment for theprovision of health care to you. Personal informationdoes not include publicly available information orinformation that is available or reported in asummarized or aggregate fashion but does notidentify you.When necessary or appropriate for your care ortreatment, the operation of our health plans, or otherrelated activities, we use personal informationinternally, share it with our affiliates, and disclose it tohealth care providers (doctors, dentists, pharmacies,XII