Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The member's benefit plan determines coverage. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Members should discuss any matters related to their coverage or condition with their treating provider.Įach benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Treating providers are solely responsible for medical advice and treatment of members. The ABA Medical Necessity Guide does not constitute medical advice. The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. For more information, visit our Health care privacy FAQs.īy clicking on “I Accept”, I acknowledge and accept that: Just call the number on the back of your card. Keep your medical information private by requesting a confidential communication. Dental PPO and dental indemnity insurance plans are underwritten and/or administered by Aetna Life Insurance Company (Aetna).Įach insurer has sole financial responsibility for its own products. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156.ĭMO dental benefits and dental insurance plans are underwritten by Aetna Dental Inc., Aetna Dental of California Inc., Aetna Health Inc. In Utah and Wyoming, by Aetna Health of Utah Inc. and/or Aetna Life Insurance Company (Aetna). For all other states, health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna HealthAssurance Pennsylvania Inc. In Idaho, health benefits and health insurance plans are offered and/or underwritten by Aetna Health of Utah Inc.
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