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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

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How do I dispute a denied claim with Aetna?

To help us resolve the dispute, well need: A completed copy of the appropriate form. The reasons why you disagree with our decision. A copy of the denial letter or Explanation of Benefits letter. The original claim. Documents that support your position (for example, medical records and office notes)

How do I use my Aetna Healthy Benefits card?

Its easy to look up covered items using the NationsBenefits mobile app on your smartphone. You can download the app for free on the App Store and Google Play. The Extra Benefits Card can be used at approved retail locations. At checkout, simply swipe your card and select credit when prompted for payment type.

How to use Aetna Extra Benefits Card 2023?

At checkout, simply swipe your card and select credit when prompted for payment type. When you select credit, no PIN is required. Or you can shop for home delivery of healthy foods at Aetna.NationsBenefits.com, or over the phone by calling 1-877-204-1817 (TTY: 711).

How often does Aetna deny claims?

With a total of more than 5.6 million denials over five years, the researchers estimated that there were 0.81 denials per beneficiary. In comparison to the overall pool of services, denied claims were fairly rare. Less than two percent of Aetnas claims were denied (1.4 percent).

What happens when I docHub my out-of-pocket maximum Aetna?

When your eligible out-of-pocket expenses docHub the maximum limit, your remaining eligible expenses are covered by the HMO plan at 100% for the remainder of the plan year. PLAN FEATURES Aetna HealthFund: Amount Contributed to the Fund per contract year.

Does insurance pay everything after you meet your deductible?

That means that as each person in the family incurs a medical expense, the out-of-pocket payment will go to the family deductible. Once that is met, the health plan will pay for all covered medical expenses for everyone in the family, minus any co-pays or coinsurance.

What can I buy with my Healthy Benefits card?

What can you buy? Food. Utilities, rent and mortgage. Gas at the pump. Non-medical transportation. Home supplies. Personal supplies. Over-the-counter medicine. Pet food and supplies.

Why is Aetna denying claims?

If your health or disability benefits have been denied, Aetna may have claimed the following: The procedure is merely cosmetic and not medically necessary. The treating physician is out of network or out of plan. The claim filed was for a medical condition that isnt authorized or covered.

How do deductibles work with Aetna?

A deductible is the amount you pay for coverage services before your health plan kicks in. After you meet your deductible, you pay a percentage of health care expenses known as coinsurance. Its like when friends in a carpool cover a portion of the gas, and you, the driver, also pay a portion.

Why does my insurance keep denying my claim?

Some of the most common reasons for claim denials are exceeding the policy limit, lacking the needed coverage and breaking the law. Additionally, sometimes claims are incorrectly denied. Learn what you can do to resolve a claims dispute.

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