![]() ![]() 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. An emergency room copay does not apply when you are admitted for an overnight hospital stay.īy clicking on “I Accept”, I acknowledge and accept that:.You are responsible for any emergency room copay.Any services you receive must be covered under the terms of your Aetna plan.When seeking emergency care, please note that: In other cases, you should notify your primary care doctor and Aetna within 48 hours of an emergency.If you are admitted to an inpatient facility, you should immediately notify your primary care doctor and Aetna.You should seek immediate treatment for any illness or injury that would be considered an emergency, or for the care of any urgent problem.Remember that urgently needed care is covered while you are traveling outside of your local Aetna service area.If an emergency happens when you’re traveling away from home: Please note that all follow-up care should be coordinated through your primary care doctor.Your primary care doctor knows your medical history and is also responsible for coordinating your health care. Once an emergency facility has stabilized your condition, their staff members should try to contact your primary care doctor.In all cases, you should contact your primary care doctor as soon as possible after receiving treatment. If possible, you should also call your primary care doctor. Call your local emergency hotline ( 911) or go to the nearest emergency facility. ![]()
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