Haris Ashley
Aetna offers a range of health insurance plans, including international coverage for travellers, expatriates, and business travel employees. The specific benefits and limitations of each plan vary, with some plans offering more comprehensive coverage than others. While Aetna provides international emergency medical coverage for its members, it is important to note that non-emergency care may not be covered outside of the Aetna network, and members are advised to carefully review their chosen plan's documents to understand their coverage limits. Additionally, Aetna offers a Medicare Advantage plan that provides health coverage for travellers within the United States.
| Characteristics | Values |
|---|---|
| Company | Aetna |
| Type of Insurance | Medicare Advantage Coverage |
| Coverage | Domestic and international |
| Medical Necessity Determinations | Made on a case-by-case basis |
| Plan | Includes dental, vision, and hearing coverage |
| Network | Includes doctors in many parts of the country |
| Providers | In-network and out-of-network |
| Support | Available 24/7 in 240 languages |
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What You'll Learn
Aetna Medicare Advantage plans for international travel
If you're planning to travel, it's important to ensure that you have the right health coverage. Original Medicare, which is the combination of Medicare Parts A and B, is widely accepted by healthcare providers across the country and can be a good option for domestic travel. However, if you're looking for international coverage, you may want to consider a Medicare Advantage (MA) plan.
Medicare Advantage plans are sold by private companies and offer benefits that may not be included in Original Medicare, such as dental, vision, and hearing coverage. MA plans also include a network of providers, which can be helpful when travelling. With Health Maintenance Organization (HMO) plans, you typically need to use an in-network provider to be covered, but Preferred Provider Organization (PPO) plans offer more flexibility and allow you to see out-of-network providers for a higher cost.
Aetna® Medicare offers a range of MA plans that can provide coverage while travelling, both within the United States and internationally. These plans are designed to give you peace of mind and ensure that you have the health coverage you need during your adventures. To find the right plan for your needs, it's important to check with Aetna directly and review the specific details of each plan, as coverage may vary.
It's worth noting that MA plans are offered based on your ZIP code, so your eligibility for a particular plan depends on your location. Additionally, the Centers for Medicare & Medicaid Services (CMS) require members to be disenrolled from their MA plan if they live outside their plan's service area for more than six months. However, there are MA plans available that allow you to stay on your plan even if you spend a significant amount of time outside the service area.
When considering international travel, it's recommended to review your immunization record and get any necessary vaccinations or boosters. Additionally, most health plans, including some Aetna plans, cover emergency care worldwide, including medical evacuation. Travel insurance is another option to consider, as it can provide coverage for medical expenses, trip cancellation, and other concerns.
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Aetna's clinical policy and medical necessity
Aetna's clinical policies are defined by their Clinical Policy Bulletins (CPBs). These bulletins are developed to assist in administering plan benefits and do not constitute medical or dental advice. They are based on nationally recognized recommendations and peer-reviewed medical literature. The CPBs express Aetna's determination of whether certain services or supplies are medically necessary, experimental, investigational, unproven, or cosmetic. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis.
The CPBs do not constitute a description of plan benefits. Members and their providers need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations. The benefit plan ultimately determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. In the event of a discrepancy between a CPB and a member's plan of benefits, the benefits plan will govern.
Aetna Dental Clinical Policy Bulletins (DCPBs) are also available, which are designed to assist in administering plan benefits and do not constitute dental advice. Members should discuss any DCPB related to their coverage or condition with their treating provider. The DCPBs describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information.
If a member disagrees with a coverage determination, they have the right to appeal the decision. They may also have the opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater.
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International medical insurance for employers
International medical insurance is essential for employers with staff working or travelling abroad. Even if your employees have domestic medical insurance, it's unlikely to cover them adequately while they're overseas. In fact, it may not be accepted at all if they're hospitalised due to an accident or illness.
There are many companies that offer international health insurance for employers, including:
- International Medical Group (IMG)
- Allianz Worldwide Partners
- Cigna
- GeoBlue
- William Russell
These companies can provide quotes for tailored plans that meet your specific needs. IMG, for example, offers temporary coverage for accidents, sickness, and emergency evacuations when visiting or travelling outside of your home country. Allianz, meanwhile, is known for its global network and for providing businesses with international medical insurance for employees.
When choosing an international health insurance plan for your employees, it's important to evaluate several key factors, including the range of benefits, the price, and the level of coverage. You should also check whether the plan includes travel insurance, as well as medical coverage. Travel insurance can protect your employees and your business from financial losses due to trip delays, interruptions, and cancellations. It can also provide extra protection in the event of missed connections, baggage loss, and non-refundable expenses.
Finally, remember that your employees can always contact the insurance company directly if they have any questions about their coverage or benefits.
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Aetna member services and support
As an Aetna member, you have access to a wide range of services and support to help you stay healthy and manage your health care needs, especially while travelling.
International Health Insurance
Aetna offers international health insurance plans for individuals and employers, providing coverage for expatriates, business travellers, and students. These plans offer access to a global network of healthcare providers and facilities, ensuring you can receive the medical care you need while abroad.
Emergency and Non-Emergency Medical Care
Aetna members can have peace of mind knowing that emergency medical care is covered worldwide. This includes emergency room services, emergency medical transportation, and urgent care visits. Emergencies that occur out-of-network, both domestically and internationally, are covered at the in-network rate.
Additionally, for University faculty, staff, and their dependents enrolled in the UM/Aetna plan, non-emergency medical care is also covered while travelling within or outside the United States. This includes access to International SOS for emergency and non-emergency assistance.
Member Services Team
Aetna's Member Services team is available 24 hours a day, 7 days a week, to provide you with support in over 240 languages. They can assist you with understanding your benefits, locating healthcare providers, submitting claims, and more. You can reach them by calling the number on the back of your member ID card or by using the contact information provided on the Aetna website.
Clinical Policy and Coverage Determinations
Aetna's Clinical Policy Bulletins (CPBs) outline the company's clinical policies and procedures. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. If you disagree with a coverage determination, Aetna provides members with the right to appeal the decision and request an independent external review under certain conditions.
Exclusions and Limitations
It is important to note that Aetna does not provide or guarantee access to all health services. Exclusions and limitations may apply, and members should carefully review their plan documents to understand their specific coverage.
By leveraging these services and support options, Aetna members can confidently navigate their health care needs, especially during international travel, ensuring they receive the necessary care and assistance.
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Aetna medical plans for university faculty, staff, and students
Aetna provides medical plans for university faculty, staff, and students, including international student health insurance. These plans are underwritten by the Aetna Life Insurance Company (Aetna) and, in MD and NJ, by the Aetna Health and Life Insurance Company (AHLIC). Self-insured plans are funded by the applicable school, with claims administration services provided by Aetna Life Insurance Company.
Aetna Student HealthSM is the brand name for products and services provided by Aetna Life Insurance Company, Aetna Health and Life Insurance Company, and their affiliated companies. Aetna has served colleges and universities for nearly 40 years, and currently serves over 400,000 members and 150 schools. Their tailored offerings include integrated medical and behavioral health support for students' whole health.
Aetna's member website, the Aetna HealthSM app, and digital ID card provide digital plan tools for students. With On-Call International, students can access medical assistance and information anytime, anywhere in the world. This includes services such as finding lost luggage and arranging for family to be there in their time of need.
The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate levels and types of care for patients with behavioral health conditions. However, it is important to note that treating providers are solely responsible for medical advice and treatment, and members should discuss any matters related to their coverage or condition with their provider. Each benefit plan defines which services are covered, excluded, or subject to dollar caps or other limits.
While travelling on university business, faculty, staff, and covered dependents enrolled in the UM/Aetna plan have access to emergency and non-emergency medical care within or outside of the US. Medicare Advantage plans, sold by private companies, also offer benefits for travellers, including dental, vision, and hearing coverage. These plans can provide excellent health coverage during travel within the United States, and some plans are designed to provide coverage while travelling internationally.
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Frequently asked questions
Aetna's international medical insurance provides emergency medical treatment, help with local legal advice, lost checks, and more. It also offers culturally relevant resources, emergency assistance services, and local care coordination.
There is no explicit mention of a coverage limit. However, it is important to note that not all health services are covered, and members should refer to their benefit plans to understand their specific coverage details.
Aetna's international medical insurance is currently only offered to employers for their expatriate and business travel employees.
In the event of a disagreement, Aetna allows members to appeal the decision and request an independent external review of coverage denials. This review is based on medical necessity or the experimental and investigational status of the service or supply in question.
Aetna Medicare Advantage plans can provide coverage for international travel. These plans are sold by private companies and offer benefits such as dental, vision, and hearing coverage.
