Values in Action

Simplicity | Focus | Connection

Aetna MA: Coming Soon: A New, Improved Contracting Process

Great news! We’re replacing our existing Aetna Medicare contracting system (nomoreforms™) with an improved tool that will expedite the contracting process for MA/MAPD products. It’ll be available starting May 13.  The new contracting tool (powered by CallidusCloud®) will streamline and simplify the contracting process, and improve the onboarding/contracting experience for new Medicare producers. We look [...]

Aetna: Heads up, Potential genetic testing scam – Know what to watch for

Recently, the Centers for Medicare and Medicaid Services (CMS) alerted us of a scam designed to generate Medicare member referrals to genetic testing companies. Please read this communication so you know what to watch out for and can help educate your clients. Agents: Please be wary of any offers of payment in exchange for referrals [...]

Aetna: New Medicare ID numbers | Welcome calls | Preferred pharmacies | Compliance tips for sales and marketing events

Medicare Producer News Individual MA/MAPD: February 21, 2019 New welcome/onboarding program New CMS Medicare ID numbers are here Saving money with preferred pharmacies Member meetings — Encourage your clients to attend Compliance tips for sales and marketing events New welcome/onboarding calls help members engage with their plan early Did you know? All 2019 Aetna and Aetna [...]

Leaving Money on the Table? Complete VBE

Are you leaving money on the table? You could earn up to $50 every time you enroll a client in an Aetna Medicare (MA/MAPD) plan through the Ascend app just by completing a value-based enrollment (VBE). It's easy! Here's how it works: Enroll your client in a plan with Ascend. After you submit the enrollment and before you [...]

Aetna: An Easier LOA Renewal Payment Validation Process

Good news: Effective February 9, uplines will no longer need to request an agent of record reassignment when a license-only writing agent (LOA) terminates from your company, or does not meet renewal commission requirements.  What’s the new process? Going forward, the original LOA may remain the agent of record on the policy, without impacting the renewal [...]

CVS ExtraCare Health Cards | Personalized member videos | Save $$ w/ preferred pharmacies

Medicare Producer News Individual MA/MAPD: February 06, 2019 Members get ExtraCare Health Card New materials on Studio New personalized video for members Saving $$ with preferred pharmacies How to read a formulary Special rules for some drugs _______________________________________ NEW: Members to receive ExtraCare Health Card Aetna and Aetna Coventry MAPD and PDP members will receive [...]

Aetna News: Walmart Remains In-Network | Plus, SilverSneakers, CollegeSave, Member ID Cards, Diabetic Supplies and More

Medicare Producer News Individual MA/MAPD: January 16, 2019 Don't worry, Walmart is still an in-network pharmacy for 2019 MAPD and PDP products CVS Health recently announced that Walmart has opted to leave its pharmacy network for Commercial and Medicaid plans. As stated in the press release, this has no impact on Medicare plans. Please let your clients [...]

Aetna DSNP Application Tips

When your clients enroll in an Aetna DSNP, be sure to include an accurate phone number so their Aetna-assigned personal care team can connect with them All 2019 Aetna Medicare Dual-eligible Special Needs Plan (DSNP) members get access to our personal care team led by a nurse case manager. After your client enrolls, a representative from the [...]

Aetna & CVS Merge Complete

A New Day in Health Care We are excited to share that CVS Health, the nation’s premier health innovation company, has completed its acquisition of Aetna. The combination of CVS Health and Aetna is a transformative moment for our company and our industry. With the combined capabilities of two leading organizations, our goal is to [...]

MO, KS Agents: Submit 3 for Chance to Win a $50 gift card

Chance to win $50 gift card to a local grocery store for your holiday dinner Kansas & Western MO agents: The holidays are almost here— which means holiday feasts and treats too! Here's your chance to win a $50 gift card to your local grocery store. Just submit 3 new 2019 Aetna or Aetna Coventry MAPD [...]

Add 2019 Star Ratings to your Enrollment Kits

Action required: Add 2019 star ratings to 2019 enrollment kits CMS requires producers to review the 2019 star ratings document with beneficiaries when presenting 2019 Individual Medicare plans (MA/MAPD, PDP). By October 31, you must update all 2019 enrollment kits to include the new 2019 star ratings document. To update 2019 enrollment kits with the new 2019 [...]

CVS-Aetna merger faces resistance in New York

New York state officials are considering blocking parts of the $68 billion merger of drugstore store chain CVS Health Corp. and Aetna Inc., jeopardizing billions of dollars in insurance premiums for Aetna. CVS and Aetna won approval from the U.S. Justice Department on Oct. 10, contingent on Aetna divesting its Medicare Part D business, which covers prescription drugs for [...]

U.S. Department of Justice will allow CVS Health acquisition of Aetna to proceed

On October 10 we learned that the Department of Justice (DOJ) will allow CVS Health’s acquisition of Aetna to proceed. Under the DOJ consent decree, closing of the CVS Health-Aetna transaction may proceed prior to the effective date of Aetna’s previously announced divestiture of its entire standalone Medicare Part D business to a subsidiary of WellCare [...]

Aetna Medicare Producer News

Individual MA/MAPD, PDP:  October 02, 2018 Start marketing 2019 plans as of October 1 Download 2019 MA/MAPD sales presentations How to submit 2019 enrollments: NEW addresses & fax numbers Fresh look for AetnaMedicare.com Provider look up: Are your clients' doctors in-network? Order/download 2019 AEP marketing materials on Studio   Ready, set, go — 2019 AEP marketing [...]

Agreement to Sell all Aetna Standalone Medicare Part D Business

On September 26, 2018, Aetna signed an agreement to divest all of Aetna’s standalone Medicare Part D business to a subsidiary of WellCare Health Plans, Inc. (WellCare).  You can read the announcement here.  There are several important elements of this announcement to highlight: The sale includes both Individual and Group standalone Part D members. This [...]

Need help finding tools and resources to help you sell Medicare?

KS, OK, AR, MO-West agents: We’re here to help! Attend a webinar in March to get the tools and resources you need to help you sell our 2018 Individual Medicare Advantage plans. During the trainings, you’ll learn how to access and navigate: • Producer World • Medicare Marketing Studio • Provider lookup and prescription lookup […]

Aetna: Happy Holidays | Payment options for members | 2018 coupon books | Recertify renewal payments by 12/31

INDIVIDUAL MEDICARE NEWS (MA/MAPD, PDP): December 18, 2017 Happy holidays Premium payment options for members 2018 coupon books—Top 5 things you need to know Deadline to recertify for renewals is December 31 Happy holidays   Thank you for your business during 2017, and for your ongoing commitment to serving our Medicare members. We wish you […]

Aetna: Reminder – Telephone Consumer Protection Act: What you need to know

The Telephone Consumer Protection Act (TCPA): What you need to know The Telephone Consumer Protection Act (TCPA) is a Federal Communications Commission (FCC) regulatory law that Aetna selling partners are obligated to comply with, in addition to CMS Medicare Marketing Guidelines. What is TCPA? The Telephone Consumer Protection Act (TCPA) and other laws regulate telemarketing […]

CVS Health’s proposed acquisition of Aetna

To our valued brokers, As you may have seen in the news, CVS Health, the largest pharmacy health care provider in the U.S., has agreed to acquire Aetna. This has no immediate effect on the products your clients have purchased or the products you are selling today. We are very excited about this combination. CVS […]

“Aetna agrees to $69 billion sale to CVS Health” -Reuters: What does this mean for you?

The rumors of Aetna selling to CVS Health seem to be coming to fruition.  The agreement should be announced today by both companies. Here is the link to the Reuters article. In this last week of AEP, do you know who you are putting your business with?  Is it with a trusted, stable partner? What will […]

Aetna: Xarelto is back! | Top PDP in 27 states | Provider lookup hotline | 2018 Referral option (use your NPN)

INDIVIDUAL MEDICARE NEWS (MA/MAPD, PDP): November 17, 2017 Xarelto is back… Back on our 2018 formulary! Updated Aetna Medicare Producer Guide Top PDP on Medicare Plan Finder in 27 states + DC Need help looking up providers? Call us Resources for Living – Exclusively for Aetna/Coventry members Grow your business with referrals – How to […]

Aetna: 2018 Individual Medicare administrative fee payments

2018 Individual Medicare administrative fee payments Administrative fee payments are currently being processed and paid for Individual Medicare enrollments (MA/MAPD, PDP) effective January 2018 that were submitted during the Annual Election Period (AEP). To be eligible to receive administrative fee payments, all writing agents, uplines, payees and principals must be “ready to sell.” To eliminate or […]

Aetna: NEW provider lookup hotline plus Tips for provider lookup tools and Aetna’s Select Rx is a top PDP on Plan Finder

INDIVIDUAL MEDICARE NEWS (MA/MAPD, PDP): November 09, 2017 NEW broker hotline for provider lookup help New enhancements — Now easier to look up network providers Aetna’s Select Rx is top PDP on Medicare Plan Finder in 27 states + DC NEW provider lookup hotline: 1-844-375-2394 You can now call a new Medicare provider lookup hotline for help […]

Aetna: $0 PPO in Joplin/Springfield markets!

Don’t miss the 2018 Advantra Freedom PPO (H1608-018): It’s the ONLY $0 premium PPO in Southwest Missouri Check out key features of the 2018 Advantra Freedom PPO (H1608-018): The only $0 premium PPO (MAPD) in Joplin and Springfield markets Large network of hospitals and providers Mercy, Cox and Freeman are all in network No preferred/standard pharmacy network […]

Aetna: Aetna’s Silence Doesn’t Mean It’s Not Listening to CVS

By Max Nisen An all-cash bid may be more than CVS can handle Silence may still be golden for Aetna shareholders. On its earnings call Tuesday morning, Aetna Inc. refused to discuss “rumors and speculation” about a possible acquisition by CVS Health Corp. But don’t take that as a sign the company isn’t interested. Though Aetna beat […]

3 Possible CVS-Aetna Deal Effects, for Agents

By Allison BellInsurance EditorThinkAdvisor The Wall Street Journal set off a stock trading frenzy Thursday by reporting rumors that Woonsocket, Rhode Island-based CVS Corp. is offering about $60 billion to acquire Hartford, Connecticut-based Aetna Inc. A sentimental insurance agent or broker’s immediate reaction to the news of the CVS-Aetna deal rumors might be: How sad. Aetna is not the biggest […]

INDIVIDUAL MEDICARE NEWS: October 19, 2017

2018 Star ratings How to submit enrollments 2018 Sales videos NEW for 2018: SilverSneakersSM fitness benefit NEW for 2018: Resources for LivingSM NEW for 2018: Diabetic testing supplies Aetna once again outperforms industry average in latest Medicare star ratings Aetna’s Medicare Advantage Prescription Drug (MAPD) plans have once again received higher than average ratings from the […]

Aetna New AOR Policy

Aetna has released a new AOR policy change please be aware of changes below.  Key points Aetna Medicare Producer Guide – March 2017 pages 67-73

Aetna to Pull Out of Current Affordable Care Act Exchanges

May 11th, 2017 | By: Anna Wilde Mathews The Wall Street Journal  (5/10, Mathews, Subscription Publication) reports that on Wednesday, Aetna Inc. announced it would exit the Affordable Care Act marketplaces in Delaware and Nebraska in 2018, which means it will no longer sell any ACA plans. The insurer estimated that it would lose about […]

Humana Updates

      Humana Daily update ⋅ February 15, 2017   FINANCE   Stock price: HUM (NYSE) $205.48 -0.49 (-0.24%) February 15, 2017 at 12:33:04 PM EST | Disclaimer   NEWS   Humana Plans to Pull Out of Obamacare’s Insurance Exchanges New York Times Humana announced on Tuesday that it would no longer offer health […]

Aetna and Humana break up

February 14th 2017 | By: Allison Bell  Aetna Inc. and Humana Inc. say they have agreed to call off efforts to merge. Hartford, Connecticut-based Aetna once hoped that acquiring Louisville, Kentucky-based Humana would be a good way to help both companies respond to pressure to cut costs in the face of regulatory uncertainty. But a federal court […]

Blocked insurer mergers: What the decisions mean and what lies ahead

February 13th 2017 | By: Leslie Small  When four of the country’s five largest for-profit health insurers announced two summers ago that they would pair off, many saw the moves as a game changer. Now, with both the Aetna-Humana and Anthem-Cigna deals struck down by the federal courts, the implications for both the health insurance […]

Agent Portal

Log in or Register for Producer World Our secure website can help you sell our products and manage your book of business. Once logged in, select ‘Individual Medicare’ at the top. There, you’ll find:

  • Product availability by service area
  • Reports
  • Marketing materials
  • Sales presentations
  • Requirements to sell (certification, contracting, licensing and appointment information)
Contact Number(s)
Medicare Broker Services Department
866-714-9301
Email(s)
Broker Support Email
brokersupport@aetna.com
Fax Information

New Business Fax Number Aetna MA 877-819-9167

Fax Cover Sheet Aetna MA

New Business Fax Number Coventry MA 888-554-7668

Fax Cover Sheet Coventry MA

New Business Fax Number Coventry PDP 866-415-2232

Fax Cover Sheet Coventry PDP
Plans

Find & Compare Plans

Enter a zip code, select ‘Find Plans’ and then ‘Compare Plans’ from the top right

Forms
Need a specific form or document? We can help you access it quickly and easily. You will need to log in to Aetna before clicking the link above. 

 

Summary of Benefits

Summary of Benefit Search

The Summary of Benefits and Coverage search gives you three ways to find account numbers, plan IDs and more

Search online for providers (recommended)
There are two online provider search sites. Both sites are updated 6 days a week. Make sure you are using the site that corresponds with your client’s plan.

For Aetna plans:
Aetnamedicare.com/findprovider

For Aetna Coventry plans:
Coventry-medicare.com/findprovider

Call the provider lookup hotline: 1-855-242-9735
You can call our Medicare provider lookup hotline for help looking up providers during the busy AEP selling season. This hotline is for ready-to-sell brokers only and is available now through December 7. Representatives are available 7 a.m. to 9 p.m. CT.

Download and print a provider directory

  • You can find Aetna provider directory PDFs on Producer World. These directory PDFs are updated monthly.
  • For Aetna Coventry provider directory PDFs, you can use the Coventry online directory, search for providers, and then choose the “print to PDF” option.

Remember, provider directory PDFs show providers that are in network as of the date printed on the cover page. Whenever possible, use our online directory tools— they’re more up-to-date.

5 tips to help you use the online provider lookup tools
  1. Use the website that corresponds with your client’s plan. Since providers vary by plan, you’ll need to search for in-network providers based on your client’s plan. We have two online provider search sites: Aetnamedicare.com/findprovider and Coventry-medicare.com/findprovider
  2. Enter a “city” and “state” on the provider search page instead of a zip code. Be sure to spell out the state name completely (e.g., Pennsylvania, not PA). Even better, start typing the name of the city and select the correct city and state from the drop down.
  3. Enter a provider’s full first and last name. Don’t use:
    1. Nicknames (e.g., Bill, Will)
    2. A first name if you’re unsure of the spelling (e.g., MaryAnn or Maryanne)
  4. Enter a provider’s name without credentials. Don’t include words like “Doctor,” “Dr” or “MD.”
  5. The primary care physician (PCP) may be listed under their contracted group name. All applicants are encouraged to select a PCP when enrolling for a plan. This helps ensure the right PCP is assigned to the member’s file. To find the primary care ID, be sure to use the provider lookup tool that corresponds with your clients’ plan. A PCP may have two different provider care IDs: one for Aetna plans and one for Aetna Coventry plans.
Find Pharmacies & Other Providers

Types of providers in our network You’ll find more than 25 types of health care providers in our online directories. Our network includes doctors, hospitals, pharmacies, urgent care centers, drug and alcohol counselors, hospice providers, diabetic supply providers, dialysis centers and physical therapists.

Participating physicians, hospitals and other health care providers are independent contractors. They’re neither agents nor employees of Coventry. The availability of any particular provider can’t be guaranteed. Provider network make-up is subject to change.
Aetna has contracts with pharmacies that equal or exceed CMS requirements for pharmacy and preferred pharmacy access in your area.

Medicare Producer News

  • Commission system migration –  What you need to know
  • Ascend Virtual Sales Office app now EASIER to use

Get certified to sell MA/MAPD and PDP plans

It’s time to get certified to sell Aetna’s Individual Medicare plans! To get started, go to AetnaMedicareProducerCertification.com.

Aetna MA/MAPD and PDP Certification Steps:

  1. Log into the Aetna certification portal: Certification Training for Individual Medicare
  2. Follow the steps found in the Aetna Certification Guide: (have a link to our guide- here’s where the pdf is on the Z: Z:\Companies\Aetna\Contracting\Certification Instructions)

AHIP:

  1. If you have completed AHIP, you will need to log into their site and request that Aetna be notified.
  2. If you have not completed AHIP, you will need to complete this and request that Aetna be notified. (Please contact us for tips and help completing AHIP).
 

Commissions

Commission system migration — What to know & expect

Aetna will be migrating commission systems to streamline their commission payment process. What this means is that you’ll receive one combined commission statement for your Aetna and Coventry Medicare business, and you’ll be able to access your reports in one place.

During this system migration, there will be some temporary disruptions to reports, processing time for newly submitted contracts, and commission payments for new-to-Medicare enrollments only. Please review key dates and information to ensure you’re prepared.

 

Ascend Virtual Sales Office App

Ascend Virtual Sales Office app – New & Improved

Aetna recently made some exciting changes to the home screen of the Ascend Virtual Sales Office app that make it much easier to use. The Ascend app is Aetna’s  electronic enrollment tool for producers. If you weren’t impressed with it before, we encourage you to take another look! This app is a great way to help you save time, schedule more appointments, minimize errors and more.

Brochure

 

Order Enrollment Kits  You must first be ready to sell. You’ll need your National Producer Number (NPN) to log in and place your order. Or fill out the form below.

Aetna Insurance Company organized an annuity fund to sell life insurance in 1850. In 1853, the Annuity department separated from Aetna Insurance and was incorporated as Aetna Life Insurance Company. Aetna’s core values include creating a better healthcare system through simplicity, focus, and connection in their services. As one of the nation’s leading diversified health care benefits companies, Aetna provides people with information and resources to help them make better informed decisions about their health care – and the financial side of health care.

You could earn up to $50 every time you enroll a client in an Aetna Medicare (MA/MAPD) plan through the Ascend app just by completing a value-based enrollment (VBE).

It’s easy! Here’s how it works:

  1. Enroll your client in a plan with Ascend.
  2. After you submit the enrollment and before you close the application, initiate the VBE.
  3. Your client will meet with a wellness advocate over the phone to discuss their health goals, risks and ambitions.
  4. You earn up to $50 per client who completes a VBE. (For example: If 165 of your clients complete a VBE through the “Call now” option, you’d earn 165 x $50=$8,250.)

Q&A: Can I complete a VBE if I submit an enrollment outside of business hours?
Yes. If you select the “Call now” or the “Schedule a Callback” option to complete a VBE outside of normal business hours, your client will get a recorded call. Then, a wellness advocate will call your client back when the wellness center opens. The wellness center is open Monday – Friday, 8 a.m. to 8 p.m. ET. They’re also open on Saturdays from 8 a.m. to 8 p.m. ET, until March 31.

NEW Spanish VBE option.

Do your clients speak Spanish? Now you can select the Spanish option when initiating a VBE. This option will connect your clients to a Spanish-speaking wellness advocate

 

For technical support using VBE in the Ascend app, contact the Ascend app help desk at 1-833-923-1431. They’re open Monday – Friday, 8 a.m. – 8 p.m. Until March 31, they’re also open Saturdays, 8 a.m. – 8 p.m. ET.