On Oct. 2, 2018, we advised that many members had received denials from Aetna for lack of pre-authorization of care. We immediately approached Aetna regarding this as the new pre-authorization program is not set to begin here in New Jersey until Jan. 1, 2019
As previously reported, Aetna’s contract with Triad/eviCore is expiring on Dec. 31, 2018. A vendor called National Imaging Associates (NIA) will be managing a new pre-authorization program immediately following the Triad contract expiration, starting Jan. 1, 2019.
We want to remind you about the chiropractic benefits that are available as part of your Aetna Medicare Advantage PPO plan with Extended Service Area (ESA). We’re matching your current benefits. This is a custom benefit for members of the State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP).
As a follow up to our earlier email regarding the revisions to Aetna’s SHBP/SEHBP Medicare Advantage plans please be advised that the Summary of Benefits and Coverage documents for these plans have been updated and re-posted to the NJ Division of Pension and Benefits website.
Late Friday we were notified by Aetna of revised plan designs for the SHBP/SEHBP Medicare Advantage plans for 2019.
December 19, 2018
Presenter: Heather M. Garcia, CMAA, CBCS, CMB
January 10, 2019
February 14, 2019