Empowering Health: Understanding Your Benefitsgraingertotalrewards.com/Documents/Aetna Intl - Understanding You… · Self-help resources through myStrength ™ You’re also empowered

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Empowering Health: Understanding Your Benefits

2019

The slides are for reference only and reflects Plan information and resources as of 2019. Please note that these are subject to change. Questions related to your plan of benefits should be directed to Aetna International by dialing the number listed on your ID card.

2 ©2018 Aetna Inc.

Agenda

1. Your plan details

2. Aetna International Health Hub

3. Aetna International member services

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The slides are for reference only and reflects Plan information and resources as of 2019. Please note that these are subject to change. Questions related to your plan of benefits should be directed to Aetna International by dialing the number listed on your ID card.

How your plan works

4 ©2018 Aetna Inc.

How your plan works

The options Pick your doctor How it works

Outside the U.S. Go to any doctor. No referrals required.

Here’s what direct settlement means for you: • Easier claim submissions• Additional reimbursement and prepayment choices• Lower out of pocket costs at the point of service• Letter of Authorization (LOA) documents sent directly to the treatment facility

If you choose to go outside of direct settlement for care, you’ll have to pay for the charges and submit the claim.

U.S. – In network Go to any doctor in the network. No referrals required.

Network doctors contract with Aetna to offer rates that are often much lower than their regular fees. This helps you save.

Your network doctor will: • Provide care• Get approval from us before giving you certain services*• File claims for you

You may pay a portion of your doctor’s charges. This could be in the form of a copay (a fixed amount) or coinsurance (a percentage).

This option typically costs you less.

U.S. – Out of network

Visit any licensed doctor or specialist without a referral.

You may have to: • Get approval from Aetna before receiving certain services*• Pay the full amount at the time of service• File your own claims

We will process your claim and reimburse you based on your employer’s specific plan and benefits details. For example, if you have not met your deductible yet, that will be subtracted from your reimbursement amount. As will any copay or coinsurance you owe.

Note: Your out-of-network deductible is usually higher than the deductible you need to pay when you see a network doctor. Check your plan documents for your plan’s details.

This option typically costs you more.

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How to see a doctor outside of the U.S.

Find a direct settlement doctor: • Online: Log in to your secure member website at aetnainternational.com.

Click on ‘Find health care’ and enter your location.

• Mobile App: Search “Aetna International” in the App Store or Google Play store.If you haven’t already registered for Health Hub, you’ll need to do that beforeyou can use the International Mobile Assistant app.

• You can also call us for help by using the number on the back of your Member ID card.

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Show your Aetna Member ID card when you go to your appointment. 4

Schedule an appointment, identifying yourself or your family member as an Aetna member. 2

Apple, the Apple logo and iPhone are trademarks of Apple Inc., registered in the United States and other countries. App Store is a service mark of Apple Inc. Google Play and the Google Play logos are trademarks of Google LLC.

Notify us by requesting a letter of authorization • Submitting your request online

• Or calling the number on the back of your Member ID card.

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How to see a U.S. network participating provider

• Log in to your secure member website at aetnainternational.com

- Choose ‘Find health care’

- Select U.S. as country

- You will be directed to aetna.com. From there, enter the type of provider and preferred location

- Refine your search using the available parameters.

• Schedule an appointment, identifying yourself or your family member as an Aetna member.

• Show your Aetna Member ID card when you go to your appointment.

10 ©2018 Aetna Inc.

Obtaining prescriptions

You have several options for obtaining your prescriptions:

Within the U.S.

You can get up to a 365 day supply at a network retail

pharmacy (such as Walgreens or Rite Aid). A copay per one month

supply applies.

You can get up to a 365 day supply at an out of network retail

pharmacy.

You can use the domestic mail order program called Aetna Rx

Home Delivery for shipments within the US. A copay per one month

supply applies. Up to a three month’s supply can be included in each shipment. A copay per

one month supply applies. Contact Aetna Rx Home Delivery

at 1-800-227-5720.


Obtaining prescriptions

Outside the U.S.

You can get up to a 365 day supply at a pharmacy. You can

submit claims for reimbursement, with coverage at 100%.

You can use the international mail order drug program.

Visit expatps.com/aetna or call toll-free 1-855-336-XPAT or

direct 540-283-7520. Your claims would covered at 100%.


Your Member ID card

Your Member ID card is your key to quality health care. Make sure you keep the card in a safe place — you’ll be asked to present it whenever you receive care. You may also need to have it handy when registering for the website or calling the Member Service Center.

Supporting you


Your personal health care support

Pre-trip planning

Discharge planning

Locate providers & specialists

Second opinion

Maternity management

Case management

Pharmacy management

Provider Member

C A R E T E A M

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Aetna Assistance

Our Aetna International in-house service model created to integrate the entire spectrum of care, from routine to emergent, with faster processes and stronger medical oversight of cases. Our clinical Care and Response Excellence (CARE) team of clinicians works together with our operational teams to get members proper care in the most efficient way.

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International Employee Assistance Program (EAP)

Balanced living relies on total well being. It is important to recognize when situations create an unhealthy amount of stress, distraction, or worry. Before any work or life issue becomes a larger problem, or for support when you’re facing difficulties, access free confidential counseling, resources and information to help you regain focus.

You and your family are supported worldwide

• Available 24 hours a day, 7 days a week, 365 days a year

• Available access worldwide

• Up to 5 counseling sessions per issue, per year

• Provides information, resources, and counseling on any work, life, personal or family issue that matters to you

• No cost to use this service

• The service is confidential


Accessing Employee Assistance Program (EAP)

iConnectYou: Your EAP on the go

• Access your EAP through the iConnectYou app on your portable device or mobile phone.

• Secure and confidential access to:

– clinical counselors – work-life experts

• Connect by phone, instant message, text or video chat

Self-help resources through myStrength™

You’re also empowered to boost your emotional health using the myStrength website and mobile app. These confidential, clinically proven self-help resources offer:

• Insight through articles, videos and eLearning programs

• Inspiration quotes

• Mood tracking

• Check-in reminder option


Health Hub Secure Member Website


Table of contents

1. Log in/Registration

2. Home page

3. Find health care

4. My claims

5. Health and wellness

6. My plan and me

7. Questions

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Log In/ Registration


Log In/Registration

Go to www.aetnainternational.com, Click on “Log In/Register”


Log In/Registration

If you are a new member or have not yet registered, please click the “Register” button and follow the instructions.

If you are an existing member, enter your username or email and password details in the boxes provided.


Registration (continued)

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To create an account you will need to share some personal information. 1. Enter you first and last

name 2. Type in the day,

month and year you were born

3. Select “Aetna International Plan Member”

4. Enter your Member ID 5. Read and Check “I

accept the terms & conditions”

6. Click “Get Started”


Create login – all members

1. Please fill in your personal email, then repeat to confirm

2. Create a unique username

3. Create a password for account

4. Repeat that password to confirm account password

5. Select security question from the dropdown with a memorable answer unique to you

6. Click “Continue”

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Confirm preferences

1. Select your country from the dropdown

2. Select preferred language from the dropdown

3. Select country of citizenship from dropdown

4. Click “Register”

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Inside Health Hub


Home page

Regionalized content banners display content and information based on member’s region.

Main navigation located at the top of the page.

Task-driven navigation centered around a regionalized image.


Find health care – Care outside the U.S.

Search our international doctor and direct settlement directory to find providers from Australia to Zimbabwe.

Helpful tips and overview simplifies the process.


Find health care – Care within the U.S.

If you are located in the U.S. and choose “United States of America” in the country field, upon searching you will be forwarded to aetna.com to find U.S. provider.


Find health care – Print/save your own directory

Click “Print results” to create a PDF of the full results.

The results can be printed or downloaded/saved to your computer or device.


Find health care

Results displayed with the option to expand and view more details.

Request direct settlement directly from result.

You can show or hide advanced filtering options. They include provider name, specialty, facility or tier.


My claims

You can view the status of your claims and your Explanation of Benefits by visiting aetna.com.

Filter your claims by member name, provider name, etc.

Go to aetna.com


My claims

The claims submission process is simpler and consolidated into one experience:

2 Claim details

3 Payment details

4 Upload your documents

5 Confirmation!

1 Patient details


Health and wellness

Take your personalized health assessment.

Contact our CARE team for any number of queries including pre-trip planning and world coordination of care.

Easier access to health and wellness information… like our health library.


My plan and me

Members have in-depth information about their plan and member details.

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Manage consent

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Member details

3 View

documents

4 Repeat repayment

details


My plan and me

In your plan documents section, you can find member kit materials and other relevant plan information.

“View ID cards” will take you to aetna.com where you can view and print your ID cards.


Questions

If you can’t find what you need, we’re available 24/7.

Get answers to our most frequently asked questions here.

Use the contact information to call us or send us a message via a web form.


aetna.com

Within the new Aetna International Health Hub, you will be directed to aetna.com for certain tasks and features.

These include printing temporary Member ID cards, viewing a claim status and locating providers inside the United States.

Go to aetnaInternational.com to locate providers and facilities OUTSIDE the United States.


aetna.com– Member ID cards

View or print your Member ID card


aetna.com– U.S. Provider search

Search for doctors inside the U.S. based on:

• Name

• Specialty

• Language

• Gender

• Hospital affiliation

• Individual/Group PIN


aetna.com– U.S. Provider search

Search for doctors inside the U.S. based on:

• Name

• Specialty

• Language

• Gender

• Hospital affiliation

• Individual/Group PIN


aetna.com– Claims

Once a member has submitted a claim on Health Hub, he or she will be able to view and track the status on aetna.com.

Member services

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Aetna International member service

• Available 24 hours a day, 7 days a week, 365 days a year

• Assistance with locating care, claims and more

• Speak to a live person every time — no recordings

• First call resolution


Claims processing

1 2 3 Submitting a claim

Mail Online App

• Claim adjudication system experts

• Translation services available in-house

• Reimbursement options: Electronic Funds Transfer (EFT), wire and check

• Reimbursement can be made in more than 135 currencies

• Aetna International will not assess a member for any fees to process a wire

• Reimbursement directly to any bank account, except for in sanctioned countries

• Submit claims by mail or online through the secure member website or Aetna International mobile app

• Members can monitor claims status online once they have been given an Aetna International Member ID number.


Contact information

Telephone inquiries: 800-231-7729 (Toll-Free from virtually anywhere in the world)

813-775-0190 (Direct dial and collect from outside U.S.)

E-mail Inquiries: [email protected]

To submit claims by fax: 800-475-8751 (Toll-Free from virtually anywhere in the world)

859-425-3363 (Inside U.S.)

To submit claims by mail: Aetna International/ Aetna P.O. Box 981543 El Paso, TX 79998-1543, USA

Thank you The slides are for reference only and reflects Plan information and resources as of 2019. Please note that these are subject to change. Questions related to your plan of benefits should be directed to Aetna International by dialing the number listed on your ID card.