Aetna Forms for Prior Authorization

You may need Aetna forms for Prior Authorization. But, you may not know where you are able to get it. Here, I will inform you where you are able to get Aetna forms for Prior Authorization.

Finding Aetna Forms for Prior Authorization

If you are looking for Aetna forms for prior authorization, you are able to find it here. On that site, you are able to find forms for healthcare professionals and patients.

Here are Aetna forms for prior authorization that you can find on that site.

Medicare Precertification

    • Aranesp (darbepoetin alfa) Prior Authorization request (PDF)
    • Lidocaine patch (generic Lidoderm), ointment and cream Prior Authorization request (PDF)
    • Linezolid (generic Zyvox) Prior Authorization request (PDF)
    • Modafinil (generic Provigil) and armodafinil (generic Nuvigil) Prior Authorization request (PDF)
    • Oral ondansetron (generic Zofran) Prior Authorization request (PDF)
    • Procrit (epoetin alfa) Prior Authorization request (PDF)
    • Regranex (becaplermin) Prior Authorization request (PDF)
    • Topical Testosterone Prior Authorization request (PDF)
    • Tracleer (bosentan) Prior Authorization request (PDF)

State-specific Forms

General Forms

    • New Mexico Uniform Prior Authorization form (PDF)
    • Texas Standard Prior Authorization, Health Care Services request (PDF)

Prescription Drug Forms

    • California Prescription Drug Prior Authorization or Step Therapy Exception request (PDF)
    • Colorado Prescription Drug Prior Authorization request (PDF)
    • Illinois Uniform Electronic Prior Authorization Form for Prescription Benefits (PDF)
    • Iowa Prescription Drug Prior Authorization request (PDF)
    • Louisiana Prescription Drug Prior Authorization form (PDF)
    • Michigan Prescription Drug Prior Authorization request (PDF)
    • New Hampshire Prescription Drug Prior Authorization request (PDF)
    • New York Contraceptive Exception request (PDF)
    • Oregon Prescription Drug Prior Authorization, Medical Exception request (PDF)
    • Texas Prescription Drug Prior Authorization request (PDF)

About Prior Authorization

As explained on the Aetna Better Health site, there are some types of care which have to be preapproved by your doctor. Aetna will connect you to the right care when you need it. The process’s name is prior authorization or preapproval. What does it mean? The meaning is that Aetna agrees that the care is important for your health. It is important for you to note that for emergencies, you do not need preapproval even when you are outside of your network.

Some common services which need prior authorization or preapproval are listed below as explained on the Aetna Better Health.

    • Overnight hospital stays
    • Major surgeries
    • Services outside of the Aetna Better Health service area
    • Specialist visits
    • Any service which is considered medically necessary
    • Expensive medications administered by your provider or at your provider’s office

Getting Prior Authorization

How to get prior authorization? You may want to know how to get it. So, you are able to follow the steps below to get preapproval according to the Aetna Better Health site.

    • For prescription drugs, you can access this: medi-calrx.dhcs.ca.gov/home/
    • Aetna Better Health of California information will be given by your primary care physician (PCP) about the services that they think you need.
    • The information will be reviewed by an Aetna Better Health of California provider.
    • Let’s say that the provider does not think the request should be approved. If so, a different Aetna Better Health of California provider will review this information.
    • A letter will be received by you and your provider which states whether the service has been approved or denied.
    • They will make a decision within 5 business days or 72 hours for urgent care.
    • If your service is denied by them, they will explain why in the letter.
    • If a service is denied by them, you or your provider, with your written permission, is able to file an appeal.

About Aetna

According to Wikipedia, Aetna is an American managed health care company where it sells traditional and consumer directed health care insurance and related services such as pharmaceutical, medical, dental, behavioral health, disability plans, long-term care, which are primarily through employer-paid insurance and benefit programs and through Medicare. It is explained that the company has been a subsidiary of CVS Health since November 28th, 2018.

The network of the company includes 22.1 million medical members, 12.7 million dental members, 13.1 million pharmacy benefit management services members, 1.2 million health-care professionals, over 690,000 primary care doctors and specialists and over 5,700 hospitals.

On Aetna site, it is explained that as a health care leader, Aetna believes that their corporate responsibility begins with helping people live healthier lives. So, the meaning is that using their resources to make the communities and  world we live in better places.

People in communities which are low-income and minority often do not get the health care that they need. So, Aetna wants to help change that through the work of the Aetna foundation. It is explained on the Aetna site that since 1980, the Aetna Foundation has awarded more than $445 million to promote health, wellness and access to high quality health care.

Aetna also support national health initiatives that can make a difference in the lives of people such as fighting heart disease and improving the mental health of veterans.

On the Aetna site, it is also explained that Aetna strives to provide a work environment which is safe and healthy. Their safety program, which is developed and managed by Aetna’s Safety and Environmental Unit (S&E) – addresses health and safety hazards which are usually associated with their facilities, processes and activities. During orientation, new employees are introduced to the Aetna Safety Handbook and the handbook is available online. Employees are encouraged to be able to review it thoroughly before their job activities start.

With Aetna, you are able to access to a quality network of health care providers, specialized management for chronic conditions such as kidney disease, hypertension, diabetes and more and local walk-in clinic appointments.

Aetna will cover what you have to know such as whether you are eligible for financial help to lower your costs, whether there are life events that affect when you can enroll and more.

Well, that’s the information that I can give to you about Aetna according to Wikipedia, Aetna and Aetna CVS Health site.

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