Medicare Alert: Temporary Member Access
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- Lucinda Camilla Cole
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1 Medicare Alert: Temporary Member Access Plan Sponsor: Coventry/Aetna Medicare Part D Effective Date: Jan. 12, 2015 Geographic Area: National If your pharmacy is a Non Participating provider in the Aetna/Coventry 2015 Standard or Standard Preferred networks, you will be able to TEMPORARILY process claims for certain Coventry Medicare Part D members at Premier Preferred in-network reimbursement rates starting Monday, Jan. 12, The effective date of this temporary transition will be Jan. 1, Standard Network Coventry Medicare Part D claims associated with this network should successfully process starting Jan. 12, Standard Preferred Network: During the temporary transition period, non-participating providers will be able to process claims for Coventry Medicare Part D members associated with the Standard Preferred network in weekly transition phases through January/February and thereafter. Announcement: This TEMPORARY Medicare Part D network transition will not impact the ongoing contracting process for the Standard or Standard Preferred Network, and you will continue to receive separate communications concerning the status of your agreement. If you have previously requested network access via our pharmacy network mailbox (PharmNetwrkSrvc@Aetna.com), we are continuing to process those requests. Aetna s goal with this temporary transition is to ensure members can easily access the drugs they need at Aetna s network pharmacies. Please look for continuing updates. We will keep you informed, including providing the date when this temporary access will end. If there are any questions regarding this communication, please contact our pharmacy network mailbox: PharmNetwrkSrvc@Aetna.com
2 Medicare Alert: Temporary Member Access (Continued) Please process claims for these members using the information below. Prescription Processing Information: BIN: PCN: MEDDPRIME RxGroup: CVTYMED Or CVTYRTL Or CVTYMEB Sample ID Card:
3 Medicare Alert: Temporary Member Access (Continued) ATTACHMENT A: Plan to Network Crosswalk COVENTRY MAPD H Coventry Vista Ideal (HMO) FL Premier Preferred H Coventry Vista Ideal (HMO) FL Standard Preferred H Coventry Vista Maximum (HMO SNP) FL Standard H Coventry Summit Plus (HMO) FL Standard Preferred H Coventry Summit Maximum (HMO SNP) FL Standard H Coventry Summit Ideal (HMO) FL Premier Preferred H Coventry Summit Plus (HMO) FL Premier Preferred H Coventry Summit Ideal (HMO) FL Premier Preferred H Coventry Summit Maximum (HMO SNP) FL Standard H Coventry Summit Ideal (HMO) FL Premier Preferred H Coventry Advantra Platinum (PPO) IA, SD Standard Preferred H Coventry Total Care (PPO) SD Standard Preferred H Coventry Total Care (PPO) IA Standard Preferred H Coventry Total Care (PPO) IA Standard Preferred H Coventry Advantra Silver (HMO) IA Standard Preferred H Coventry Total Care (HMO) IA Standard Preferred H Coventry Total Care (HMO) IA Standard Preferred H Advantra Silver (HMO) WV Premier Preferred H Advantra Silver (HMO) WV Premier Preferred H Advantra (PPO) IL, MO Standard H Advantra Premier Plus (PPO) AR Standard Preferred H Coventry Premier Plus (PPO) MO Standard Preferred H Advantra Option 2 (HMO) IL, MO Standard H Gold Advantage (HMO) IL, MO Standard H Advantra Option 1 (HMO-POS) IL, MO Standard H Advantra Dual Eligible SNP (HMO SNP) MO Standard H Coventry Total Care (HMO-POS) MO Standard H Coventry Total Care (HMO) IL Standard H Coventry Total Care (HMO) IL Standard H Advantra (HMO) IL Standard H Coventry Advantage (HMO) MO Standard Preferred H Coventry Advantage Plus (HMO-POS) MO Standard Preferred H Advantra Advantage (HMO) KS, MO Standard Preferred H Advantra Advantage (HMO) KS Standard Preferred H Coventry Medicare Advantage Total Care (HMO) KS Standard Preferred H Advantra Total Care (HMO) AR Standard Preferred H Coventry Advantage (HMO) OK Standard Preferred H Advantra Select Plus (HMO) AR, KS, MO, OK Standard Preferred H Advantra (HMO) LA Premier Preferred H Advantra (HMO) LA Premier Preferred H Advantra Gold (HMO) PA Premier Preferred H Advantra Gold (HMO) PA Premier Preferred H Advantra Silver (HMO) PA Standard H Advantra Silver (HMO) PA Premier Preferred H Advantra Silver (HMO) PA Standard H Advantra Silver Plus (HMO) PA Premier Preferred H Advantra Silver (HMO) PA Standard H Advantra Cares (HMO SNP) PA Standard H Advantra Cares (HMO SNP) PA Standard H Advantra Northern Pennsylvania Gold (HMO) PA Premier Preferred
4 ATTACHMENT A: Plan to Network Crosswalk H Advantra UCPN Plus (HMO) PA Standard H Advantra Silver Plus (HMO) PA Premier Preferred H Advantra (HMO) TX Standard Preferred H Advantra (HMO) TX Standard Preferred H Advantra Silver (HMO-POS) GA Premier Preferred H Advantra Freedom (PPO) KS, MO Standard Preferred H Coventry Medicare Advantage (PPO) KS Standard Preferred H Advantra Freedom (PPO) KS, MO Standard Preferred H Advantra Freedom (PPO) MO Standard Preferred H Advantra Freedom (PPO) KS Standard Preferred H Advantra Freedom (PPO) AR Standard Preferred H Coventry Freedom (PPO) OK Standard Preferred H Advantra Freedom Plus (PPO) KS, MO Standard Preferred H Coventry Total Care (PPO) KS Standard Preferred H Advantra Gold (PPO) PA Premier Preferred H Advantra Gold (PPO) PA Premier Preferred H Advantra Silver (PPO) PA Premier Preferred H Advantra Silver (PPO) PA Premier Preferred H Advantra Silver Plus (PPO) PA Premier Preferred H Advantra Gold (PPO) PA Premier Preferred H Advantra Gold (PPO) PA Premier Preferred H AdvantraOne (PPO) PA Premier Preferred H ADVANTRA SILVER (PPO) PA Premier Preferred H Coventry Advantra Silver (HMO) NE Standard Preferred H Coventry Total Care (HMO) NE Standard Preferred H Advantra Select Plus (HMO) NE Standard Preferred H Advantra (PPO) IL Standard H Advantra Value (PPO) IL Standard Preferred H Advantra Value (PPO) IL Standard Preferred H Advantra Select Plus (PPO) IL Standard Preferred H Advantra (PPO) TX Standard H Coventry Advantra Platinum (PPO) NE Standard Preferred H Altius Advantra (HMO) UT, WY Standard Preferred H Advantra Silver (PPO) OH Standard Preferred H Advantra Gold (PPO) OH Standard Preferred H Advantra Gold (PPO) WV Premier Preferred H Advantra Gold (PPO) WV Premier Preferred H Advantra Gold (PPO) NC Standard Preferred H Advantra Preferred (PPO) GA Premier Preferred COVENTRY PDP S First Health Part D Value Plus (PDP) NY Standard Preferred S First Health Part D Premier Plus (PDP) NY Premier Preferred S First Health Part D Value Plus (PDP) NH, ME Standard Preferred S First Health Part D Value Plus (PDP) CT, MA, RI, VT Standard Preferred S First Health Part D Value Plus (PDP) NJ Standard Preferred S First Health Part D Value Plus (PDP) DE, DC, MD Standard Preferred S First Health Part D Value Plus (PDP) PA, WV Standard Preferred S First Health Part D Value Plus (PDP) VA Standard Preferred S First Health Part D Value Plus (PDP) NC Standard Preferred S First Health Part D Value Plus (PDP) SC Standard Preferred S First Health Part D Value Plus (PDP) GA Standard Preferred S First Health Part D Value Plus (PDP) FL Standard Preferred S First Health Part D Value Plus (PDP) AL, TN Standard Preferred
5 ATTACHMENT A: Plan to Network Crosswalk S First Health Part D Value Plus (PDP) MI Standard Preferred S First Health Part D Value Plus (PDP) OH Standard Preferred S First Health Part D Value Plus (PDP) IN, KY Standard Preferred S First Health Part D Value Plus (PDP) WI Standard Preferred S First Health Part D Value Plus (PDP) IL Standard Preferred S First Health Part D Value Plus (PDP) MO Standard Preferred S First Health Part D Value Plus (PDP) AR Standard Preferred S First Health Part D Value Plus (PDP) MS Standard Preferred S First Health Part D Value Plus (PDP) LA Standard Preferred S First Health Part D Value Plus (PDP) TX Standard Preferred S First Health Part D Value Plus (PDP) OK Standard Preferred S First Health Part D Value Plus (PDP) KS Standard Preferred S First Health Part D Value Plus (PDP) IA, MN, MT, ND, NE, SD, WY Standard Preferred S First Health Part D Value Plus (PDP) NM Standard Preferred S First Health Part D Value Plus (PDP) CO Standard Preferred S First Health Part D Value Plus (PDP) AZ Standard Preferred S First Health Part D Value Plus (PDP) NV Standard Preferred S First Health Part D Value Plus (PDP) OR, WA Standard Preferred S First Health Part D Value Plus (PDP) ID, UT Standard Preferred S First Health Part D Value Plus (PDP) CA Standard Preferred S First Health Part D Premier Plus (PDP) DE, DC, MD Premier Preferred S First Health Part D Premier Plus (PDP) PA, WV Premier Preferred S First Health Part D Premier Plus (PDP) VA Premier Preferred S First Health Part D Premier Plus (PDP) NC Premier Preferred S First Health Part D Premier Plus (PDP) SC Premier Preferred S First Health Part D Premier Plus (PDP) GA Premier Preferred S First Health Part D Premier Plus (PDP) AL, TN Premier Preferred S First Health Part D Premier Plus (PDP) MI Premier Preferred S First Health Part D Premier Plus (PDP) OH Premier Preferred S First Health Part D Premier Plus (PDP) WI Premier Preferred S First Health Part D Premier Plus (PDP) IL Premier Preferred S First Health Part D Premier Plus (PDP) MO Premier Preferred S First Health Part D Premier Plus (PDP) AR Premier Preferred S First Health Part D Premier Plus (PDP) MS Premier Preferred S First Health Part D Premier Plus (PDP) LA Premier Preferred S First Health Part D Premier Plus (PDP) TX Premier Preferred S First Health Part D Premier Plus (PDP) OK Premier Preferred S First Health Part D Premier Plus (PDP) KS Premier Preferred S First Health Part D Premier Plus (PDP) CO Premier Preferred S First Health Part D Premier Plus (PDP) AZ Premier Preferred S First Health Part D Premier Plus (PDP) NV Premier Preferred S First Health Part D Premier Plus (PDP) NH, ME Premier Preferred S First Health Part D Premier Plus (PDP) CT, MA, RI, VT Premier Preferred S First Health Part D Premier Plus (PDP) NJ Premier Preferred S First Health Part D Premier Plus (PDP) FL Premier Preferred S First Health Part D Premier Plus (PDP) IN, KY Premier Preferred S First Health Part D Premier Plus (PDP) IA, MN, MT, ND, NE, SD, WY Premier Preferred S First Health Part D Premier Plus (PDP) NM Premier Preferred S First Health Part D Premier Plus (PDP) OR, WA Premier Preferred S First Health Part D Premier Plus (PDP) ID, UT Premier Preferred S First Health Part D Premier Plus (PDP) CA Premier Preferred S First Health Part D Premier Plus (PDP) HI Premier Preferred S First Health Part D Premier Plus (PDP) AK Premier Preferred
6 ATTACHMENT A: Plan to Network Crosswalk S First Health Part D Value Plus (PDP) AK Standard Preferred S First Health Part D Value Plus (PDP) HI Standard Preferred
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