Knowledge Base – Aetna International

Question: How do I sign up on the Aetna Health Hub?

Answer:  see the attached flyer, or follow the instructions below

• Go to https://www.aetnainternational.com/members/login.do
• Click on “Register”
• Enter your Name, Date of Birth
  Make sure that Aetna International Plan Member is selected under “Your Plan type”
• Enter in your Aetna member ID
  Check the box “I accept the terms & conditions”
  Click on “Get Started” to create your account

Here is a link that gives screenshots of the website and walkthrough instructions for Health Hub.

You’ll also find instructions on how to search for a doctor, how to file claims, and navigate the website!

Question: Which app do I use and where?

Answers:

Use the Aetna International Mobil assistant when you are abroad:

The Icon looks like this: In the U.S., you’ll want to use the Aetna health app. The Icon looks like this:

Use the Aetna Health app when you are inside the U.S. to:

• Find doctors, hospitals, urgent care centers and walk-in clinics in the U.S.
• Estimate your costs
• Track your claims
• Access your digital ID card
• And much more!

International Mobile App – Aetna also has a mobile app that you use. You can download the app through Google Play or Apple App Store. Just search for “Aetna International”. It should look like this, blue with a little world on it:

You will login using the same username and password as the member website. From the mobile app you can do all that you can on the member website from the convenience of your phone!

• Submit and monitor your claims.
• Search for doctors and hospitals outside of the U.S.
• Find forms, health care resources and more.
• Download ID card

Sending a message through HealthHub:

• Aetna always recommends calling in: the phone is the most efficient way to get your questions answered. However, if you prefer to use the portal, please see the information on this PDF

Did you know that Aetna International member service centers are available 24/7/365, and have the ability to communicate in over 240 different languages?

• You can reach member service centers by calling the number on the back of your Member ID Card.

1. How does my Deductible Work
2. Why is my Deductible Higher in the U.S.
3. Top 5 things to remember when you start your international employer medical group insurance

Question:  What does the Health Hub allow me to do?

Answer: Using the Health Hub allows you to search for your claims by you or your family member’s name, by the Provider’s name, by the date of service, etc., to make it easy to locate what you are looking for.  Once you are there, you can review the claim details, look at your EOB (Explanation of Benefits) once it is ready, find out what payments have been made and when, upload any requested documents, and more.

KB – AETNA INTER. Health Hub Claims Overview. Claim box.

Question:  How do I submit a claim online?

Answer:

To submit a claim online, log in to your secure member portal, then follow these steps:

• click “Claims Center”, then “Submit claims”
• complete your claim information
• copy, scan and upload your supporting documents
• click “submit claim” to finish the process
• after you have submitted your completed form and uploaded your documents, you will receive a notification via email to let you know that the claim has been submitted successfully.

You can also submit a claim by email, fax or regular mail.  For instructions, click on this link again: https://www.aetnainternational.com/en/individuals/make-most-of-plan/quick-video-guides/outside-us-video-guides-health-hub-help-faqs.html.  Then click on the banner above the video that says, “if you want to find out how to submit a claim via email, fax or traditional mail, read more here.” 

Here is the Aetna claim form that you can fill out in order to submit claims through any of their processes: Aetna Claim Form 2022.

Customer Service and Claims Questions

Email: aiservice@aetna.com  

Phone and Fax numbers:

• In the US, call toll-free at 1-800-231-7729; outside the US, you can call collect at 1-813-775-0190
• World Aware – 1-646-513-4232 For Security issues: https://my.worldaware.com/affiliates/aetna
• Fax, outside the US 1-859-425-8751; in the US 1-800-475-8751

Question:  How do I track my claim?

Answer:

1. Log in to Health Hub and select “My Claims”
2. Select “Aetna Navigator.” You’ll be taken to a screen where you can view the status of your claims and your Explanation of Benefits.

Question: What is pre-certification

Answer: Pre-Certification: For certain services in the US, pre-certification for medical necessity is required. If you are using an in-Network provider, they will take care of the process for you. It is required for in-patient care, out-patient services, and certain imaging services (such as x-rays, MRI’s, etc.). You are responsible for the precertification process if you are using an out-of-network provider.

Question: What is Guarantee of Payment (GOP):

Answer: This letter from Aetna International is sent directly to your provider and tells them exactly what treatment Aetna International will pay and how much they will pay for it.

Question: What is Explanation of Benefits (EOB)?

Answer:  This is when Aetna processes a claim, they issue a document which describes the services and what was paid to whom. It will also show the Patient Responsibility (what you may owe, if you haven’t already paid it).  If the claim – or any portion of it – is denied, the EOB will explain why.  

Question: What is a Letter of Authorization (LOA) and Guarantee of Payment (GOP)

Answer: These preauthorization documents are like a referral. They authorize treatment and let doctors know your plan will pay for their services. These are sometimes needed before you see a doctor (except in cases of emergency).

Question:  What is a direct settlement?

Answer: An agreement Aetna International makes with hospitals and clinics to have them bill Aetna directly for covered medical services. It helps:

• Lower your out-of-pocket costs at the time of service
• Make it easier for you to prepay, submit claims and get reimbursed
• By sending your Letter of Authorization / Guarantee of Payment directly to the treatment facility, we may even be able to negotiate a one-time direct settlement arrangement when you need to see a doctor outside of our network.

Appealing a Claim Denial – If your Claim was denied, you can also appeal the denial, by writing to the address on shown on your EOB. Be sure to supply supporting documents to explain why you believe Aetna should overturn the denial. Please let us know at groupservice@gninsurance.com, if you need advice on how to do this.

1. What do these different levels of deductibles mean?
2. What does “out-of-pocket maximum” mean?
3. Understanding my Explanation of Benefits (EOB)

1. Part 1 of 2 – Your out-of-pocket maximum
2. Part 2 of 2 – Your out-of-pocket maximum

Question:  What about Prescriptions?

Answer:  Prescriptions filled overseas and in the U.S. outside the network are subject to the deductible and coinsurance. If you get prescriptions in the U.S. and use the network, insurance would cover 100% after a $10 co-pay for generic, $20 co-pay for brand, or $40 co-pay for non-preferred brand per one-month supply.

Question:  How does mail order of Prescriptions work in the U.S. and Abroad?

Answer: Expatriate Prescription Services (EPS) is an overseas mail order prescription service provider that will ship direct to you overseas. This program is especially useful for those areas of the world where it is difficult or unsafe for you to fill prescriptions locally. You would be subject to the same co-pays discussed above and EPS will ship up to a maximum of 180-day supply. With EPS, there is no need to arrange for drugs to be bought and shipped from the US.

You can simply place an order by visiting https://www.expatps.com/aetna/ Shipping is included for most locations; however, you will be responsible for any customs charges there may be. You can also call 855-336-9728 for questions.

Here is the link to order prescriptions for delivery in the USA: Aetna Rx Home Delivery – https://www.aetna.com/individuals-families/pharmacy/rx-home-delivery.html. 

Question:  What about Vision Hardware and Hearing Aids?

Answer:  Vision Hardware (Glasses or contacts) are covered at 100% once a year up to $200. Hearing aids are covered subject to the deductible and coinsurance once every 3 years up to $1000 for dependent children less than 24 years of age.

To find care overseas:

1. Go to aetnainternational.com and log in to Health Hub with your user name and password
2. Using the drop-down boxes under “Find Health Care,” select a country and city, then click “Search” to find a doctor near you.

To initiate a direct settlement request for a listed hospital outside of the United States:

1. Click the “Apply for direct settlement” button to be directed to the appropriate form
2. Complete the form, then click “Submit” at the bottom of the page

CARE team:

When you are outside the United States and have questions about your health, you can call our Care and Response Excellence (CARE) team to get answers. These clinicians are available around the clock to help with: • Finding doctors and hospitals in your specific region • Providing culturally-appropriate care recommendations • Coordinating and supervising medical evacuations • Offering support in multiple languages • Accessing medical devices or prescription medications

1. Part 1 of 3 – Two key medical insurance network models
2. Part 2 of 3 – Some key differences in comparing your your medical networks
3. Part 3 of 3 – How does my U.S. and interntional medical network stack up to others?

Finding care:

Aetna International has developed strong, secure partnerships with health care providers around the world that promote access to quality care.

When you’re outside the United States:

• Aetna International recommends staying in network to avoid paying upfront
• Aetna International can issue a Letter of Authorization (LOA) if you choose an out-of-network provider. This helps guarantee procedures will be covered and your provider will settle the charges with us

Question:  What other helpful information does my Emergency Assistance provide me?

Answer: As a member, you also have access to the following helpful information through the Aetna International secure member website located at AetnaInternational.com:

• Daily security alerts from around the globe
• Country risk assessments
• Tips on traveling safely

1. Ask Doug -Who should you call in a medical emergency on your international employer group insurance?
2. Understanding your international emergency medical evacuation benefits

Look for your Member ID card – It’s your all-access pass to better care

We’ll send your Member ID card in the mail, so keep an eye out for it. We recommend keeping your Member ID card with you at all times, so you have it when you need it. Your card has:

• Your Member ID number — used when seeking care and registering online
• Member Service Center phone number — if you have questions
• Emergency Services phone number — for easy access in case of a medical emergency

Question: What is Care Team?

Answer: This is a team of registered nurses who are part of Aetna’s International Health Advisory Team (IHAT) who are available 24/7/365, and can provide assistance with:

• Pre-trip planning – you will have access to pharmacy and doctor locations, vaccinations you may need, health risks in your new country, travel tips, daily security alerts from around the globe, and even advice on places where you would want to take extra care as you travel.
• Coordinating second opinions for complex cases – whenever you have a complex medical issue that normally could mean going back to the US, IHAT’s nurses will arrange for a second opinion with a doctor in the US from the Harvard Medical Program. Using test results and other medical data, the doctor will be able to give second opinions to you anywhere in the world.
• Worldwide coordination of routine and urgent medical care – Aetna keeps track of doctor visits, emergency care, and prescriptions taken in a behind the scenes system that will automatically check for reactions between prescriptions and pass that information along to primary care providers to ensure that you are getting the best and most comprehensive care possible.
• General medical advice—they are unable to diagnose or write prescriptions, but they can give advice and steer you in the right direction for the medical care that you or your family members need.

You can access these benefits and more by contacting Member Services at aiservice@aetna.com or 1-813-775- 0190 (collect) 24/7/365 or toll free in the US at 1-800-231-7729 or by going online to your secure member website.

24/7 virtual telemedicine support

Aetna International connects your physical care with their digital tools to offer virtual support when you need it most. With our telemedicine offerings, you have 24/7 access to experienced doctors for telephone and video consultations no matter where you are.

• Teladoc – Aetna International virtual care support available to members in the United States. Teladoc services vary according to plan type. Refer to your plan documents for more information.
• vHealth – Aetna International virtual care support available to members outside the United States. vHealth by Aetna is currently available to eligible members in a number of territories around the world including India, Asia Pacific, UAE and UK

• WYSA Mental Health/Coaching app is a free download to Aetna members. 
• Wysa provides instant access to emotional and mental well-being professionals available 24/7 to help with stress, sleeplessness, relationships, anxiety and other issues.
• Here is more information on this benefit – WYSA Mental Health