Meritain Prior Authorization List (2024)

FAQs

Are Aetna and Meritain the same? ›

Meritain Health is a popular insurance provider and is a subsidiary of its parent company, Aetna.

Just call our Meritain Health Customer Service team at 1.800. 925.2272. If you have any questions about precertification, just call our Meritain Health Medical Management team at 1.800. 242.1199.

With respect to an Employee or Dependent at the time of the Initial Enrollment Period, You must submit an Enrollment Form within 31 days beginning on the initial date of Your eligibility.

On your Claims Summary page, you can enter identifying information to search for specific claims. Simply enter the information in the appropriate boxes. You can search for claims based on claim type, claim status, provider name, claim number or dates of service.

No. You can see the specialist you choose without a referral. All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies. Preventive care/screening/ immunization No Charge Not Covered You may have to pay for services that aren't preventive.

With 40 years of excellence as a third party health care benefits administrator and a proud subsidiary of Aetna® and Fortune 4 company CVS Health®, Meritain Health® delivers customized, cost-effective and convenient solutions.

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.

Meritain Health provides coverage for addiction and mental health treatment to help people recover from substance abuse and co-occurring disorders.

Log in to your Meritain Health member portal account and click Submit a Claim. Select the patient the claim is for and choose the claim type of Lifestyle Education Reimbursem*nt from the drop-down menu.

What is the payer ID for Meritain Health? ›

Solutions from Meritain Health®

Our network options through Aetna® let you access over 1.6 million health care providers nationwide, including over 307,000 behavioral health providers.

The Meritain Copay Plan gives you the flexibility to see any provider, anywhere, but you pay less when you see in-network providers. If you see an out-of-network provider, you're responsible for any billed charges that exceed customary and reasonable charges.

Remember, Aetna and Coventry are the same company, so you and your patients may see either name or logo on the communications we send to you. We're always working to improve your experience. So if you have any questions or concerns, please call us.

Aetna® is proud to be part of the CVS Health family.

2017: On December 3, 2017, CVS Health announced the acquisition of Aetna for $69 billion. Larry Merlo became chief executive of the two brands. Aetna CEO Mark Bertolini resigned and Aetna President Karen S.

Aetna and Blue Cross Blue Shield both sell Medicare Advantage plans throughout most of the United States. Aetna has more availability, with 47 states versus 42 for BCBS. Our research found that Aetna Medicare Advantage plans performed better on average versus BCBS Medicare plans.