Citi Benefits Handbook
Aetna Cancer Support
Aetna medical plan members can experience enhanced care through Aetna's cancer support program, administered through New Century Health (NCH). The program provides access to highly personalized, quality and efficient care.
With the oncology management program, you can benefit from:
- Care that is based on nationally recognized clinical guidelines using evidence-based criteria
- A team approach that works closely with a patient's physician to deliver quality patient care
- Physician-to-physician discussions on the optimal treatment plans for members
- A simplified administrative process, which means timely authorizations and claim payments
This program is provided for members age 18 or older who have been diagnosed with cancer. It applies to patients undergoing chemotherapy for a maximum of six months per treatment cycle.
Teladoc — Doctors on Demand
Teladoc provides access to a national network of U.S. board-certified doctors, pediatricians, psychologists or therapists who are available on-demand 24 hours a day, 7 days a week, 365 days a year to diagnose, treat and prescribe medication (when necessary) for many medical issues via phone or online video consultations. Teladoc does not replace the existing primary care physician, psychologist or therapist relationship, but enhances it as a convenient, affordable alternative for medical care.
You pay a $40 copay subject to the deductible per Teladoc phone or video consultation with a physician, psychologist or therapist. After the deductible has been met, you will pay 20% of the consult, or $8 per consult. Charges for phone or video consultations with a physician, psychologist or therapist and/or other provider who is not contracted with Aetna's Teladoc service are excluded. For more information, visit www.teladoc.com.
Personal Health Record
Employees and covered family members enrolled in a medical program with Aetna have access to a Personal Health Record, which scans your information and compares it with the latest medical guidelines to identify potential problems and send you alerts.
When you visit the doctor, have a test or fill a prescription, the claims information gets populated automatically into your Personal Health Record. You can add important information yourself too, such as:
- Family health history
- Blood pressure, weight, blood sugar and cholesterol numbers
- Tests, procedures and more
There are several ways the tool can help you:
- Share it with your doctor. The "home page" of your Personal Health Record is the Health Summary. It's your health information at a glance. You can decide what to share with your doctor. You can print out your Health Summary, take it with you to your doctor, or share it securely online before your visit.
- Keep track of when you are due for important checkups. It can help remind you when to get preventive screenings, like a mammogram or colonoscopy.
- Track important health numbers. See how your blood pressure, blood sugar, weight and other health markers change over time in clear, easy-to-understand graphs and charts.
- Manage your family's health information. The Personal Health Record is available to employees who enroll in an Aetna health benefits or health insurance plan. Covered family members have their own Personal Health Records. As the plan subscriber, you can access and add information to their Personal Health Records — as long as they are under age 18. You can give your covered spouse this access, too.
To get started, visit www.aetna.com and create a username and password on the secure member website. Then go to the Health Records tab and click on "Personal Health Record."
Beginning Right is a maternity management program available to Aetna members that can be used throughout your pregnancy and after your baby is born. You'll get information on:
All program materials are in English and Spanish. Translation services are also available in over 170 languages.
If you have health conditions or risk factors that could impact your pregnancy, you can work with a nurse case manager to help lower those risks. If eligible, you also get:
Beginning Right also offers a Smoke-Free Moms-to-Be® program, where you'll get one-on-one nurse support to help you quit smoking for good.
To access the program, call 1 (800) CRADLE-1 (1 (800) 272-3531), weekdays from 8 a.m. to 7 p.m., ET, or log in to the secure member website at www.aetna.com and look under "Health Programs."
Aetna In Touch CareSM
Aetna's In Touch Care program gives you direct phone access to a registered nurse. Through this program, one nurse is assigned to you and any family members. This care is also available online. To register, visit www.aetna.com.
Aetna's Autism Advocate Program
Employees and their dependents have access to a designated Autism Advocate who is specifically trained in Autism Spectrum Disorder (ASD). The Autism Advocate is a dedicated single point of contact to help families affected by an autism diagnosis by:
- Addressing questions about autism benefits
- Finding providers
- Overseeing Utilization Management (authorization) for applied behavior analysis (ABA)
- Resolving claims issues
- Assuring that treatment is effective
- Connecting parents to all available resources
- Coordinating with integrated autism care providers and supports
Autism Clinical Requirements
- There must be a diagnosis of Autism Spectrum Disorder
- The maladaptive target behavior must be severe (risk to personal safety, or the safety of others in the child's environment, or very significantly/completely interferes with ability to function)
- Parent/caregiver(s) must be involved in training of behavioral techniques
- There is a time-limited, individualized treatment plan with objective measures that describes behavioral interventions
- There is involvement of community resources (such as the school district)
- Services must be provided by individuals licensed by the state or certified by the Behavior Analyst Certifying Board