![]() Not all plans are offered in all service areas. Applies to: Aetna Choice ® POS, Aetna Choice POS II, Aetna Medicare ℠ Plan (PPO), Aetna Medicare Plan (HMO), all Aetna HealthFund ® products, Aetna Health Network Only ℠, Aetna Health Network Option ℠, Aetna Open Access ® Elect Choice ®, Aetna Open Access HMO, Aetna Open Access Managed Choice ®, Open Access Aetna Select ℠, Elect Choice, HMO, Managed Choice POS, Open Choice ®, Quality Point-of-Service ® (QPOS ®), and Aetna Select ℠ benefits plans and all products that may include the Aexcel ®, Choose and Save ℠, Aetna Performance Network or Savings Plus networks.It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage.Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". ![]() In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The member's benefit plan determines coverage. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Members should discuss any matters related to their coverage or condition with their treating provider.Įach benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Treating providers are solely responsible for medical advice and treatment of members. The ABA Medical Necessity Guide does not constitute medical advice. The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. If you wait too long, the drug won’t work.īy clicking on “I Accept”, I acknowledge and accept that: You must take Tamiflu at the first sign of symptoms. It decreases your symptoms and the length of time you’re sick. Tamiflu is an antiviral drug taken by mouth that prevents the virus from multiplying in your body. ![]() Ask a doctor or pharmacist about prescription flu treatment. ![]() Recommended only for high-risk individuals, like seniors and people with chronic medical conditions. And you can break up mucus in your nose and throat by gargling with salt water or using a neti pot. Inhaling steam is another way to soothe airways use a humidifier or sit in the bathroom while you run a very hot shower. To relieve cough and nasal congestion, the fumes of a menthol ointment, like Vicks VapoRub, or eucalyptus oil (sniff from the bottle or add a few drops to hot water) can help you breathe easier. For stomach upset, some people swear by ginger root natural ginger ale or ginger tea are two good sources. Treat yourself to a favorite beverage that will encourage you to keep drinking: juice, electrolyte water, chicken soup or herbal tea with honey and lemon. Staying extra hydrated can make you feel more comfortable and speed your recovery. (You might even mistake it for a mild cold.) The catch: You have to get your shot before you come down with the flu ― ideally at least a few weeks prior, so your body has time to build up defenses against the virus. But the vaccine also reduces the strength of the virus if you do catch it. You probably know that the flu vaccine helps you avoid developing the flu. Besides the usual over-the-counter cold-and-flu formulas, doctors recommends the following: The best medicine for the flu depends on the timing.
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