I am entering graduate school this Fall to become a speech-language pathologist. Because we do clinical rotations as part of our master's program, my university requires that all students receive a Hepatitis B immunization. Aetna is refusing to pay my doctor for the immunization, stating that they do not cover routine immunizations for adults.
I contacted customer service to let them know that I am undergoing the immunization because I am in health care and it is required by my university, and I offered to submit documentation to support my need for the immunization. I also pointed out that Aetna Clinical Policy Bulletin 0410 states that "Aetna considers hepatitis B vaccine a medically necessary preventive service for..." adults who are health care workers. http://www.aetna.com/cpb/medical/data/400_499/0410.html
The customer care rep responded that the bulletin does not apply to the PPO insurance plan I have because of some decision my employer made. Her explanation was very unclear to me.
I filed an appeal using the Aetna online appeal form yesterday. Although I provided my email address, I received no confirmation of submission of any sort. I do not feel confident that I will receive a reply.
Does anyone out there have any suggestions on how to resolve this? Any help would be greatly appreciated.
Copyright 1994-2016MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.