Legal Rights & Agreement Rules · Restriction or exception
The Notice applies to insured plans, not employer self-funded plans
This Notice is for Aetna insured health benefit plans. It does not apply to plans that an employer self-funds. If you have coverage through work, the Notice says to ask your employer whether the plan is insured or self-funded, and, if it is self-funded, to ask for a copy of your employer's Privacy Notice.
Supporting quotations
This Notice of Privacy Practices is for Aetna insured health benefit plans.
It does not apply to any plans that are self-funded by an employer.
If it’s self-funded, ask for a copy of your employer’s Privacy Notice.
Qualifications & exceptions
Applies to insured plans only; plans self-funded by an employer are outside the Notice.
Not stated here
The Notice does not say what the label "Federal Risk Plans" in its footer covers beyond appearing as a form label.
Legal Rights & Agreement Rules · Context
The Notice took effect on October 1, 2025
The Notice states that it took effect on October 1, 2025. A form code in the footer, GR-67806-17 (2-26) Federal Risk Plans, also appears; the Notice does not explain what the "(2-26)" part means or whether it relates to the effective date.
Supporting quotations
Effective date: This Notice took effect on October 1, 2025.
GR-67806-17 (2-26) Federal Risk Plans
Qualifications & exceptions
The only stated date is the October 1, 2025 effective date.
Not stated here
The footer form code includes "(2-26)"; the Notice does not say what it means or whether a later revision applies.
Legal Rights & Agreement Rules · Restriction or exception
Some laws add protections for sensitive health information, and Aetna says it will follow the stricter law
Some state and federal laws may require special privacy protections, including certain requirements to obtain attestations from requestors, that limit the use and disclosure of certain sensitive health information. The Notice lists information related to alcohol or substance use disorder, biometric information, child or adult abuse or neglect including sexual assault, communicable diseases, genetic information, HIV/AIDS, mental health, minors, reproductive health, and sexually transmitted diseases. Aetna says it will follow the law that is stricter, or more protective of your PHI, where it applies to Aetna. For more information about these restrictions on your sensitive PHI, contact the Aetna Privacy Office.
Supporting quotations
Some state and federal laws may require special privacy protections, including certain requirements to obtain attestations from requestors, that limit the use and disclosure of certain sensitive health information.
Alcohol or substance use disorder
Biometric Information
Child or adult abuse or neglect, including sexual assault
Communicable diseases
Genetic information
HIV/AIDs
Mental health
Minors
Reproductive health
Sexually transmitted diseases
We will follow the law that is stricter (or more protective of your PHI), where it applies to us.
Qualifications & exceptions
The laws "may" apply; the Notice does not name them or say when they apply to Aetna.
Aetna follows the stricter law only "where it applies to us".
Not stated here
The specific state and federal laws are not identified, and the Notice does not say what attestations are required.
Legal Rights & Agreement Rules · Restriction or exception
Aetna will not use substance use disorder information against you in a legal case without consent or a court order
Aetna will not use or share this substance use disorder information in any legal case against you unless you give written consent, or a court orders Aetna with a subpoena or other legal requirement. The Notice adds that you or Aetna must also receive notice and a chance to be heard.
Supporting quotations
We will not use or share this information in any legal case against you unless:
You give us written consent, or
A court orders us with a subpoena or other legal requirement.
You or Aetna must also receive notice and a chance to be heard.
Qualifications & exceptions
Exceptions: your written consent, or a court order with a subpoena or other legal requirement.
Notice and a chance to be heard must also be given to you or Aetna.
Legal Rights & Agreement Rules · Context
Under federal privacy laws you have rights about your PHI
The Notice says that under federal privacy laws you have rights when it comes to your PHI, and then lists them: choosing how or where Aetna communicates with you, asking Aetna to limit uses and sharing, getting a copy, asking to fix it, getting a list of certain disclosures, being notified after a breach, learning the reasons for denial of a policy, and limits on pretext interviews.
Supporting quotations
Under federal privacy laws, you have rights when it comes to your PHI.
Qualifications & exceptions
The individual rights are carded separately with their own conditions.
Legal Rights & Agreement Rules · Company commitment
Aetna says insurers may not take part in pretext interviews except in some cases, and Aetna does not take part
The Notice says insurers are not allowed to take part in pretext interviews, except in some cases such as suspected fraud or criminal activity. It says Aetna does not take part in these.
Supporting quotations
Insurers aren’t allowed to take part in pretext interviews, except in some cases, such as suspected fraud or criminal activity.
We don’t take part in these.
Qualifications & exceptions
The general rule has exceptions in some cases, such as suspected fraud or criminal activity.
Not stated here
"Pretext interview" is not defined in the Notice.
Legal Rights & Agreement Rules · User right or choice
You can file a complaint with Aetna's Privacy Office or by mail, or write to the Secretary of Health and Human Services
If you think someone has violated your privacy rights, you have the right to file a complaint. You can send an email to the Aetna Privacy Office, or send a letter to the Aetna HIPAA Member Rights Team at P.O. Box 14079, Lexington, KY 40512-4079; a fax number is listed with that address. You also may write to the Secretary of the U.S. Department of Health and Human Services. The Notice says there are no penalties for filing a complaint.
Supporting quotations
You also have the right to file a complaint if you think someone has violated your privacy rights.
To do so, just send an email to Aetna Privacy Office at PrivacyAetna@aetna.com
send a letter to: Aetna HIPAA Member Rights Team P.O. Box 14079
Lexington, KY 40512-4079 Fax: 859-280-1272
You also may write to the Secretary of the U.S. Department of Health and Human Services.
There are no penalties for filing a complaint.
Qualifications & exceptions
The complaint right applies if you think someone has violated your privacy rights.
Not stated here
The Notice lists a fax number with the mailing address but does not say whether complaints may be sent by fax.
Legal Rights & Agreement Rules · Company commitment
Federal law requires Aetna to keep your PHI private, tell you its duties and follow the Notice in effect
Federal privacy law requires Aetna to keep your PHI private and to tell you about its legal duties and privacy practices. Aetna must also follow the terms of the Notice in effect.
Supporting quotations
Federal privacy law requires us to keep your PHI private.
And we must tell you about our legal duties and privacy practices.
We must also follow the terms of the Notice in effect.
Legal Rights & Agreement Rules · Permission or license
Aetna may change the Notice and its privacy policies at any time, and changes apply to all information it holds or gets
Aetna may change the terms of the Notice and its privacy policies anytime. If it does, the new terms and policies will be effective for all the information it now has about you and will apply to any information it may get or hold in the future.
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We may change the terms of this Notice and our privacy policies anytime.
If we do, the new terms and policies will be effective for all the information we now have about you.
And they’ll apply to any information that we may get or hold in the future.
Qualifications & exceptions
Changes apply to existing information and information obtained in the future.
Not stated here
The Notice does not say how Aetna will tell you about a change or how much advance notice it gives.
Legal Rights & Agreement Rules · Context
Aetna is described as a brand name used by the Aetna group of companies
The Notice says Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates. This brand description is broader than the definition at the start of the Notice, which says Aetna and "we" mean the HMO and licensed insurer subsidiaries of Aetna Inc. designated as a single affiliated covered entity.
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Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Not stated here
The Notice does not say whether the brand-name group of companies and the affiliated covered entity are the same set of entities.