Covers Aetna's insured student plans, not plans a school self-funds
The notice says it applies to Aetna's insured health benefit plans and does not apply to any plans that a school funds itself. It describes Aetna Student Health as a brand name for products and services provided by Aetna Life Insurance Company and its applicable affiliated companies, and says fully insured student health insurance plans are underwritten by Aetna Life Insurance Company.
Supporting quotations
This Notice of Privacy Practices applies to Aetna’s insured health benefit plans. It does not apply to any plans that are self-funded by a school.
Fully insured student health insurance plans are underwritten by Aetna Life Insurance Company (Aetna).
is the brand name for products and services provided by Aetna Life Insurance Company and its applicable affiliated companies (Aetna).
Qualifications & exceptions
Applies to Aetna's insured health benefit plans; it does not apply to plans self-funded by a school.
Not stated here
The notice does not say which schools' plans are insured and which are self-funded, so it does not tell a student whether this notice covers their plan.
Legal Rights & Agreement Rules · Company commitment
Aetna says it treats personal information as confidential and protects it under law and its own policies
Aetna says it considers personal information confidential and protects it in line with federal and state privacy laws and its own company privacy policies. It says this notice describes how it may use and disclose information about you in administering your benefits, how you can get access to your medical information, and your legal rights regarding that information.
Supporting quotations
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
We protect the privacy of that information in accordance with federal and state privacy laws, as well as our own company privacy policies.
This notice describes how we may use and disclose information about you in administering your benefits, and it explains your legal rights regarding the information.
Qualifications & exceptions
The stated purpose is administering your benefits.
Legal Rights & Agreement Rules · Context
What "personal information" and "health information" mean in this notice
In this notice, "personal information" means information that identifies you as an individual, such as your name and Social Security Number, plus financial, health and other nonpublic information about you that Aetna obtains so it can provide insurance coverage. "Health information" means information that identifies you and relates to your medical history, meaning the health care you receive or the amounts paid for that care.
Supporting quotations
When we use the term “personal information,” we mean information that identifies you as an individual, such as your name and Social Security Number, as well as financial, health and other information about you that is nonpublic, and that we obtain so we can provide you with insurance coverage.
By “health information,” we mean information that identifies you and relates to your medical history (i.e., the health care you receive or the amounts paid for that care).
Qualifications & exceptions
Personal information is limited to nonpublic information Aetna obtains to provide coverage.
Not stated here
Elsewhere the notice uses "PHI" and "protected health information" without a separate definition beyond the passing mention in the affiliated covered entity passage.
Legal Rights & Agreement Rules · Context
The notice states an October 1, 2025 effective date
The notice says it became effective on October 1, 2025. The page header carries the form code GR-68050 (2-26).
Supporting quotations
This notice became effective on October 1, 2025.
GR-68050 (2-26)
Not stated here
The notice does not explain what "(2-26)" in the form code means, and does not state any other date, such as a revision date.
Account & Service Control · User right or choice
The notice offers a Spanish version through a number in the document
A line in Spanish says that to receive this notice in Spanish, you should call the number provided in this document.
Supporting quotations
Para recibir esta notificación en español por favor llamar al número provisto en este documento.
Not stated here
The notice does not say which number in the document this refers to; elsewhere it refers to the toll-free Customer Services number on your ID card.
Sharing & Disclosure · Company practice
Aetna entities designated as one affiliated covered entity can share protected health information
In this notice "Aetna," "we," "us" and "our" refer to all of the HMO and licensed insurer subsidiaries of Aetna Inc. Those entities are designated as a single affiliated covered entity for federal privacy purposes, and its members can share protected health information with each other for treatment, payment and health care operations of the affiliated covered entity and as HIPAA and this notice allow.
Supporting quotations
For purposes of this notice, “Aetna” and the pronouns “we,” “us” and “our” refer to all of the HMO and licensed insurer subsidiaries of Aetna Inc. These entities have been designated as a single affiliated covered entity for federal privacy purposes. The members of the Aetna ACE can share Protected Health Information (PHI) with each other. We do this for the treatment, payment and health care operations of the Aetna ACE and as allowed by HIPAA and this Notice.
For a full list of the members of the Aetna ACE, contact the Aetna Privacy Office at PrivacyAetna@aetna.com.
Qualifications & exceptions
Sharing among members is for treatment, payment and health care operations of the affiliated covered entity, or as HIPAA and the notice allow.
Not stated here
The notice does not list the members of the affiliated covered entity; it says to contact the Aetna Privacy Office for the list.
Data Access & Collection · Company practice
Aetna gets personal information from your school or student health center, other insurers and health care providers
Aetna says it needs personal information to provide coverage and obtains it from many sources, particularly your school or Student Health Center, other insurers, HMOs or third-party administrators, and health care providers.
Supporting quotations
In order to provide you with insurance coverage, we need personal information about you, and we obtain that information from many different sources – particularly your school or Student Health Center, other insurers, HMOs or third-party administrators (TPAs), and health care providers.
Qualifications & exceptions
The sources are introduced with "particularly," so the named sources are examples rather than a complete list.
Use & Processing · Context
The uses and disclosures that follow are introduced as examples ("including")
Aetna says that in administering your health benefits it may use and disclose personal information in various ways, including the health care operations, payment, treatment and other covered entity disclosures described next. The word "including" shows the list is not stated to be complete here.
Supporting quotations
In administering your health benefits, we may use and disclose personal information about you in various ways, including:
Qualifications & exceptions
Additional reasons, required disclosures, and the authorization rules appear in later sections of the notice.
Use & Processing · Company practice
Health care operations: Aetna may use and disclose information to run its health business
Aetna may use and disclose personal information in running its health business, for example quality assessment and improvement, accreditation, performance measurement, health services research, preventive health, case management and care coordination. It gives nurse case managers as an example. Other operational uses include underwriting and rating, fraud detection and investigation, pharmaceutical program administration and payments where applicable, transfers of policies or contracts between health plans, and general administration such as data systems management and customer service.
Supporting quotations
Health Care Operations: We may use and disclose personal information during the course of running our health business – that is, during operational activities such as quality assessment and improvement; accreditation by independent organizations; performance measurement and outcomes assessment; health services research; preventive health, case management and care coordination.
Other operational activities requiring use and disclosure include underwriting and rating; detection and investigation of fraud; administration of pharmaceutical programs and payments (when applicable); transfer of policies or contracts from and to other health plans; facilitation of a sale, transfer, merger or consolidation of all or part of Aetna Student Health with another entity (including due diligence related to such activity); and other general administrative activities, including data and information systems management, and customer service.
Qualifications & exceptions
Pharmaceutical program administration applies "when applicable."
The operational activities are described with "such as" and "include," so the list is not stated to be exhaustive.
Sharing & Disclosure · Company practice
Information may be disclosed to facilitate a sale, merger or transfer of the plan business, including due diligence
As a health care operations activity, Aetna may use and disclose personal information to facilitate a sale, transfer, merger or consolidation of all or part of Aetna Student Health with another entity, including due diligence related to that activity. It also lists transferring policies or contracts from and to other health plans.
Supporting quotations
facilitation of a sale, transfer, merger or consolidation of all or part of Aetna Student Health with another entity (including due diligence related to such activity)
transfer of policies or contracts from and to other health plans
Not stated here
The notice does not say who the other entity would be, what information would be disclosed, or whether members would be notified.
Use & Processing · Company practice
Payment: Aetna may use and disclose information to pay for covered services
To help pay for your covered services, Aetna may use and disclose personal information in conducting utilization and medical necessity reviews, coordinating care, determining eligibility and formulary compliance, collecting premiums, calculating cost-sharing amounts, and responding to complaints, appeals and requests for external review. For example, it may use your medical history to decide whether a treatment is medically necessary and what the payment should be, and may disclose information to your provider during that process.
Supporting quotations
Payment: To help pay for your covered services, we may use and disclose personal information in a number of ways – in conducting utilization and medical necessity reviews; coordinating care; determining eligibility; determining formulary compliance; collecting premiums; calculating cost-sharing amounts; and responding to complaints, appeals and requests for external review.
For example, we may use your medical history and other health information about you to decide whether a particular treatment is medically necessary and what the payment should be – and during the process, we may disclose information to your provider.
Qualifications & exceptions
Introduced as "in a number of ways," so the listed activities are not stated to be exhaustive.
Sharing & Disclosure · Company practice
Explanation of Benefits forms and claim information are mailed to the subscriber
Aetna mails Explanation of Benefits forms and other information to the address it has on record for the subscriber, meaning the primary insured. That can include claim information about a covered dependent.
Supporting quotations
We also mail Explanation of Benefits forms and other information to the address we have on record for the subscriber (i.e., the primary insured).
Qualifications & exceptions
The Your Legal Rights section lets you ask Aetna to communicate at a different address or in a certain way, and says Aetna will accommodate reasonable requests; it also describes a way to stop paper mailing of Explanation of Benefits forms.
Not stated here
This passage does not itself say that the subscriber receives information about adult dependents; the notice's later example of an adult dependent wanting a different address suggests it can.
Sharing & Disclosure · Company practice
Claims information is available to subscribers and covered dependents on the Navigator health site
Aetna makes claims information available to subscribers and covered dependents on its Navigator health site.
Supporting quotations
In addition, we make claims information available to subscribers and covered dependents on the Navigator® health site.
Not stated here
The notice does not say how access to the site is controlled or what claim detail each covered dependent can see.
Sharing & Disclosure · Company practice
Treatment: Aetna may disclose information to doctors, pharmacies, hospitals and other providers who care for you
Aetna may disclose information to doctors, dentists, pharmacies, hospitals and other health care providers who take care of you. It gives as an example doctors requesting medical information from Aetna to add to their own records, and says it may send certain information to doctors for patient safety or other treatment-related reasons.
Supporting quotations
Treatment: We may disclose information to doctors, dentists, pharmacies, hospitals, and other health care providers who take care of you. For example, doctors may request medical information from us to supplement their own records. We also may send certain information to doctors for patient safety or other treatment-related reasons.
Qualifications & exceptions
The recipients are providers who take care of you.
Sharing & Disclosure · Company practice
Aetna may disclose information to other covered entities and their business associates
Aetna may disclose personal information to other covered entities, or business associates of those entities, for treatment, payment and certain health care operations purposes. For example, it may disclose information to another health plan, such as a parent's plan covering you as a dependent, if arrangements have been made to do so to have certain expenses reimbursed.
Supporting quotations
Disclosures to Other Covered Entities: We may disclose personal information to other covered entities, or business associates of those entities for treatment, payment and certain health care operations purposes. For example, we may disclose personal information to other health plans (i.e. if you are covered as a dependent under a parent’s plan) if it has been arranged for us to do so in order to have certain expenses reimbursed.
Qualifications & exceptions
Limited to treatment, payment and "certain" health care operations purposes.
Not stated here
The notice does not say which health care operations purposes are covered by "certain."
Use & Processing · Company practice
Aetna may use information for treatment alternatives, reminders and other health-related benefits and services
Aetna may use or disclose personal information to provide you with treatment alternatives, treatment reminders, or other health-related benefits and services. It then lists further reasons it may disclose information, covered in the cards that follow.
Supporting quotations
We may use or disclose personal information about you in providing you with treatment alternatives, treatment reminders, or other health-related benefits and services.
We also may disclose such information in support of:
Not stated here
The notice does not say who delivers these alternatives, reminders or services, or whether they can include marketing; it treats marketing unrelated to your benefit plan separately as needing written authorization.
Sharing & Disclosure · Company practice
Plan administration: disclosure to your school when plan documents contain appropriate language
Aetna may disclose information to your school for plan administration when it has been informed that appropriate language is included in your plan documents.
Supporting quotations
Plan Administration – to your school, when we have been informed that appropriate language has been included in your plan documents.
Qualifications & exceptions
Applies only when Aetna has been informed that appropriate language has been included in the plan documents.
Not stated here
The notice does not say what information goes to the school, what the "appropriate language" is, or who informs Aetna.
Sharing & Disclosure · Company practice
Research: disclosure to researchers when privacy protection measures are taken
Aetna may disclose information to researchers, provided measures are taken to protect your privacy.
Supporting quotations
Research – to researchers, provided measures are taken to protect your privacy.
Qualifications & exceptions
Conditioned on measures being taken to protect your privacy.
Not stated here
The notice does not say what those measures are, who decides they are adequate, or whether the information is identifiable.
Sharing & Disclosure · Company practice
Business partners: disclosure to service providers who assure Aetna they will protect it
Aetna may disclose information to persons, including student health centers, who provide services to Aetna and assure Aetna they will protect the information.
Supporting quotations
Business Partners – to persons, including student health centers, who provide services to us and assure us they will protect the information.
Qualifications & exceptions
Conditioned on the recipient assuring Aetna that it will protect the information.
Not stated here
The notice does not say what services these partners provide, how many there are, or what form the assurance takes.
Legal Rights & Agreement Rules · Company practice
Regulators, workers' compensation and legal requirements
Aetna may disclose information to state insurance departments, the U.S. Department of Labor and other government agencies that regulate it, to comply with workers' compensation laws, and to comply with legal obligations and requirements.
Supporting quotations
Industry Regulation – to state insurance departments, U.S. Department of Labor and other government agencies that regulate us.
Workers’ Compensation – to comply with workers’ compensation laws.
As Required by Law – to comply with legal obligations and requirements.
Legal Rights & Agreement Rules · Company practice
Law enforcement: disclosure to federal, state and local law enforcement officials
Aetna may disclose information to federal, state and local law enforcement officials.
Supporting quotations
Law Enforcement – to federal, state, and local law enforcement officials.
Not stated here
Unlike the neighboring items, this item states no condition or purpose; the notice does not say here what circumstances apply.
Legal Rights & Agreement Rules · Company practice
Legal proceedings: disclosure in response to a court order or other lawful process
Aetna may disclose information in response to a court order or other lawful process.
Supporting quotations
Legal Proceedings – in response to a court order or other lawful process.
Qualifications & exceptions
Tied to a court order or other lawful process.
Legal Rights & Agreement Rules · Company practice
Public welfare: matters of public interest as required or permitted by law
Aetna may disclose information to address matters of public interest as required or permitted by law, for example child abuse and neglect, threats to public health and safety, and national security.
Supporting quotations
Public Welfare – to address matters of public interest as required or permitted by law (e.g., child abuse and neglect, threats to public health and safety, and national security).
Qualifications & exceptions
As required or permitted by law; the examples are introduced with "e.g." and are not stated to be exhaustive.
Sharing & Disclosure · Company practice
Decedents and organ donation: coroners, medical examiners, funeral directors and organ donation groups
Aetna may disclose information to a coroner or medical examiner to identify a deceased person, determine a cause of death, or as authorized by law, and to funeral directors as necessary to carry out their duties. It may also disclose information to organ donation groups to facilitate donation and transplantation.
Supporting quotations
Decedents – to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or as authorized by law; and to funeral directors as necessary to carry out their duties.
Organ Procurement – to respond to organ donation groups for the purpose of facilitating donation and transplantation.
Legal Rights & Agreement Rules · Company practice
Required disclosures: to you or your personal representative, and to the federal health secretary
Aetna says it must disclose your personal information to you or to someone with the legal right to act for you, your personal representative, to administer your rights under the notice, and to the Secretary of the Department of Health and Human Services as necessary for HIPAA compliance and enforcement.
Supporting quotations
Required Disclosures: We must use and disclose your personal information in the following manner:
To you or someone who has the legal right to act for you (your personal representative) in order to administer your rights as described in this notice
To the Secretary of the Department of Health and Human Services, as necessary, for HIPAA compliance and enforcement purposes.
Sharing & Disclosure · Company practice
Aetna may disclose information to relatives, friends and others involved in your care or payment
Aetna may disclose health information to a Student Health Center, a relative, a friend, the subscriber of your plan, or any other person you identify, provided the information is directly relevant to that person's involvement with your health care or payment for it. For example, if a family member, student health center, school department providing a service function for Aetna, or other caregiver calls with prior knowledge of a claim, Aetna may confirm whether the claim has been received and paid.
Supporting quotations
We may disclose health information about you to a Student Health Center, a relative, a friend, the subscriber of your health benefits plan or any other person you identify, provided the information is directly relevant to that person’s involvement with your health care or payment for that care.
For example, if a family member, a student health center, or a school department providing a service function for us, or other caregiver calls us with prior knowledge of a claim, we may confirm whether or not the claim has been received and paid.
Qualifications & exceptions
Limited to information directly relevant to the person's involvement with your care or payment for it.
Not stated here
The notice does not say how Aetna verifies who is calling or whether it confirms more than whether a claim was received and paid.
Account & Service Control · User right or choice
You can stop or limit disclosures to others involved in your care by calling Customer Services
Aetna says you have the right to stop or limit disclosures to relatives, friends and others involved in your care by calling the toll-free Customer Services number on your ID card.
Supporting quotations
You have the right to stop or limit this kind of disclosure by calling the toll-free Customer Services number on your ID card.
Cross-references
contrast (model-proposed): You can ask Aetna to restrict uses and disclosures, but it may not agree — contrast: One passage says you have the right to stop or limit disclosures to relatives, friends and others involved in your care, while the rights section says Aetna will consider but may not agree to requests to restrict disclosures to persons involved in your care. The notice does not reconcile the two.
Account & Service Control · User right or choice
Minors may have the right to block parental access, if state law permits
If you are a minor, you may have the right to block parental access to your health information in certain circumstances, if state law permits. You can contact Aetna using the toll-free Customer Services number on your ID card, or have your provider contact Aetna.
Supporting quotations
If you are a minor, you also may have the right to block parental access to your health information in certain circumstances, if permitted by state law.
You can contact us using the toll-free Customer Services number on your ID card – or have your provider contact us.
Qualifications & exceptions
Applies only in certain circumstances and only if permitted by state law.
Not stated here
The notice does not say which circumstances or which state laws apply.
Use & Processing · Company commitment
Aetna asks for your written authorization in all situations other than those described
Aetna says that in all situations other than those described in the notice, it will ask for your written authorization before using or disclosing personal information about you. As examples, it will get authorization for marketing purposes unrelated to your benefit plan, before disclosing psychotherapy notes, for sale of your health information, and for other reasons required by law.
Supporting quotations
In all situations other than those described above, we will ask for your written authorization before using or disclosing personal information about you.
for marketing purposes that are unrelated to your benefit plan(s)
before disclosing any psychotherapy notes
related to the sale of your health information
for other reasons as required by law.
Qualifications & exceptions
The examples are introduced with "for example," so they are not stated to be the only situations requiring authorization.
Not stated here
The notice does not say how Aetna decides marketing is "unrelated to your benefit plan," and treats treatment alternatives and health-related benefits and services as permitted without authorization.
Account & Service Control · User right or choice
You can revoke an authorization in writing at any time, unless Aetna has already acted on it
If you have given Aetna an authorization, you may revoke it in writing at any time, if Aetna has not already acted on it. For questions about authorizations you can call the toll-free Customer Services number on your ID card.
Supporting quotations
If you have given us an authorization, you may revoke it in writing at any time, if we have not already acted on it.
If you have questions regarding authorizations, please call the toll-free Customer Services number on your ID card.
Qualifications & exceptions
Revocation does not undo something Aetna has already acted on.
Sharing & Disclosure · Restriction or exception
Health information disclosed as HIPAA permits may be redisclosed by the recipient and no longer protected by HIPAA
The notice warns that protected health information disclosed as HIPAA permits may be redisclosed by the recipient and may then no longer be protected by HIPAA.
Supporting quotations
PHI disclosed as permitted by HIPAA may be subject to redisclosure by the recipient and no longer protected by HIPAA.
Not stated here
The notice does not say whether other laws or the recipient's own policies would still protect the information.
Legal Rights & Agreement Rules · Restriction or exception
Stricter laws may protect sensitive categories of health information, and Aetna says it follows the stricter rule
Aetna says some state and federal laws may require special privacy protections, including requirements to obtain attestations from requestors, that limit use and disclosure of certain sensitive health information. The notice lists 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 stricter, more protective law where it applies to Aetna, and you can contact the Aetna Privacy Office for more information.
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. Such laws may protect 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
Sexually transmitted diseases
We will follow the law that is stricter (or more protective of your PHI), where it applies to us. If you would like additional information about additional use or disclosure restrictions that may apply to your sensitive PHI, please contact the Aetna Privacy Office.
Qualifications & exceptions
The list is of information that such laws "may" protect; it does not say which laws or states apply to your plan.
Aetna follows the stricter law only "where it applies to us."
Not stated here
The notice does not name the laws, say which apply to a given student plan, or explain what attestations from requestors involve.
Aetna is not a substance use disorder treatment program but may hold information from one
Aetna says it is not a substance use disorder treatment program, but it may receive or keep information about you that comes from one. If such a program provides the information through a consent under 42 CFR Part 2, including a consent for future uses and disclosures for treatment, payment and health care operations, Aetna says it will use or share the information in accordance with both the consent and HIPAA.
Supporting quotations
We are not a substance use disorder treatment program. We may receive or keep information about you that comes from a substance use disorder program. If a substance use disorder program provides us this information through a 42 CFR Part 2 consent, including a consent for future uses and disclosures for treatment, payment, and health care operations, we will use or share that information in accordance with both the consent and HIPAA.
Qualifications & exceptions
Applies where the information arrives through a 42 CFR Part 2 consent.
Not stated here
The notice cites 42 CFR Part 2 without describing it; this card does not explain that law.
Legal Rights & Agreement Rules · Restriction or exception
Without your permission, Aetna says it follows the more protective law in limited situations
Aetna says that in limited situations where it may disclose substance use disorder information without your permission, such as medical emergencies and government audits, it will follow the law that is more protective of your information.
Supporting quotations
In limited situations where we may disclose this information without your permission, such as medical emergencies and government audits, we will follow the law that is more protective of your information.
Qualifications & exceptions
Limited situations; the examples given are medical emergencies and government audits, introduced with "such as."
Not stated here
The notice does not list all the limited situations or say which law is more protective in each.
Legal Rights & Agreement Rules · Restriction or exception
Substance use disorder information is not used in a legal case against you without consent or a court order
Aetna says it 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 are written consent, or a court order backed by a subpoena or other legal requirement.
You or Aetna must also receive notice and a chance to be heard.
Not stated here
The phrase "You or Aetna" does not say who must receive notice in a given case or whether both must.
Your privacy rights come from the federal privacy regulations
The notice says the federal privacy regulations give you several rights regarding your health information, then lists them. They are described in the cards that follow.
Supporting quotations
The federal privacy regulations give you several rights regarding your health information.
Account & Service Control · User right or choice
You can ask Aetna to communicate with you in a certain way or at a certain location
You have the right to ask Aetna to communicate with you in a certain way or at a certain location. For example, if you are covered as an adult dependent, you might ask Aetna to send Explanation of Benefits forms and other claim information to a different address from your subscriber's. Aetna says it will accommodate reasonable requests.
Supporting quotations
You have the right to ask us to communicate with you in a certain way or at a certain location. For example, if you are covered as an adult dependent, you might want us to send health information (e.g. Explanation of benefits (EOB) and other claim information) to a different address from that of your subscriber. We will accommodate reasonable requests.
Qualifications & exceptions
Aetna says it accommodates reasonable requests.
Not stated here
The notice does not say what makes a request unreasonable or how to submit it beyond the Customer Services number in a later passage.
Cross-references
qualifies (model-proposed): Explanation of Benefits forms and claim information are mailed to the subscriber — qualifies: Aetna mails Explanation of Benefits forms to the subscriber's address on record; the rights section lets you ask Aetna to communicate at a different address or in a certain way, and Aetna says it will accommodate reasonable requests.
Account & Service Control · User right or choice
You can ask Aetna to restrict uses and disclosures, but it may not agree
You have the right to ask Aetna to restrict how it uses or discloses health information for health care operations, payment and treatment, and to restrict disclosures to persons involved in your health care. Aetna says it will consider but may not agree to such requests. The notice separately says you have the right to stop or limit disclosures to relatives, friends and others involved in your care by calling the toll-free Customer Services number.
Supporting quotations
You have the right to ask us to restrict the way we use or disclose health information about you in connection with health care operations, payment, and treatment. We will consider, but may not agree to, such requests. You also have the right to ask us to restrict disclosures to persons involved in your health care.
You have the right to stop or limit this kind of disclosure by calling the toll-free Customer Services number on your ID card.
Qualifications & exceptions
Aetna "will consider, but may not agree to" restriction requests for operations, payment and treatment.
The Disclosure to Others Involved in Your Health Care section describes a right to "stop or limit" that kind of disclosure, which reads more firmly than a request Aetna may decline.
Not stated here
The notice does not reconcile "right to stop or limit" family and friend disclosures with "may not agree" for restriction requests to persons involved in your care, so it is unclear whether Aetna can decline the latter.
Account & Service Control · User right or choice
You can ask for a copy of records in your designated record set
You have the right to ask Aetna for a copy of health information in your designated record set, meaning medical records and other records maintained and used in making enrollment, payment, claims adjudication, medical management and other decisions. Aetna may ask for the request in writing, may charge a reasonable fee for producing and mailing copies, and in certain cases may deny the request.
Supporting quotations
You have the right to ask us to obtain a copy of health information that is contained in a “designated record set” – medical records and other records maintained and used in making enrollment, payment, claims adjudication, medical management, and other decisions. We may ask you to make your request in writing, may charge a reasonable fee for producing and mailing the copies, and, in certain cases, may deny the request.
Qualifications & exceptions
Aetna may ask for a written request, may charge a reasonable fee for producing and mailing copies, and may deny the request in certain cases.
Not stated here
The notice does not say in which cases a request may be denied or how large the fee may be.
Account & Service Control · User right or choice
You can ask Aetna to amend your records, in writing with a reason
You have the right to ask Aetna to amend health information in your designated record set. The request must be in writing and include the reason. If Aetna denies the request, you may file a written statement of disagreement.
Supporting quotations
You have the right to ask us to amend health information that is in a “designated record set.” Your request must be in writing and must include the reason for the request. If we deny the request, you may file a written statement of disagreement.
Qualifications & exceptions
The request must be in writing and include the reason for it.
Not stated here
The notice does not say what happens to a statement of disagreement once filed.
Account & Service Control · User right or choice
You can ask for a list of certain disclosures; a fee may apply to repeat requests
You have the right to ask Aetna for a list of certain disclosures it has made about you, such as disclosures to government agencies that license it. The request must be in writing. If you ask for such an accounting more than once in a 12-month period, Aetna may charge a reasonable fee.
Supporting quotations
You have the right to ask us to provide a list of certain disclosures we have made about you, such as disclosures of health information to government agencies that license us. Your request must be in writing. If you request such an accounting more than once in a 12-month period, we may charge a reasonable fee.
Qualifications & exceptions
Request must be in writing; a reasonable fee may apply to more than one request in 12 months.
Not stated here
The notice does not say which disclosures are included or excluded from the list.
Security & Safeguards · User right or choice
You have the right to be notified of a breach involving your health information
You have the right to be notified following a breach involving your health information.
Supporting quotations
You have the right to be notified following a breach involving your health information.
Not stated here
The notice does not say how or how quickly Aetna notifies you.
Use & Processing · User right or choice
Underwriting: reasons for unfavorable decisions, and genetic information is not used
You have the right to know the reasons for an unfavorable underwriting decision. Previous unfavorable underwriting decisions may not be used as the basis for future underwriting decisions unless Aetna makes an independent evaluation of the basic facts. Your genetic information cannot be used for underwriting purposes.
Supporting quotations
You have the right to know the reasons for an unfavorable underwriting decision. Previous unfavorable underwriting decisions may not be used as the basis for future underwriting decisions unless we make an independent evaluation of the basic facts. Your genetic information cannot be used for underwriting purposes.
Qualifications & exceptions
A prior unfavorable underwriting decision can be a basis for a later one only after an independent evaluation of the basic facts.
Legal Rights & Agreement Rules · User right or choice
Pretext interviews: a right not to be subjected to them, and Aetna says it does not participate
You have a right, with very limited exceptions, not to be subjected to pretext interviews, and Aetna says it does not participate in pretext interviews.
Supporting quotations
You have the right with very limited exceptions, not to be subjected to pretext interviews.
We do not participate in pretext interviews.
Qualifications & exceptions
Subject to very limited exceptions.
Not stated here
The notice does not define pretext interviews or name the exceptions; a footnote marker "2" follows the right in the supplied text, but no footnote text for it appears in the supplied source.
Account & Service Control · Procedure
You can make these requests or ask for a paper copy of the notice by calling Customer Services
You may make the requests described above, ask for a paper copy of the notice, or ask questions about the notice by calling the toll-free Customer Services number on your ID card.
Supporting quotations
You may make any of the requests described above, may request a paper copy of this notice, or ask questions regarding this notice by calling the toll-free Customer Services number on your ID card.
Not stated here
Several rights say requests must be in writing; the notice does not reconcile that with making the request by phone.
Account & Service Control · Procedure
You can file a privacy complaint with Aetna or the federal health secretary and will not be penalized
If you think your privacy rights have been violated, you can email the Aetna Privacy Office or write to the HIPAA Member Rights Team at the address given. You may also write to the Secretary of the U.S. Department of Health and Human Services, and the notice says you will not be penalized for filing a complaint.
Supporting quotations
You also have the right to file a complaint if you think your privacy rights have been violated. To do so, please send an email to Aetna Privacy Office at PrivacyAetna@aetna.com or send your inquiry to the following address:
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. You will not be penalized for filing a complaint.
Account & Service Control · User right or choice
You can stop paper mailing of Explanation of Benefits forms by registering on aetna.com
You may stop the paper mailing of Explanation of Benefits forms and other claim information by visiting aetna.com, selecting "Log In/Register," and completing the one-time registration. You can then log in at any time to view past copies of those forms.
Supporting quotations
You may stop the paper mailing of your EOB and other claim information by visiting www.aetna.com and click “Log In/Register”. Follow the prompts to complete the one-time registration. Then you can log in any time to view past copies of EOBs and other claim information.
Legal Rights & Agreement Rules · Company commitment
Federal privacy regulations require Aetna to keep personal information private and follow this notice
The notice says the federal privacy regulations require Aetna to keep your personal information private, to give you notice of its legal duties and privacy practices, and to follow the terms of the notice currently in effect.
Supporting quotations
The federal privacy regulations require us to keep personal information about you private, to give you notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
Security & Safeguards · Company commitment
Aetna says it uses administrative, technical and physical safeguards
Aetna says it guards your information with administrative, technical and physical safeguards against unauthorized access and against threats and hazards to its security and integrity, and that it complies with all applicable state and federal law on the security and confidentiality of personal information.
Supporting quotations
We guard your information with administrative, technical, and physical safeguards to protect it against unauthorized access and against threats and hazards to its security and integrity.
We comply with all applicable state and federal law pertaining to the security and confidentiality of personal information.
Not stated here
The notice does not describe the specific safeguards.
Legal Rights & Agreement Rules · Permission or license
Aetna may change the notice at any time, and new terms apply to information it already has
Aetna may change the terms of this notice and its privacy policies at any time. If it does, the new terms and policies apply to all the information it already has about you as well as any it receives or holds in the future.
Supporting quotations
We may change the terms of this notice and our privacy policies at any time. If we do, the new terms and policies will be effective for all of the information that we already have about you, as well as any information that we may receive or hold in the future.
Not stated here
The notice does not say how members will be told of a change.
Retention & Deletion · Company practice
Aetna does not destroy your personal information when your coverage ends
Aetna says it does not destroy personal information about you when you terminate coverage, because it may be necessary to use and disclose that information for the purposes described in the notice even after coverage ends. It says policies and procedures remain in place to protect against inappropriate use or disclosure.
Supporting quotations
Please note that we do not destroy personal information about you when you terminate your coverage with us. It may be necessary to use and disclose this information for the purposes described above even after your coverage terminates, although policies and procedures will remain in place to protect against inappropriate use or disclosure.
Not stated here
The notice does not state a retention period or how long after coverage ends information is kept.