Aetna voluntary plans notice of privacy practices

Account & Service Control · Procedure

Spanish copy available by calling Member Services

A line in Spanish says that to receive this notice in Spanish you should call the toll-free Member Services number printed on your ID card.

Supporting quotations

Para recibir esta notificación en español por favor llamar al número gratuito de Member Services (Servicios a Miembros) que figura en su tarjeta de identificación.

Qualifications & exceptions

• Request is made by phone using the number on the ID card

Not stated here

• The Spanish version is not part of the supplied text

Account & Service Control · User right or choice

Minors may be able to block parental access

If you are a minor, you also may have the right to block parental access to your health information in certain circumstances, if state law permits. You can call the toll-free Customer Service number in the notice, 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 Service number at 1-888-772-9682 – or have your provider contact us.

Qualifications & exceptions

• Only “may”: depends on circumstances and on state law permitting it
• Contact is by phone or through your provider

Not stated here

• The circumstances and the state laws involved are not described

Account & Service Control · User right or choice

You can revoke an authorization in writing

If you have given Aetna an authorization, you may revoke it in writing at any time, if Aetna has not already acted on it. Questions about authorizations can be directed to the toll-free Customer Service number in the notice.

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 Service number at 1-888-772-9682.

Qualifications & exceptions

• Revocation must be in writing
• Does not undo what Aetna has already acted on

Account & Service Control · User right or choice

Right to ask for communications in a certain way or place

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 want health information such as Explanation of Benefits and other claim information sent to a different address from your subscriber’s. Aetna says it will accommodate reasonable requests. This is separate from the default of mailing Explanation of Benefits forms to the subscriber’s address on record.

Supporting quotations

The federal privacy regulations give you several rights regarding your health information.

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.

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

• Aetna will accommodate “reasonable” requests
• The example involves an adult dependent whose subscriber is a different person

Not stated here

• The notice does not define which requests are reasonable

Cross-references

• qualifies (model-proposed): Explanation of Benefits mailed to the subscriber’s address — The right to ask for communications at a different address qualifies the default of mailing EOBs to the subscriber’s address on record.

Account & Service Control · User right or choice

Right to ask for restrictions, which Aetna may refuse

You have the right to ask Aetna to restrict how it uses or discloses health information about you for health care operations, payment and treatment. Aetna says it will consider such requests but may not agree to them. You also have the right to ask Aetna to restrict disclosures to persons involved in your health care. Elsewhere the notice 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 Service 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.

Disclosure to Others Involved in Your Health Care

You have the right to stop or limit this kind of disclosure by calling the toll-free Customer Service number at 1-888-772-9682.

Qualifications & exceptions

• For operations, payment and treatment, Aetna will consider the request but may not agree
• Restrictions on disclosures to persons involved in your care are described both as a request and, in the earlier section, as a right to stop or limit by phone

Not stated here

• The notice does not say whether a request to restrict disclosures to persons involved in your care can be refused

Cross-references

• contrast (model-proposed): Disclosure to people involved in your care, and your right to stop it — One section describes a right to stop or limit disclosure to people involved in your care by phone; the rights section describes a right to ask Aetna to restrict such disclosures. The notice does not say whether the request can be refused for these disclosures, as it can for operations, payment and treatment.

Account & Service Control · User right or choice

Right to a copy of your designated record set

You have the right to ask Aetna to obtain a copy of health information in a 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 you to make the request in writing, may charge a reasonable fee for producing and mailing the 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

• May require a written request
• May charge a reasonable fee for producing and mailing copies
• May deny the request in certain cases

Not stated here

• The notice does not state the fee amount, the response time or the cases in which a request may be denied

Account & Service Control · User right or choice

Right to ask for amendment of your records

You have the right to ask Aetna to amend health information in a designated record set. The request must be in writing and must 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

• Request must be in writing and include a reason
• If denied, you may file a written statement of disagreement

Not stated here

• The notice does not state when Aetna may deny an amendment or whether the statement of disagreement is attached to your record

Account & Service Control · User right or choice

Right to a list of certain disclosures

You have the right to ask Aetna for a list of certain disclosures it has made about you, such as disclosures of health information to government agencies that license it. The request must be in writing. If you request 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

• Covers “certain” disclosures, not all
• Request must be in writing
• Reasonable fee may apply to a second or later request within 12 months

Not stated here

• Which disclosures are included or excluded is not listed beyond the licensing-agency example

Account & Service Control · Procedure

How to make requests and get a paper copy

The notice says you may make any of the requests described above, request a paper copy of the notice, or ask questions about the notice by calling the toll-free Customer Service number. Several of the rights above require a written request, so a phone call may not be enough for those.

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 Service number at 1-888-772-9682.

Qualifications & exceptions

• Phone number given is 1-888-772-9682
• Some rights separately say the request must be in writing

Not stated here

• The notice does not say how a written request is submitted for those rights, apart from the complaint address

Account & Service Control · User right or choice

Stop paper mailing of EOBs by registering online

You may stop the paper mailing of your EOB and other claim information by visiting www.aetna.com, clicking Log In/Register and completing the one-time registration. You can then log in to view past copies of EOBs and other claim information.

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.

Qualifications & exceptions

• Requires one-time online registration
• Past copies are then viewable online

Not stated here

• The notice does not say what information Aetna collects at registration

Cross-references

• qualifies (model-proposed): Explanation of Benefits mailed to the subscriber’s address — Online registration lets you stop paper mailing of EOBs, which otherwise go to the subscriber’s address on record.