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. The Braven Health℠ name and symbols are service marks of Braven Health.By clicking on “I Accept”, I acknowledge and accept that: The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. The Blue Cross® and Blue Shield® name and symbols are registered marks of the Blue Cross Blue Shield Association. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. This website does not display all Qualified Health Plans available through Get Covered NJ. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. Educational Materials Educational Materials.Resources for New Members Resources for New Members.Navigating the Health Network Navigating the Health Network.Explanation of Benefits Explanation of Benefits.Understanding Your Coverage Understanding Your Coverage.Employee Health Coaching Employee Health Coaching.Healthy Rewards at Work Healthy Rewards at Work.Private Information Forms Private Information Forms.Prescription Drug Mail Order Prescription Drug Mail Order.FEP 32275 Request To Represent A Deceased Member (0516) FEP 32275 Request To Represent A Deceased Member (0516).Federal Employee Program Privacy Forms Federal Employee Program Privacy Forms.Enroll / Elect / Apply Enroll / Elect / Apply.Spending / Savings Account Spending / Savings Account.Individual & Family Individual & Family.State & School Employees State & School Employees.
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