August 6, 2018
Dear SWSCHP Retiree,
As an Aetna Medicare Advantage member you have been identified as a retiree that utilizes the Montefiore Health System. You may have received a letter from Aetna that as of September 8, 2018 Montefiore Health System will no longer be in the Aetna Medicare Advantage PPO network of participating providers.
Aetna is required by the Centers for Medicare and Medicaid Services (CMS) to send notices when a provider no longer participates with the plan. Please do not be alarmed, you will be able to continue to receive services from Montefiore Health System. The SWSCHP Aetna Medicare Advantage PPO ESA plan designed for SWSCHP Medicare primary members does not require you to see providers that are in the Aetna network. As long as the provider accepts Medicare and willing to bill the plan you can continue to receive services and you will have the same cost share as if you were receiving services from a participating provider, just like you do today.
Aetna continues to work with Montefiore Health System and may reach an agreement prior to September 8, 2018. Should an agreement be reached Aetna will send out a notice making you aware. Regardless, of whether an agreement is reached; SWSCHP wants you to know that you do not need to make any changes to the providers you see today.
For any questions regarding this letter or about your Montefiore Health System, please contact Aetna at 1-855-395-9722 Monday through Friday from 8 am to 6 pm in all time zones.
SWSCHP Executive Director
Are You Using the Quest Diagnostics Lab Card?
24 July 2018 - The Lab Card program allows you to obtain laboratory testing services at NO COST to you when you use a Quest Diagnostics laboratory. When the testing is covered and approved by your health benefit plan and provided through Quest Diagnostics —you pay no deductibles, no copays and no coinsurance.*
At your physician’s office, show your SWSCHP healthcare card and/or your separate Quest Diagnostics Lab Card and verbally request to use the LabCard Program. The testing must be covered and approved by your health benefit plan and Lab Card must be clearly marked on the paperwork that accompanies your specimens.
Your physician can collect your specimens in the office and call for the specimens to be picked up. Or you can contact your Care Coordinators at 1-888-779-7247 www.swschp.org or visit www.LabCard.com or call 1-800-646-7788 for an approved Lab Card collection site. Quest Diagnostics performs the tests and sends the results to your doctor (usually the next day).
YOU SAVE! No deductibles, no copays
What if I receive a bill for lab work?
If you receive a bill from Quest Diagnostics after receiving an explanation of benefits or denial for services from your health benefit plan, and you disagree with the denial, contact your Care Coordinator for assistance. If the denial of services is due to lack of health benefit plan coverage, you will be responsible for payment. If you have questions about whether or not specific testing is covered, please consult your health benefit plan.
Can testing under the Lab Card Program be sent to any Quest Diagnostics laboratory?
Yes. To ensure you receive the benefit of the Lab Card Program, you should show your SWSCHP healthcare card and/or Quest Diagnostics Lab Card and verbally request to use the Lab Card Program. Your physician should clearly mark Lab Card on your laboratory orders and call 1-800-646-7788 for a Lab Card pick up. Or, visit our website: www.LabCard.com to locate an approved
collection facility, which will collect your specimen, send it to an approved Quest Diagnostics laboratory and the results will be sent
back to your physician, typically the next day.