If you are currently receiving ongoing treatment for a serious medical condition, you may be eligible for transition of care. Aetna offers a Transition of Care program to allow newly enrolled members to complete ongoing care with their current provider or to transition smoothly from their current provider to an Aetna network provider. Applicants for such care are subject to meeting the program’s eligibility requirements and receiving approval from Aetna, before they can receive care in 2023.
Applying for Transition Coverage
If you are in an active course of care and your provider is not in the Aetna network, follow these steps to apply for transition coverage for ongoing treatment.
- Download the appropriate Transition Coverage Request form:
- If you’re enrolling in the Aetna HMO: HMO Transition Coverage Request form
- If you’re enrolling in either the Aetna Managed Choice POS or Managed Choice POS HDHP: CA OAMC Transition Coverage Request form
- Complete sections 1 through 3 of the form.
- Give the form to your health care provider to complete section 4.
- Fax the completed form to Aetna at 1-859-455-8650 for review.
- Aetna will send you a letter explaining their decision on your request.
Details on transition of care, including what kinds of treatment are eligible for transition of care, can be found on each form.
More Details on the Way
We’ll be providing more information and resources about transition of care in the coming weeks, including a Transition to Aetna Guide, which contains detailed information for those in an ongoing course of treatment at year end. The guide will be mailed to your home in mid-October.
Please contact LMU Human Resources at OpenEnrollment2023@lmu.edu with any questions.
