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See below for helpful resources for managing your plan and how to get started with common requests.
You can choose someone to do all of the above. This person is your appointed representative. An appointment is good for one year from the date that you and your representative sign an Appointment of Representative form.
Fill out the form below and mail it to us. Any time your representative makes a request for you, they should send us a signed copy. You'll leave Aetna Medicare and go to the Center for Medicare & Medicaid Services (CMS) website if you link to the form.
Medicare Helpline & Website - Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. Call 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 7 days a week, 24 hours a day. If you need help in a language other than English or Spanish, say “Agent” to talk to a customer service representative. Or visit the Medicare website.
Social Security Administration - For questions about Medicare eligibility, Social Security retirement benefits or help paying for prescription drugs. Call 1-800-772-1213 or TTY: 1-800-325-0778, Monday to Friday, 8 AM to 7 PM or visit the Social Security website.
Most health care professionals and organizations that provide Medicare services are honest. Unfortunately, there may be some who are not. If you ever suspect fraud, please contact Member Services at the number on the back of your ID card, or call Medicare toll-free at 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 7 days a week, 24 hours a day.
If you’re moving or getting a new phone number, you need to tell us and School Employees Retirement System of Ohio (SERS) right away.
Call School Employees Retirement System of Ohio (SERS) at 1-800-878-5853 (TTY: 711) Monday to Friday, 8 AM to 4:30 PM ET.
We help you get medically necessary health care services in the most cost-effective way under your health plan. And we work with you and doctors to evaluate services for medical appropriateness, timeliness and cost.
Base our decisions on appropriateness of care, service and plan coverage
Use nationally recognized guidelines and resources to make changes
Don’t pay or reward providers, employees or others for denying coverage or care
Focus on reviewing the risks of members who aren’t fully using certain services
Doctors and health care companies continuously develop new technologies. This can include anything from a new procedure to a new way to use a device.
When we learn about a new technology, we:
Carefully review the latest information and ask experts for their opinions
Compare the information with well-known standards
Base all of our decisions on making sure you have the right care and services
A PPO is a preferred provider organization plan. A PPO plan with an extended service area (ESA) gives you the flexibility to see any provider, in or out of network, at the same cost, according to the costs listed on your plan benefits summary. They just have to be licensed, eligible to receive Medicare payments and willing to accept your plan. View our network of doctors, hospitals or other providers.
With a PPO plan with ESA, you have the option to choose a primary care physician. But when we know who your doctor is, we can better support your care.
Please call us or see your Evidence of Coverage for more information, including the cost share for out‐of‐network services.
The Centers for Medicare & Medicaid Services periodically issues National Coverage Determinations. They issue these when a service’s or drug’s coverage rules change.
Please note that following this link will take you to a public Aetna site and not all links on this public page will apply to your Medicare Advantage plan.