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Idaho, Washington and Oregon: American Specialty Health provides Aetna® with an Individual MA supplemental benefits program

 

American Specialty Health (ASH) is providing Aetna with an Individual Medicare Advantage (MA) supplemental benefits program option (some Individual MA plans are excluded) with a benefit for chiropractic, acupuncture, naturopathy and therapeutic massage.

 

Chiropractic and acupuncture

 

The supplemental benefits option provides routine services and benefits as well as Centers for Medicare & Medicaid Services’ required benefit for chiropractic (subluxation) and the newly defined, CMS-required acupuncture benefit (chronic low back pain). The supplemental benefits program options go beyond CMS required benefits for chiropractic and acupuncture and provide members with a broader range of covered services for a broader range of conditions.

 

Naturopathy and therapeutic massage

 

ASH provides a supplemental benefits option for naturopathy and therapeutic massage even though these services are not currently required/covered by CMS.

 

Claims

 

This program is fully delegated (credentialing, claims and patient management) for all administrative and claims costs for in-network and out-of-network (if applicable) benefits. Under this program, ASH provides a credentialed/contracted practitioner network that submits claims through ASH for program services.

 

More information

 

Providers interested in joining the ASH network or who have questions about Aetna program participation can call ASH at 1-888-511-2743.

 

State-specific county and supplemental benefits offerings

 

Idaho

 

For non-Medicare members, Aetna uses Network Management Group’s network to provide acupuncture, chiropractic, massage therapy and naturopathy services (when covered). Providers contracted with NMG for Medicare may also provide CMS-required benefits only to Medicare members. Providers interested in joining the NMG network can call NMG at 1-801-747-3228.

 

See the chart below for alternative benefits offerings administered by American Specialty Health Specialties.

 

Plan name

Plan type

Counties

2023 supplemental benefit

Elite Plan

HMO- POS

Ada, Canyon, Elmore, Gem, Owyhee, Payette, Washington

Acupuncture

Choice Plan

PPO

Ada, Canyon, Elmore, Gem, Owyhee, Payette, Washington

Therapeutic massage

Acupuncture

Eagle Plan

PPO- MA Only

Ada, Bonner, Canyon, Elmore, Gem, Kootenai, Owyhee, Payette, Shoshone, Washington

Acupuncture

Choice Plan

PPO

Bonner, Kootenai, Shoshone

Therapeutic massage

Naturopathy

Plan name

Elite Plan

Plan type

HMO- POS

Counties

Ada, Canyon, Elmore, Gem, Owyhee, Payette, Washington

2023 supplemental benefit

Acupuncture

Plan name

Choice Plan

Plan type

PPO

Counties

Ada, Canyon, Elmore, Gem, Owyhee, Payette, Washington

2023 supplemental benefit

Therapeutic massage

Acupuncture

Plan name

Eagle Plan

Plan type

PPO- MA Only

Counties

Ada, Bonner, Canyon, Elmore, Gem, Kootenai, Owyhee, Payette, Shoshone, Washington

2023 supplemental benefit

Acupuncture

Plan name

Choice Plan

Plan type

PPO

Counties

Bonner, Kootenai, Shoshone

2023 supplemental benefit

Therapeutic massage

Naturopathy

 

Washington

 

For non-Medicare members, Aetna uses Tivity Health, Healthway’s Whole Health Network (HWHN) (in WA and Kootenai County, ID) to provide acupuncture, chiropractic, massage therapy and naturopathy services (when covered). Providers contracted with HWHN Medicare may also provide CMS-required benefits only to Medicare members. Providers interested in joining the HWHN network can call HWHN at 1-800-274-7526.

 

See the chart below for alternative benefits offerings administered by American Specialty Health Specialties.

 

Plan name

Plan type

Counties

2023 supplemental benefit

Value Plan

HMO- POS

Clark, Cowlitz

Therapeutic massage

Chiropractic

Naturopathy

Elite Plan

HMO- POS

Clark, Cowlitz

Therapeutic massage

Chiropractic

Naturopathy

Value Plan

HMO- POS

Spokane, Stevens

Therapeutic massage

Naturopathy

Elite Plan

HMO- POS

Spokane, Stevens

Therapeutic massage

Naturopathy

Value Plus Plan

HMO- POS

King, Kitsap, Lewis, Pierce, Snohomish, Thurston

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Platinum Plus Plan

HMO- POS

King, Kitsap, Lewis, Pierce, Snohomish, Thurston

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Elite Plan

HMO- POS

King, Kitsap, Lewis, Pierce, Snohomish, Thurston

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Value Plus Plan

HMO- POS

Benton, Franklin, Walla Walla, Yakima

Therapeutic massage

Chiropractic

Acupuncture

Value Plan

HMO- POS

Mason

Therapeutic massage

Chiropractic

Platinum Plan

HMO- POS

Mason

Therapeutic massage

Chiropractic

Prime Plan

HMO- POS

Pierce

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Choice Plan

PPO

Clark, Cowlitz, King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Thurston

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Select Plan

PPO

King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Thurston

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Eagle Plan

PPO- MA Only

Benton, Clark, Cowlitz, Franklin, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Yakima

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Choice Plan

PPO- MA Only

Benton, Franklin, Walla Walla, Yakima

Therapeutic massage

Chiropractic

Acupuncture

Preferred Plan

PPO

King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Spokane, Thurston

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Choice Plan

PPO

Mason

Therapeutic massage

Chiropractic

Plan name

Value Plan

Plan type

HMO- POS

Counties

Clark, Cowlitz

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Plan name

Elite Plan

Plan type

HMO- POS

Counties

Clark, Cowlitz

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Plan name

Value Plan

Plan type

HMO- POS

Counties

Spokane, Stevens

2023 supplemental benefit

Therapeutic massage

Naturopathy

Plan name

Elite Plan

Plan type

HMO- POS

Counties

Spokane, Stevens

2023 supplemental benefit

Therapeutic massage

Naturopathy

Plan name

Value Plus Plan

Plan type

HMO- POS

Counties

King, Kitsap, Lewis, Pierce, Snohomish, Thurston

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Platinum Plus Plan

Plan type

HMO- POS

Counties

King, Kitsap, Lewis, Pierce, Snohomish, Thurston

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Elite Plan

Plan type

HMO- POS

Counties

King, Kitsap, Lewis, Pierce, Snohomish, Thurston

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Value Plus Plan

Plan type

HMO- POS

Counties

Benton, Franklin, Walla Walla, Yakima

2023 supplemental benefit

Therapeutic massage

Chiropractic

Acupuncture

Plan name

Value Plan

Plan type

HMO- POS

Counties

Mason

2023 supplemental benefit

Therapeutic massage

Chiropractic

Plan name

Platinum Plan

Plan type

HMO- POS

Counties

Mason

2023 supplemental benefit

Therapeutic massage

Chiropractic

Plan name

Prime Plan

Plan type

HMO- POS

Counties

Pierce

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Choice Plan

Plan type

PPO

Counties

Clark, Cowlitz, King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Thurston

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Select Plan

Plan type

PPO

Counties

King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Thurston

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Eagle Plan

Plan type

PPO- MA Only

Counties

Benton, Clark, Cowlitz, Franklin, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Yakima

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Choice Plan

Plan type

PPO- MA Only

Counties

Benton, Franklin, Walla Walla, Yakima

2023 supplemental benefit

Therapeutic massage

Chiropractic

Acupuncture

Plan name

Preferred Plan

Plan type

PPO

Counties

King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Spokane, Thurston

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Choice Plan

Plan type

PPO

Counties

Mason

2023 supplemental benefit

Therapeutic massage

Chiropractic

 

Oregon

 

See the chart below for alternative benefits offerings administered by American Specialty Health Specialties.

Plan name

Plan type

Counties

2023 supplemental benefit

Elite Plan

HMO- POS

Clackamas, Columbia, Marion, Multnomah, Polk, Washington, Yamhill

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Value Plan

HMO- POS

Clackamas, Columbia, Jackson, Josephine, Marion, Multnomah, Polk, Washington, Yamhill

Chiropractic

Naturopathy

Eagle Plan

PPO- MA Only

Clackamas, Columbia, Jackson, Josephine, Marion, Multnomah, Polk, Washington, Yamhill

Therapeutic massage

Choice Plan

PPO

Clackamas, Columbia, Marion, Multnomah, Polk, Washington, Yamhill

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Elite Plan

HMO- POS

Jackson, Josephine

Chiropractic

Choice Plan

PPO

Jackson, Josephine

Chiropractic

Plan name

Elite Plan

Plan type

HMO- POS

Counties

Clackamas, Columbia, Marion, Multnomah, Polk, Washington, Yamhill

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Value Plan

Plan type

HMO- POS

Counties

Clackamas, Columbia, Jackson, Josephine, Marion, Multnomah, Polk, Washington, Yamhill

2023 supplemental benefit

Chiropractic

Naturopathy

Plan name

Eagle Plan

Plan type

PPO- MA Only

Counties

Clackamas, Columbia, Jackson, Josephine, Marion, Multnomah, Polk, Washington, Yamhill

2023 supplemental benefit

Therapeutic massage

Plan name

Choice Plan

Plan type

PPO

Counties

Clackamas, Columbia, Marion, Multnomah, Polk, Washington, Yamhill

2023 supplemental benefit

Therapeutic massage

Chiropractic

Naturopathy

Acupuncture

Plan name

Elite Plan

Plan type

HMO- POS

Counties

Jackson, Josephine

2023 supplemental benefit

Chiropractic

Plan name

Choice Plan

Plan type

PPO

Counties

Jackson, Josephine

2023 supplemental benefit

Chiropractic

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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