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Getting preapproval

To help you get the best care at a lower price, Aetna requires preapproval for some medical services. These include:

  • Advanced imaging like MRIs and CAT scans
  • Hospital stays
  • Certain ambulatory procedures

An in-network doctor should obtain this preapproval for you. It’s part of their contract with Aetna. If they don’t get approval and your claim is denied, you can contact Aetna right away for resolution.

If you use a doctor outside the network, you’ll have to get any required preapprovals yourself. If you don’t, you may be responsible for payment if the claim is denied.

Preapproval is not required for emergency care.

 

 

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