2.0 KiB
type, category, person, source
| type | category | person | source |
|---|---|---|---|
| insurance-card | medical | Yanxin Lu | lu_medical_card.png |
Yanxin Lu — Aetna Medical Insurance Card
Member and Network Information for Providers
| Field | Value |
|---|---|
| Group # | 16424 |
| Member | YANXIN LU |
| Member ID | 3928092626 |
| Network | Aetna Choice POS II |
| Plan | EPO |
Copays
| Service | Copay |
|---|---|
| Office Visit | $15 |
| Specialist | $15 |
| Urgent Care | $25 |
| ER | $100 |
| INN OOP | $3,000 |
- Claims Payer: Meritain Health
- For Submission, see reverse
Pharmacy Plan
| Field | Value |
|---|---|
| RXBIN | 610014 |
| RXPCN | ADV |
| RXGRP | RX2336 |
Pharmacy: CVS Caremark
Pharmacy Member: 844.248.4511
Pharmacy Provider: 800.364.6331
Providers Only
| Field | Value |
|---|---|
| Provider Service | 866.761.3018 |
| Precertification | 866.415.6831 |
| Non-Physician | $42 |
Member Support
| Field | Value |
|---|---|
| Call | 844.287.3866 |
| Website | mymeritain.apcbcbs.com |
Download Acrcolade Mobile to send a secure message with questions about eligibility, claims and plan benefits.
Extras available by phone 24/7.
Claims Submission / Appeals
Mail All Claims & Correspondence to:
Meritain Health, PO Box 853921
Richardson TX 75085-3921
EDV: WidER/Endpoint/ChangeHealthcare
at 47424 or MascoCapGroup/Health 1933
Mail All Appeal Correspondence to:
Meritain Health, PO Box 27651
Golden Valley MN 55427
Precertification
Pre-authorization is required before a primary care doctor may refer to another physician. Some services may require precertification. Without pre-approval, you may be responsible for some or all costs. Please review or comply with your plan's precertification requirements listed on the back of this card.
Call Progyny at 844.734.8366 to pre-certify and enhance any fertility benefits.
Elected into the NY Pool
The Plan Sponsor and Hospitals are independent providers and are neither agents nor employees of Aetna.
Network: First Health Network