July 10, 2008  GOOD NEWS FOR MIP and RMIP MEMBERS USING VANBREDA  We are very pleased to announce a new partnership between Vanbreda and Aetna.  Effective September 1, 2008, when you or your covered family members visit the United States, you will be able to access the Aetna US network for doctors, dentists, labs, hospitals, urgent care facilities and receive the In-Network benefit.  We believe this change will be positive for both members and the MIP.  We have outlined below the reasons for this change and some points to remember: Why is the US network changing for those using Vanbreda? The Aetna network offers a broader selection of network doctors and facilities than HSI, the current US network used by Vanbreda.  A disruption analysis of current HSI network usage indicates that the pricing is better and that both members and the MIP will benefit from this selection.    How do I access the Aetna network? You will receive (from Aetna) an Aetna/MIP card in August. When you are in the United States, present the Aetna card to your in-network dentist or doctor when you have services.  For medical office visits, pay the office co-pay at the time of service and the doctor will submit the claim to Aetna. The office visit co-pay does not apply to dental treatments.  Aetna and Vanbreda will adjust your claims and records behind the scenes, so you do not need to notify Vanbreda separately that you had Aetna network services nor file your network claims to Vanbreda.            How do I find an Aetna network doctor? You will be assigned to the same Open Choice PPO network used by US staff and retirees. You may go to www.aetna.com to view network choices through DocFind, or you may contact Aetna for network providers in the US area you will be staying.  Use zip code 20037 to find network providers near the World Bank. After 9/1/08, you may also register for Aetna Navigator, Aetna’s secure online member claims and healthcare site.  Only one secure sign-on is provided per household. Aetna member services can assist if you have trouble enrolling in Navigator.   Aetna contact information is provided at the end of this letter.              May I still use my US doctor who is not in the Aetna network? Yes. While the MIP strongly encourages the use of in-network services, you retain the choice to see out of network doctors. File these claims as usual to Vanbreda. Note that in the US, even if your doctor is not in the network, many services such as lab tests, x-rays, urgent care, hospital care, etc. are provided through the Aetna network and you should present your Aetna card at the time of these services to make sure you receive the network benefit. QUEST is the preferred Aetna in-network lab and they will file your claims to Aetna for you.   Lab services through LabCorp will be considered out of network and these claims should be sent to Vanbreda for out of network processing.            I need to change my home address.  Do I tell Aetna or Vanbreda? Neither. Active Staff change their address through the online HR Kiosk. Retirees are required to notify the Pension office in writing. Once the address is updated at the World Bank, the insurance records will be updated.            I’ve met my deductible for the year. How will Aetna know? Prior to 9/1/08, your annual deductible, out of pocket maximum, and lifetime accumulators will be shared with Aetna. The records will be updated monthly to avoid the need to adjust claims after initial processing.            If I buy a prescription in the United States, do I show my Aetna card? No. The US prescription plan is currently Caremark, formerly Pharmacare. When traveling in the US, carry both your Aetna and Caremark cards. (Prescription cards showing PharmaCare are still valid and do not need to be replaced).            Will access to the Aetna network change my benefits? No. Your current benefits will be in effect through 12/31/2008. If there are plan or benefit changes for 2009, you will be notified in a separate communication. Remember…. Ø      Effective 9/1/08, Aetna Open Choice PPO will be your US network for doctors, facilities, and dentists. If you have not received an Aetna card by the end of August, please contact Aetna. Ø      When you are in the US, use your Aetna card for in-network medical and in-network dental care.   Do not submit claims to Aetna – doctors, dentists, and facilities in the network do this for you. Ø      Use your Caremark (or PharmaCare) card for prescription purchases at CVS, RiteAid, Giant, Safeway, Foers, or one of many participating pharmacies.  When you present your pharmacy card at the time of purchase, you pay only your patient portion. Do not submit these patient portion receipts to Aetna or Vanbreda for further reimbursement.  Ø      Use your Vanbreda card for your non US and out of network claims. Submit these claims as usual to Vanbreda by mail, fax, or scanned attachment to mcc200@vanbreda.com. Always include your ID (UPI) in your claims or correspondence. Contact Information: Aetna and Vanbreda available by phone 24 hours a day  ********************SPECIAL NOTE FOR SURVIVING SPOUSE MEMBERS*****************************                                                             Vanbreda continues to recognize your claims under the original members ID.                           Aetna and Caremark use your surviving spouse ID and your ID cards will show this number. Insurance Contracts Administration, HRSCM – July 2008  |
