All policy exceptions to timely filing today will apply after this change and will be supported as they are today. The updated limit will: Start on JanuMaintain dental limits at 27 months Match Centers for Medicare & Medicaid Services (CMS) standards Providers will begin seeing denials in 2023. For example, creditable prescription drug coverage from an employer or union that is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage. We’ve changed the standard nonparticipating-provider timely filing limit from 27 months to 12 months for traditional medical claims.

*If you don’t have a creditable prescription drug coverage for 63 days or more, you may have to pay a late enrollment penalty. You’ll return to Original Medicare if you switch from a Medicare Advantage plan (with drug coverage) to a Medicare prescription drug plan.*

Important Note: If you change from a Medicare Advantage plan that includes prescription drug coverage to a Medicare prescription drug plan, this will disenroll you from your Medicare Advantage plan.

There are only certain times when you can disenroll. explanation of benefits form in response to the filing of any claim under a policy or certificate providing coverage for hospital or medical expenses. We'll let you know if you're able to leave your plan. This document outlines Aetna Better Health of Florida (ABHFL) standard timeframes. Medicare Advantage (MA) or Medicare Advantage Prescription Drug (MAPD)Ĭall us at the number on your ID card if you want to leave your current plan and not join another one.

Aetna claims timely filing limit