Aetna Implements New Newborn/Adoption Policy
Effective November 16, 2009, Aetna implemented a new policy for dependent verification related to newborn/adopted child(children) for all Aetna Advantage Plans for Individuals, Families and Self-Employed nationwide. The new policy requires an attestation form verifying eligibility for the newborn/adopted child(children) to be submitted in order for the newborn/adopted child(children) to be added to the member’s policy after the first 31 days of life/adoption.
A verification form is required if:
- The mother is not on the plan
- The mother is on the plan, but has no record of maternity claims
- Adoption
To add a newborn/adopted child to the member’s policy, Aetna requires a completed attestation form from the subscriber/member within 31 days of the date-of-birth/adoption. In order for the child to remain on the plan, the policyholder must provide a birth certificate, Adoption Decree or proof of legal responsibility within 60 days of DOB/Adoption unless otherwise required by the state. If documentation is not received within the allotted time frame, the request for coverage may be declined.
Note: The newborn/adopted child will be covered under the policyholder’s plan during the first 31 days (whether or not we receive a form as is required by the state).
No additional verification is required if the mother is covered under an Aetna Advantage Plan, either as a subscriber or dependent, and has maternity-related claims in the system or an admission for delivery is indicated. Newborn child(children) will be enrolled when Aetna receives a written request within state guidelines.
