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What is Direct - Settlement ?

"Direct-Settlement" are arrangements that Aetna has established with leading hospitals and clinics throughout the world, to facilitate admissions and payment processes for our members. When Aetna members seek care at contracted “Direct-Settlement” medical facilities, we’ll take care of the up-front costs so that they can focus on getting the care they require.

We want our members to have convenient access to health care wherever they are in the world. This includes helping them manage their out-of-pocket expenses for higher-cost treatments such as inpatient hospitalizations, complex medical procedures and emergency care. That’s why we’re continuing to develop direct-settlement partnerships with leading international hospitals and other medical facilities in all areas where our members work and travel. Please note, we do not offer direct-settlement arrangements to individual doctors for health care expenses such as routine checkups or office visits. Members are responsible for paying the doctor directly and then submitting a claim to Aetna for reimbursement for those out-of-pocket expenses.

A list of "Direct-Settlement" facilities for pre-planned or non-emergency procedures can be found in our online database. Once members locate a facility, before scheduling an appointment they should contact Aetna to initiate a direct-settlement request to the selected facility. We will then process and send a Verification of Benefits letter to the facility if the request is approved.

In the case of an emergency, members are instructed to proceed immediately to the nearest hospital or designated medical facility. If the emergency visit results in a hospital admission, please contact Aetna as soon as possible (prior to discharge) and we will work with the facility and the member to initiate a direct-settlement arrangement on the member’s behalf.

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