Aetna HMO Offers a broad range of voluntary, traditional, and consumer-directed health insurance products and related services. Some services include behavioral health services, medical, pharmacy, dental plans, group life and disability plans.
They serve many customers with Medicare Advantage plans, categorized into parts A, B, and C.
The different plans under Medicare are HMO, HMO-POS, Aetna D-SNP Plan, and PPO Plan, which have significant advantages attached to them.
Regardless of the plan you choose, you can get access to doctors and hospitals who have contracts with your health plan.
The doctors with contracts with your health plan are referred to as Aetna in-network doctors, while those without such contracts are called out-of-network doctors.
In-Network Doctors
These are doctors, specialists, hospitals, pharmacies, or health providers who agree to the terms and conditions of a particular health plan.
They offer their services based on their contracts and negotiations with Medicare such as Aetna. When a patient uses their services, the health plan pays for it.
Out-of-Network Doctors
These are doctors, specialists, pharmacies, hospitals, or health providers who do not have any agreement or negotiations with any health plan.
They offer their services with their prices attached to them which patients have to pay from their pocket unlike when the health plan has to pay.
When to see an Aetna Medicare In-Network Doctor
You can visit an in-network doctor in the following situations depending on the type of plan you have or the type of service you are seeking, however, you can reach out to in-network doctors in the following ways.
- For illnesses
- For Diagnosis
- For several tests
In summary, you can visit the in-network doctors for all cases except emergency care as you are typically not required to stay within the in-network in the case of an emergency.
How to Find a Doctor
You can find a doctor through the following ways:
- You can find a doctor in the plan through your employer
- You can find a doctor in the plan through individual or family plans
- You can find a doctor by contacting Aetna.
FAQs
How do I Find an Aetna care Provider near me?
You can find a health provider with Aetna by speaking with a licensed insurance agent near you. The licensed agent can help you find Aetna Medicare plans in your area.
The agent can also help you find out if the health care provider is in the plan’s network, you can find the agents 7 days a week on their general call line.
What are the Aetna Medicare plans Available?
If you enroll in the Aetna Medicare plans, you will be a part of the following available plans:
- Aetna Medicare plan (HMO)
- Aetna Medicare Open Access (HMO)
- Aetna Medicare Prime Plan (HMO)
- Aetna Medicare plan (PPO)
- Aetna Medicare Prime Plan (PPO)
- Aetna Medicare Advantage Dual Special Needs plans (DNSP)
As a Member, how do I Find a Doctor?
You can find a doctor as a member, by following the practical steps below:
- Ensure your device is connected to the internet
- Visit the website on your device
- Enter the URL below
- aetna.com
- Under already a member? Click “find a doctor?”
- Follow the on-screen instructions
Check Out:
- The Difference Between HMO, EPO, and PPO Health Insurance Plans
- HMO – Health Maintenance Organization
- HMO and PPO Health Insurance Plans
- PPO – Preferred Provider Organization
