What is a PPO plan with Aetna?
Preferred provider organization (PPO) plans let you choose any provider who accepts Medicare. You don’t need a referral from a primary care physician for specialist or hospital visits. However, using providers in your plan’s network may cost less. Aetna Medicare Advantage plans at a glance
How do I find doctors that accept Aetna Health Insurance?
Aetna members, log in to find doctors, dentists, hospitals and other providers that accept your plan. For non-members, choose the type of plan you're interested in and search for health care providers that accept it.
Does Aetna Medicare cover dental?
But most allow non-network dental providers. In addition to PPO plans, Aetna offers you other Medicare Advantage plan options — many with a $0 monthly plan premium. We can help you find a plan that’s right for you. With many of our HMO plans, an in-network primary care physician coordinates the care you receive to help you achieve your best health.
What is the provider network for Aetna Medicare?
Aetna Medicare Plans (HMO) have a contracted provider network. This means that you have access to tens of thousands of health care providers across the United States who are in your plan network.
How to contact Aetnamedicare?
For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp.
How many doctors are in Aetna network?
Aetna networks include close to 1.2 million health care professionals, over 700,000 primary care doctors and specialists ...
What is an HMO plan?
Aetna Medicare Prime Plan (HMO) Aetna Medicare SM Plan (PPO) Aetna Medicare Prime Plan (PPO) Each type of plan has different network rules. No matter which Aetna Medicare Advantage plan you choose, be sure to ask your doctor or health care provider if they accept the terms of your plan before seeking care.
How to speak to an Aetna agent?
Speak with a licensed insurance agent by calling. 1-877-890-1409. 1-877-890-1409 TTY users: 711 24 hours a day, 7 days a week.
What is the average rating for Aetna?
For 2020, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.3 out of 5 stars. And the majority of Aetna Medicare plan members are enrolled in plans with a rating of 4.5 stars or higher. 4.
Do you have to pay Medicare Part B premium?
You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members (those who have both Medicare and Medicaid, and meet the state’s requirements for full Medicaid benefits). The formulary, pharmacy network, and/or provider network may change at any time.
What is Aetna insurance?
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans contain exclusions and limitations. See all legal notices.
Is Aetna liable for the content of linked sites?
Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Please log in to your secure account to get what you need. You are now leaving the Aetna Medicare website.
How does Medicare Advantage PPO work?
How do Medicare Advantage PPO plans work? Preferred provider organization (PPO) plans let you choose any provider who accepts Medicare. You don’t need a referral from a primary care physician for specialist or hospital visits. However, using providers in your plan’s network may cost less.
Does a dental plan have RX coverage?
Yes, if plan has Rx coverage. Yes, if plan has Rx coverage . Yes. Dental, vision and hearing coverage. Yes, in many plans. Yes, in most plans. Yes. ER and urgent care coverage worldwide. Yes.
Does Aetna have a meal at home program?
Yes. Meals-at-home program. (meals delivered to your home after a hospital stay) Yes, in many plans. Yes, in many plans. Yes, in many plans. Aetna Medicare Advantage plans at a glance. Our PPO plans. Requires you to use a provider network.
Does Aetna offer Medicare Advantage?
Medicare Advantage plans for every need. In addition to PPO plans, Aetna offers you other Medicare Advantage plan options — many with a $0 monthly plan premium. We can help you find a plan that’s right for you.
How to contact Aetna Medicare?
For information on Aetna Medicare Plan (HMO) (PPO) network providers in your area, just call us toll-free at 1-800-282-5366 (TTY: 711), Monday to Friday, 8 AM to 8 PM. You can also visit us on aetnamedicare.com.
What is Aetna PHO?
Aetna contracts with provider organizations called an Independent Practice Association (IPA) or a Physician-Hospital Organization ( PHO). An IPA/PHO is an association of independent providers. It may include hospitals, primary care doctors and specialist doctors, who together provide health care services.
What is Aetna accreditation?
Accreditation by the National Committee for Quality Assurance. Aetna is committed to accreditation by the National Committee for Quality Assurance (NCQA). It demonstrates our commitment to continuous quality improvement and meeting customer expectations.
How long is Aetna covered?
If you need emergency care, you’re covered 24 hours a day, 7 days a week, anywhere in the world. Whether you’re in or out of an Aetna Medicare service area, please follow these guidelines when you think you need emergency care: Call the local emergency hotline (for example, 911) or go to the nearest emergency facility.
What is a provider?
A provider, by entering a ZIP code, county or city. A provider’s name, facility, specialty or condition. A hospital or urgent care center. You may have to select a product or plan name to complete the search. Read More Read Less.
Does Aetna require prior authorization?
Certain network health care services, such as hospitalization or outpatient surgery, require prior authorization from Aetna Medicare. This means that Aetna Medicare must approve the service before the plan will cover it. Check your Evidence of Coverage for a list of services that require prior authorization.
Can I travel outside of Aetna?
If you travel outside of the Aetna Medicare Plan (HMO) (PPO) service area. You’re covered for emergency and urgently needed care. You can always get emergency care from the closest available provider, in or out of the service area.
How to contact Aetna Medicare?
If you have any questions about your Aetna Medicare Advantage plan or how to find Aetna network providers, you can contact Aetna Customer Service at 1-800-282-5366 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days a week, from October 1 – February 14 and 8 a.m. to 8 p.m., local time, Monday – Friday, from February 15 – September 30.
Why is Aetna fee higher than Medicare?
The fees for health services may be higher. This is because Aetna providers agree to accept a certain amount for your care. For example, if you usually pay 20% of the Medicare-approved cost for in-network care, you may be responsible for up to 50% of the cost for out-of-network care.
How does Aetna work?
If you’re enrolled in a Medicare Advantage plan through Aetna, and you choose to use a provider outside your plan’s provider network, one or more of the following things may happen: 1 Your plan may pay less toward your care. Some plans do cover certain out-of-network services, while others pay nothing for non-emergency care outside the network. 2 The fees for health services may be higher. This is because Aetna providers agree to accept a certain amount for your care. For example, if you usually pay 20% of the Medicare-approved cost for in-network care, you may be responsible for up to 50% of the cost for out-of-network care. 3 Any amount you pay might not contribute to your plan deductible, if you have one. 4 You may need preauthorization for any services you receive in order for any coverage to apply.
How to find contracted Aetna?
The easiest way to find contracted Aetna providers is to use Aetna’s online Medicare Advantage . You simply enter your location (zip code) and the type of medical provider you are looking for, and the tool lists Aetna’s Medicare providers in your area. You can also use Aetna’s provider search tool to find health-care facilities, pharmacists, ...
Does Aetna have Medicare Advantage?
Aetna’s Medicare Advantage providers include primary care doctors, specialists, hospitals, surgical centers, laboratories, imaging centers, dentists, pharmacists, and other health-care professionals. Aetna’s network providers have agreed under contract to provide care for its members, usually at lower rates than they would otherwise charge you ...
Does Aetna pay for out of network care?
Depending on the plan you choose, you may be required to get all your care from providers in your Aetna Medicare Advantage plan network; you may have to pay in full (other than emergency treatment) for out-of-network care.
Does Medicare cover out of network services?
If you’re enrolled in a Medicare Advantage plan through Aetna, and you choose to use a provider outside your plan’s provider network, one or more of the following things may happen: Your plan may pay less toward your care. Some plans do cover certain out-of-network services, while others pay nothing for non-emergency care outside the network.
What is the number for Aetna?
1-877-890-1409. 1-877-890-1409 TTY Users: 711. They’re available 24 hours a day, 7 days a week. They can help you find a doctor, pharmacist or other health care provider near you who accepts an Aetna Medicare Advantage plan.
What is the average rating for Aetna?
For 2020, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.3 out of 5 stars. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. 3.
What is a PPO plan?
Aetna Medicare SM Plan (PPO) Aetna Medicare Prime Plan (PPO) Aetna Medicare Advantage Dual Special Needs plans (DNSP) Be sure to ask your health care provider if they accept the terms of your plan before you seek care. The Centers for Medicare and Medicaid Services releases annual Star Ratings for Medicare Advantage plans.
Does Aetna offer global coverage?
Health care providers who accept Aetna Medicare Advantage (also called Medicare Part C) plans can be found in many areas of the country. Aetna Medicare Advantage plans even offer global coverage for emergency care.