Frequently Asked Questions (FAQs)

What is a health care network?

A health care network is a group of professionals and facilities, such as doctors, hospitals, clinics, suppliers of durable medical equipment, home health services, and lab services that have agreed to accept discounted reimbursement.

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How do I find out which doctors are in the network?

Access Aetna's DocFind® from the Physicians & Facilities web page. It offers a list of physicians, hospitals and other facilities participating in our network.

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What are the advantages of using Aetna's DocFind?

You can:

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What type of information is available in the online provider directory?

You can find hospitals, primary physicians (PCP), specialists and other facilities participating in our plans. Aetna's DocFind also includes:

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Can I find a specialist using Aetna's DocFind?

Yes. Aetna's DocFind includes participating specialists. Please know that you should always verify if a physician or facility is participating in our network before receiving services. You can do this by calling Aetna Member Services at 1-866-244-1573.

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How often is Aetna's DocFind updated?

Directory information is updated weekly.

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Do I need a referral to see a specialist?

HDHP Gold Plan and HDHP Silver Plan: No.

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Is there any way I can find out ahead of time how much a procedure will cost?

To get estimated average costs for medical treatments and procedures, tests and other services in your area, log on to Aetna Navigator and use the Cost of Care tools. For example, you can compare the cost of over 30 common medical procedures (such as MRI, CT scan, and colonoscopy) at facilities in select locations around the country. When you use the tool, you’ll get a list showing hospitals and other facilities in your area that perform these procedures, with actual cost ranges — by facility — for each procedure.

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What should I do in an emergency?

If you need immediate medical attention, dial 911 and ask for help. A life-threatening condition resulting from an injury or illness is covered at the in-network level 24 hours a day, 7 days a week, at any emergency facility.

Please note: It is your responsibility to notify Aetna if you are admitted to a hospital or receive other services that require notification. Services that require notification are listed on your Medical ID card.

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Where do I find information on pharmacy benefits?

Pharmacy Benefits are provided by Express Scripts®.
Click here for open enrollment information, or call Express Scripts at 1-800-716-2938.
Once you're a member, you can access Pharmacy Benefits information online at
www.express-scripts.com or by calling 1-800-716-2938.