Example: biology

Aetna Medicare Plan (HMO) (PPO) Provider Directory

9/26/2011 9:57 AM Page 3. Aetna MedicareSM plan (HMO) (PPO). Provider Directory Georgia Y0001_M_PE_MM_10537 CMS Approved 07/28/2011. 9/26/2011 9:57 AM Page 4. 9/26/2011 9:58 AM Page I. Table of Contents Aetna Medicare plan Maps of Service Introduction ..VII. Spanish Hospitals and Skilled Nursing Facilities ..2. Primary Care Obstetricians and Gynecologists / Women's Health Behavioral Health Eye Care Providers ..510. Dental Other Participating Institutes of Excellence Transplant Facilities ..625. Institutes of Quality ..631. Index of Providers Speaking Additional Index of Providers.

Aetna MedicareSM Plan (HMO) (PPO) Provider Directory Individual Plan Names: ValueSM Plan (HMO) StandardSM Plan (PPO) PremierSM Plan (HMO) Employer Group Plan Names: Aetna MedicareSM Plan (HMO) Aetna MedicareSM Plan (PPO) This directory provides a list of Aetna MedicareSM Plan (HMO) (PPO) network providers. Please refer to the Service Area Maps starting on the next page for …

Tags:

  Aetna, Plan

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of Aetna Medicare Plan (HMO) (PPO) Provider Directory

1 9/26/2011 9:57 AM Page 3. Aetna MedicareSM plan (HMO) (PPO). Provider Directory Georgia Y0001_M_PE_MM_10537 CMS Approved 07/28/2011. 9/26/2011 9:57 AM Page 4. 9/26/2011 9:58 AM Page I. Table of Contents Aetna Medicare plan Maps of Service Introduction ..VII. Spanish Hospitals and Skilled Nursing Facilities ..2. Primary Care Obstetricians and Gynecologists / Women's Health Behavioral Health Eye Care Providers ..510. Dental Other Participating Institutes of Excellence Transplant Facilities ..625. Institutes of Quality ..631. Index of Providers Speaking Additional Index of Providers.

2 662. I. 9/26/2011 9:58 AM Page II. 9/26/2011 9:58 AM Page III. Aetna MedicareSM plan (HMO) (PPO). Provider Directory Individual plan Names: ValueSM plan (HMO) StandardSM plan (PPO). PremierSM plan (HMO). Employer Group plan Names: Aetna MedicareSM plan (HMO) Aetna MedicareSM plan (PPO). This Directory provides a list of Aetna MedicareSM plan (HMO) (PPO) network providers. Please refer to the Service Area Maps starting on the next page for the service area counties included in this Directory . This Directory is current as of January 1, 2012. Some network providers may have been added or removed from our network after this Directory was printed.

3 We do not guarantee that each Provider is still accepting new members. To get the most up-to-date information about Aetna Medicare plan (HMO) (PPO) network providers in your area, you can visit or call our Customer Service Department at 1-800-282-5366, 8 am to 8 pm, 7 days a week. TTY/TDD users should call 1-888-760-4748. This information is available for free in other languages. Please contact our Customer Service number at 1-800-282-5366 for additional information. (TTY/TDD: 1-888-760-4748). Hours of operation: 7 days per week, 8 to 8 Esta informaci n est disponible en otros idiomas de manera gratuita.

4 Si desea m s informaci n, comun quese con Servicios al Cliente al 1-800-282-5366 (TTY/TDD: 1-888-760-4748). Horario de atenci n: los 7 d as de la semana, de 8 a 8 This document may be available in an alternate format such as Braille, larger print or audio, please contact our Customer Service number listed above for more information. A Medicare Advantage organization with a Medicare contract. III. 9/26/2011 9:58 AM Page IV. Aetna MedicareSM. Individual plan (HMO) (PPO). Service Area Map This map represents the counties in which Aetna Medicare Individual Plans (HMO) (PPO) are offered.

5 Cherokee Forsyth Gwinnett Cobb DeKalb Fulton Aetna Medicare Individual plan (HMO) (PPO). Aetna Medicare Individual plan (HMO). Questions? Members: Sales: TTY/TDD: Call toll-free 1-800-282-5366 1-800-832-2640 1-888-760-4748. (Hearing-impaired only). IV. 1000. 9/26/2011 9:58 AM Page V. Aetna MedicareSM. Employer Group plan (HMO) (PPO). Service Area Map This map represents the counties in which Aetna Medicare Employer Group Plans (HMO) (PPO) are offered. Cherokee Forsyth Gwinnett Cobb Paulding DeKalb Fulton Douglas Rockdale Clayton Henry Chatham Aetna Medicare Employer Group plan (HMO) (PPO).

6 Aetna Medicare Employer Group plan (PPO). Questions? Members: Sales: TTY/TDD: Call toll-free Call the number 1-800-307-4830 1-888-760-4748. on your ID card (Hearing-impaired only). V. 1001. 9/26/2011 9:58 AM Page VI. 9/26/2011 9:58 AM Page VII. Section 1 Introduction doctor visit copay. Although you are not required to This Directory provides a list of Aetna Medicare (HMO) select a PCP, you are encouraged to do so. If you (PPO) network providers. To get detailed information receive covered services from an out-of-network about your health care coverage, please see your Provider , it is important to confirm they will accept Evidence of Coverage.

7 Your PPO plan and are eligible to receive Medicare If you are enrolled in a standard Aetna Medicare payment. Health Maintenance Organization (HMO) plan , The network providers listed in this Directory have you will have to choose one of our network providers agreed to provide you with your health care, vision, who are listed in this Directory to be your Primary Care hearing and dental coverage. You may go to any of {Physician/ Provider } (PCP). The term PCP will be our network providers listed in this Directory ; however, used throughout this Directory . Generally, you must some services may require a referral.

8 If you have been get your health care coverage from your PCP. Your going to one network Provider , you are not required PCP will issue referrals to participating specialists and to continue going to that same Provider . In some facilities for certain services. For some services, your cases, you may get covered services from non-network PCP is required to obtain prior authorization from providers. Aetna . You must use network providers except for In cases where non-contracting providers submit a bill urgent care or out-of-area urgent care or renal dialysis. directly to you, you should not pay the bill, but submit Except for those benefits described in your plan it to Aetna Medicare for processing and determination documents as direct-access benefits, or in an of your financial liability, if any.

9 Emergency, you will need to obtain a referral from Certain health care services, such as hospitalization or your PCP before seeking covered non-emergency outpatient surgery, require precertification with Aetna . specialty or hospital care. You must use plan providers This means the service must be approved by Aetna except in emergency or urgent care situations or for before it will be covered under the plan . Check your out-of-area renal dialysis. If you obtain routine care Evidence of Coverage for a complete list of services from out-of-network providers neither Medicare nor that require this approval.

10 When you are to obtain Aetna Medicare will be responsible for the costs. services requiring precertification from a participating If you are enrolled in an Aetna Medicare (HMO) Provider , the Provider is responsible to precertify those Open Access plan , you are not required to choose services prior to treatment. If your plan includes an a primary care physician (PCP) and are free to visit out-of-network benefit and you decide to receive network providers without a referral to receive covered covered services from an out-of-network Provider it is services. You must use network providers except for your responsibility to contact Aetna to precertify those an emergency, urgent care, out-of-area urgent care, services.


Related search queries