Will my doctor accept my Aetna Medicare plan?

At a glance

  • $0 premium plans available in some areas
  • Many plans offer prescription drug coverage and routine vision and dental benefits
  • About 2.7 million people are enrolled in an Aetna Medicare Advantage Plan1

The answer to whether your doctor will accept your Aetna Medicare Advantage (also called Medicare Part C) plan depends on the specific plan you’re enrolled in and whether your doctor is in your plan’s network.

Aetna networks include close to 1.2 million health care professionals, over 700,000 primary care doctors and specialists and over 5,700 hospitals.1

About eleven percent of all Medicare Advantage enrollees in 2021 are enrolled in an Aetna Medicare plan. This accounts for over 2.7 million Medicare Advantage plan beneficiaries.1

Aetna Medicare Advantage plans

If you’re enrolled in an Aetna Medicare Advantage plan, you’re likely a member of an:

  • Aetna MedicareSM Plan (HMO)
  • Aetna Medicare Open Access Plan (HMO)
  • Aetna Medicare Prime Plan (HMO)
  • Aetna MedicareSM 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.

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.

Aetna Medicare Open Access Plans (HMO) give you access to tens of thousands of network health care providers nationwide. In-network coverage is also available when you travel, and you are not required to seek a referral from your primary care physician to see a specialist.

Aetna Medicare Prime Plans (HMO) require you to use providers from your local provider network, except for out-of-network renal dialysis, urgent care or emergency situations.

Aetna Medicare Plans (PPO) give you the flexibility to visit providers that are both in-network and out-of-network. Your out-of-pocket costs for receiving care are typically lower when you visit an in-network provider.

Why choose an Aetna Medicare Advantage plan?

Each year, the Centers for Medicare and Medicaid Services (CMS) release Star Ratings that measure the performance of Medicare Advantage plans.3

For 2022, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.29 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

Get help from a licensed insurance agent

You can speak with a licensed insurance agent to find out what Aetna Medicare Advantage plans are offered in your area and to learn more about whether your health care provider is in that plan’s network.

Speak with a licensed insurance agent by calling TTY users: 711 24 hours a day, 7 days a week.

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