Aetna Emergency Room Coverage Ppo

The summary of benefits and coverage sbc document will help you choose a health plan.

Aetna emergency room coverage ppo.

Enrollment in our plans depends on contract renewal. The path to healthy starts here. The sbc shows you how you and the plan would. That includes students who are away at school.

If you get routine care from out of network providers medicare and aetna medicare won t be responsible for the costs. Any services you receive must be covered under the terms of your aetna plan. Choice ppo annual deductible is 800 single 1 600 family. Aetna medicare is a pdp hmo ppo plan with a medicare contract.

Self only self plus one or self and family plan type. See evidence of coverage for a complete description of plan benefits exclusions limitations and conditions of coverage. Aetna open choice coverage period. In other cases you should notify your primary care doctor and aetna within 48 hours of an emergency.

When you need emergency care for example due to a heart attack or car accident go to any doctor walk in clinic urgent care center or emergency room. You are covered for emergency care. The brochure is also being included in new member welcome packets. This mailing will also be redistributed annually.

If as part of that visit the provider administers or orders a test for influenza strep or other respiratory infection that additional testing will also be covered without member cost sharing. You are covered for emergency care. When seeking emergency care please note that. Aetna better health philadelphia pa 19103 september 21 2016.

If you re enrolled in aetna medicare plan ppo you have the flexibility to receive covered services from network providers or out of network. You are responsible for any emergency room copay. We cover without member cost sharing a same day office emergency room or other provider visit at which a covid 19 test is ordered or administered. Aetna offers health insurance as well as dental vision and other plans to meet the needs of individuals and families employers health care providers and insurance agents brokers.

Our snps also have contracts with state medicaid programs. Preferred provider organization ppo plans let you choose any provider who accepts medicare. Emergency room an urgent care facility and pcp. 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. Emergency or urgent care situations.