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I Just Want To Know
Will I be getting the Medicare health coverage I need?
Find out now.
As you look for a plan that offers the Medicare benefits you need, find out if your prescriptions are covered by the plan and if your health care provider accepts the plan. It’s important to know that you’ll receive the Medicare benefits you need — from a plan that includes doctors, hospitals and pharmacies in your area and the prescription drugs you take. You can also find out if the plan has in network and/or out-of-network Medicare health coverage. Learn more about Aetna Medicare health coverage >
Click below to find out what's covered by Aetna Medicare.
Are my doctors
participating in the plan?
Are there pharmacies
in my area?
Are my hospitals
participating in the plan?
Are my prescriptions
covered?
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(TTY/TDD: 1-888-760-4748), 8 a.m. to 8 p.m., seven days a week
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Learn more about Aetna Medicare health coverage.
Please note that provider participation may change without notice.
Are my doctors participating in the plan?
Some Aetna Medicare health plans require that you see a network doctor and others don't. Select the "Find Doctors" button above to visit DocFind and learn if your Aetna Medicare health coverage is accepted by your doctor.
Are there pharmacies in my area?
If your Medicare health coverage includes a prescription drug benefit or you have an Aetna Medicare Rx prescription drug plan, use network pharmacies to fill prescriptions. Select the "Find Pharmacies" button above to visit DocFind and search online for an in-network pharmacy.
Are my hospitals participating in the plan?
Some Aetna Medicare health plans require that you use network hospitals and others don't. If your plan allows you to go out of network, you may have to pay more for health care you receive outside the network. Select the "Find Hospitals" button above to visit DocFind and make sure your Medicare health coverage is accepted where you want to go.
Are my prescriptions covered?
If your Aetna Medicare health coverage includes a prescription drug benefit, look for your medications in our preferred drug list (formulary). Select the "Find Prescriptions" button above to search for your medications online.
What is a network provider (doctor, pharmacy, hospital, etc.)?
The term in-network provider means we have a contract with that doctor or other health care provider. We negotiate discounted rates with them to help you save money by using doctors who are participating in our network.
Doctors in our network have agreed not to bill you for any charges above our contracted rate for medical services covered by your plan. In this case, all you have to pay is your coinsurance or copay, along with any plan deductible, if applicable.
Aetna network providers are familiar with the Medical Management Programs available to you as an Aetna health plan member so you can get the most out of your health care coverage.
What is an out-of-network provider (doctor, pharmacy, hospital, etc.)?
If you have an Aetna Medicare Advantage plan that covers out-of-network benefits and you choose to get covered services from an out-of-network provider, you will generally pay more. You must continue to use providers that are eligible for Medicare payment unless you are in an emergency or urgently-needed care situation.
We will not pay for your prescriptions under your Aetna Medicare Part D plan if you use an out-of-network pharmacy, except in certain cases, for instance, illness while traveling outside of the plan's service area where there is no network pharmacy. You may have to pay more than your normal cost-sharing amount if you get your drugs at an out-of-network pharmacy. In addition, you will likely have to pay the pharmacy's full charge for the drug and submit documentation to receive reimbursement from Aetna.
Please refer to your Aetna Medicare Evidence of Coverage plan document for specific benefit coverage and payment requirements as these can vary depending on the type of plan you choose.
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Page Last Updated: November 7, 2011
