Aetna Select Health Plan
The Aetna Select Plan provides quality care for a low out-of-pocket cost.
The plan has no deductible and no coinsurance for most services. You pay a low flat fee (called a copay) for most covered services. Some of the plan's copay amounts are shown in the Summary of Benefits chart. You can access this information by selecting the appropriate version under Summary of Benefits on the left.
Aetna's extensive nationwide Aetna Select provider network has approximately 519,000* primary care physicians, specialists, hospitals, and other health care providers across the United States. This means you and your family have access to a full range of medical services almost anywhere you live, work or travel. For an up-to-date listing of participating providers, logon to NGC DocFind and enter your search criteria to locate network providers in your zip code area.
Your Aetna Select Plan also offers several unique special programs that focus on specific health needs and conditions providing information, guidance and discounts that complement our standard medical coverage. One such program is Healthy Outlook, Aetna's disease management program for members diagnosed with diabetes, asthma or congestive heart disease. Healthy Outlook provides information and support to help you manage your condition, avoid complications and enjoy better overall health.
Aetna Navigator™ is your online member website where you can get the latest health information plus access to special programs and tools.
With an emphasis placed on wellness, the Aetna Select plan covers preventive care at 100 percent. We also offer a full range of online and telephone services designed to keep you and your family healthy.
There are never any claims to file or balances to pay if you utilize the Aetna Select network. Instead you pay a flat copay amount for most eligible services. Your primary care physician (PCP) will handle any precertification required for certain types of care.
*Aetna's enterprise provider database as of 2/2008.
Your PCP and Network Providers
When you enroll in the plan, you select a primary care physician (PCP) for yourself and each covered family member from Aetna's network of participating providers. You may choose a different PCP for each member of your family. A PCP can be a general practitioner, family practitioner, internist or pediatrician. You can change your PCP at any time.
Your PCP will:
- Provide routine and preventive care.
- Treat you for illnesses and injuries.
- Help you make important medical decisions.
- Help you find a participating network specialist when you need one.
If you need Ob/GYN or chiropractic care, you may make an appointment directly with any network Ob/GYN or chiropractor, without a referral from your PCP. For all other types of specialty care, you'll need a referral from your PCP.
How Benefits Are Paid
Benefits for covered services are paid only when your care is provided or coordinated by your PCP. You pay a low flat fee, or copay, for most services. Preventive care (such as immunizations and health screenings) and certain other services are covered at 100 percent, up to your plan maximums. There is no need to file a claim for benefits. When you visit your PCP or a network provider, simply show your Aetna ID card and pay the copay.
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