How to Find Aetna In-Network Providers

If you have a Medicare Advantage plan from Aetna or any other insurance company, your plan may require you to visit in-network doctors to maximize your plan coverage. It’s important to visit doctors in the Aetna Medicare network so that you can pay lower out-of-pocket costs for your care.

Aetna Medicare Advantage (Medicare Part C) plans combine your Original Medicare (Part A and Part B) benefits into a single plan. Aetna Medicare Advantage plans may also provide prescription drug coverage, and they may cover extra benefits such as dental, hearing, vision, SilverSneakers fitness membership (now called Renew Active plans) and other benefits that Original Medicare doesn’t cover.

Aetna Medicare Provider Search

Aetna makes it easy to find in-network doctors or to find Aetna plans that are accepted by your favorite health care providers. 

To find an Aetna in-network doctor online, you can visit the Aetna Find a Doctor page. First-time users may be asked to create an account, while existing Aetna Medicare plan members will be asked to log in with their username and password. 

If you need help, call to chat with a licensed insurance agent to find doctors near you in the Aetna Medicare network or for information about Aetna plans available where you live.

What Is an Aetna In-Network Doctor? 

A doctor or other health care provider is said to be an “Aetna in-network doctor” if they accept Aetna insurance plans and agree to the plan’s terms and conditions.

An Aetna in-network provider can be a person (such as a general doctor or specialist), a location (like a hospital or pharmacy) or a supplier (like a company that supplies insulin). 

Does Aetna Have A Good Network?

As one of the largest health insurance providers in the U.S., Aetna has a network of participating providers that makes it possible to find an in-network doctor nearly anywhere you go. 

The Aetna Medicare provider network includes:

• 1.6 million health care professionals
• Thousands of specialists, primary care physicians and hospitals

When Should You See a Doctor in the Aetna Medicare Network?

Depending on the type of Aetna plan you have or the type of service you are seeking, it may not always be necessary to visit an Aetna in-network provider. 

• For emergency care, you’re typically not required to stay within the Aetna network, as emergency care is covered the same way whether it’s administered inside or outside Aetna’s network.
  
  
• If you have an Aetna Medicare Supplement Insurance (Medigap) plan, you may visit any health care provider who accepts Original Medicare. Medigap plans do not adhere to a provider network. It’s important to note that you can’t have an Aetna Medigap plan and an Aetna Medicare Advantage plan at the same time.
  
  
• In most other situations, you typically should visit an Aetna in-network provider. Aetna HMO plans, for example, restrict coverage to the Aetna network. This means you could be responsible for the full cost of non-emergency care received outside of your Aetna plan network. 

While Aetna PPO plans typically allow for partial coverage outside of the Aetna network, your savings will usually be maximized when keeping your care inside the Aetna network for things like an annual wellness exam, other routine services or urgent care. 

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