Pharmacy (Select "Aetna National Pharmacy Network")
Simply enter the doctor’s or facility's name, procedure or condition, plus your home ZIP code. You can even find providers in another state. If you have a dependent living outside of your home zip code, please call Aetna Customer Service at 1-855-496-6289 for assistance with your provider search.
Choose Aetna National Pharmacy Network from the listing of pharmacy plans.
You’ll get a list of doctors, facilities, dentists or pharmacies based on your search. You can narrow the search by using the options to the left of the results page. Depending on the plan you select, you may see an out-of-network doctor listed. But your cost will most likely be higher. Your enrollment materials have more details.
Staying in the network is a smart move
With most Aetna plans, you have the choice of going to any doctor you choose. So why should you care about staying in the network? Here are some reasons:
You save when you use network doctors, dentists and other health care providers.
Preventive care is covered at 100 percent when done by network doctors.
Your medical plan pays a larger share of the cost when you use network doctors.
Network doctors have agreed to charge a reduced rate, so you’ll usually pay less for your share.
Out-of-network doctors can charge you more than network doctors. You’re responsible for paying the extra.
You can also save with network hospitals and labs
The Aetna network doesn't just include doctors and dentists. You'll also save when you use network labs, hospitals, urgent care centers and more.
Your medical plan pays a larger share of the cost when you use network labs and facilities.
Network labs and facilities have agreed to charge a reduced rate. Your cost share is usually less.
If you use an out-of-network hospital emergency room, non-emergency care may not be covered.
We prescreen our network providers. You can be sure you're getting quality services at maximum savings.
We'll help you finish your treatment with your out-of-network doctor
It’s easy to see the cost savings of using quality doctors in our networks. But when you’re a new member, you may need to finish treatment with a doctor who is not part of the network. Our Transition of Care program can help.
This program lets you continue a course of treatment with an out-of-network doctor for up to 90 days* at the same cost share as if your doctor was in the network. This gives you time to finish your treatment, or transition to a network doctor.
To qualify, you must be in an active course of treatment. For instance:
You’re in the second or third trimester of pregnancy, including post-partum care.
You’re getting treatment for certain acute or chronic conditions such as chemotherapy or kidney dialysis.
You’re actively engaged in an acute inpatient or outpatient rehabilitation program for a condition within 21 days of your plan’s effective date.
You’re in the hospital on the plan’s effective date.
Some conditions don’t qualify for Transition of Care include routine exams, stable chronic conditions such as diabetes or asthma, minor illness such as colds or sore throats and elective scheduled surgeries.
To apply, you and your doctor will need to complete a Transition of Care form.