Aetna® Medicare providers

Health care providers who accept Aetna Medicare Advantage (also called Medicare Part C) plans are in many areas of the country. Aetna Medicare Advantage plans even offer emergency coverage worldwide.

Do you want to find Medicare providers who accept Aetna Medicare Advantage plans? One way to do so is to compare specific plans offered in your area and search for providers who are in those plan networks. You may be eligible to enroll in a plan during the Annual Enrollment Period or, if you qualify, for a Special Enrollment Period. Things like moving to a new area or losing your existing coverage may make you eligible for a Special Enrollment Period.

You can also speak with a licensed insurance agent by calling TFN-Link TTY Users: TTY. They’re available 24 hours a day, 7 days a week. They can help you find a doctor, pharmacist or other health care provider near you who accepts an Aetna Medicare Advantage plan.

What is an Aetna in-network provider?

An in-network provider is one who accepts Aetna health insurance, like a Medicare Advantage plan. The list of Aetna participating providers may vary by plan. It can include general doctors, specialists, pharmacies, medical supply companies and more. 

Does Aetna^® have a good network?

The quality of a network is often defined by its number and diversity of providers. Larger networks can create more options for member care.

Aetna has a large network of participating providers that includes 1.8 million health care professionals and more than 800,000 physicians.² Also:

• 6,300 hospitals
• 519,000 specialists
• 285,000 primary care providers
  

Some of the types of providers and facilities you may find within the Aetna network include:

• Primary care providers
• Specialists 
• Dentists
• Pharmacies
• Hospitals
• Clinics
• Medical equipment suppliers 
• Rehabilitation facilities 
• Hospice providers
• Dialysis centers
• Therapists  

Whether or not your provider will accept your Aetna Medicare Advantage plan depends on the specific plan you enroll in. Each type of plan has different network rules.

If you’re enrolled in an Aetna Medicare Advantage plan, you’re likely a member of an:

• Aetna Medicare^SM Plan (HMO)
• Aetna Medicare Open Access Plan (HMO)
• Aetna Medicare Prime Plan (HMO)
• Aetna Medicare^SM Plan (PPO)
• Aetna Medicare Prime Plan (PPO)
• Aetna Medicare Advantage Dual Special Needs plans (D-SNP)
  

Be sure to ask your health care provider if they accept the terms of your plan before you seek care.

Aetna Medicare provider search

Aetna offers a few ways to search for in-network providers. 

Online: You can visit the Aetna Find a Doctor page to search for doctors, hospitals, pharmacies and other health care providers in your area that will accept your Aetna Medicare plan. You do not have to currently belong to an Aetna plan to use the provider search tool. 

If you have a favorite doctor but no Aetna Medicare plan, you can search online for an Aetna plan that is accepted by your current health care providers. By doing so, you can enroll in coverage while keeping your favorite doctors. 

Phone: If you are an Aetna member, you can call the phone number on your member ID card to connect with us. Then an Aetna care manager can help you find providers within your plan’s network, schedule appointments and more. Aetna members can also log in to the online members portal on the secure member website.

Talk with an agent: Another option for those who are not yet enrolled in an Aetna plan is to call a licensed insurance agent for information on participating providers.  

Aetna in-network provider list

You can also get a printed list of participating providers. To do so, just complete this online form. You can get the print directory on an annual basis. For some plans, the directory many be available in multiple languages.

Keep in mind that a printed directory may be out of date as the providers included in any particular network can change throughout the year.

When to see an in-network provider

If you are enrolled in an Aetna Medicare Advantage plan, it’s wise to seek out an Aetna in-network provider as often as possible. Visiting an in-network provider will often reduce your out-of-pocket costs. 

It’s especially important to seek care from an in-network provider if you are enrolled in an HMO (Health Maintenance Organization) plan. HMO plans do not cover care you receive outside of the network. 

If you are enrolled in a PPO (Preferred Provider Organization) plan, you may be able to receive care from a provider who is not part of the Aetna network and still receive some coverage. But remaining in the Aetna network will most often yield greater savings. 

One exception to the rule is emergency care. By law, such care is charged at the same rate regardless if the provider is in network or not. 

How do I find an Aetna Medicare provider near me?

You can speak with a licensed insurance agent to find out what Aetna Medicare Advantage plans are offered in your area. The agent can also tell you whether your health care provider is in that plan’s network.

To speak with a licensed insurance agent call TFN-Link TTY Users: TTY 24 hours a day, 7 days a week.

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