Find your providers Does your provider participate in the Aetna Medicare Advantage network? The Aetna Medicare Advantage Preferred Provider Organization with Extended Service Area (PPO ESA) gives you access to a nationwide network of providers, plus the ability to see out of network providers as long as they accept Medicare. To find out if your provider is in our network or to locate other participating providers, you may search online or contact us. Search online by visiting http://fcps.aetnamedicare.com. Call Aetna Medicare Member Services at 1-855-524-6027 (TTY: 711), Monday through Friday, 8 a.m. to 6 p.m. all U.S. time zones. 72.03.511.1-FCPS (1/18) fcps.aetnamedicare.com 1
Here are tips to help you with your search 1 Search online or contact member services To search online: 1. Search online by visiting http://fcps.aetnamedicare.com. 2. Select Search for providers. 3. If you re not yet an Aetna Medicare member or if you haven t registered for an Aetna Medicare Advantage account, select Find doctors & other providers under Not yet a member? If you ve already registered for an account, you may select Log in to find doctors & providers in your plan under Already a member? And log in to your account. 2
4. Enter your provider s name or search by provider type. If your providers are part of the Aetna Medicare Advantage network, their name will appear along with a green check mark that says In network. Search result example: 3
Call Member Services: If you don t have access to a computer or the Internet, or if you need assistance with your search, you may call Aetna Medicare Member Services for Fairfax County Public Schools at 1-855-524-6027 (TTY: 711), Monday through Friday, 8 a.m. to 6 p.m. all U.S. time zones. 2 What if I don t see my provider? Chances are your providers may accept the plan if they aren t in our network*. To see if an out-of-network doctor will accept the plan: 1. Go to www.medicare.gov to confirm your doctor accepts Medicare. Under Find doctors, providers, hospitals, plans & suppliers, select Find doctors & other health professionals. *Out-of-network doctors and hospitals must be licensed, eligible to accept Medicare payment, and willing to accept your plan. 4
2. Enter your search criteria. You may search by location, name, specialty, group, body part, or condition. 3. Providers who accept Medicare are designated by a green check mark and Accepts Medicare assignment. Search result example: 4. Your next step: Call your doctor, and ask if they ll be willing to treat you and accept your Aetna Medicare Advantage plan. Be sure to tell the provider s office that you re an Aetna Medicare Advantage member. If your providers have questions about your plan, ask them to call us. OR Contact Aetna Medicare Member Services and ask that we contact your doctor. We will help them understand how to accept and bill the Aetna plan. Your benefits are the same for in- or out-of-network providers. You can go to any provider who accepts Medicare and is willing to accept your plan. 5. What if my doctor will not submit claims to Aetna Medicare Advantage? If your doctor will not submit claims to Aetna, you may pay out-of-pocket and we ll reimburse you for covered services. Simply call us to get the necessary claim form or find it at http://fcps.aetnamedicare.com. 5
3 Questions? We re here to help. Just call us at 1-855-524-6027 (TTY: 711), Monday through Friday, 8 a.m. to 6 p.m. all U.S. time zones. Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. The provider network may change at any time. You will receive notice when necessary. Out-of-network/noncontracted providers are under no obligation to treat Aetna members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. 2018 Aetna Inc. GRP_4010_1352 1/2018 72.03.511.1-FCPS (1/18) fcps.aetnamedicare.com 6