We cover the cost of services differently based on whether doctors are “in network” or “out of network.” We want to help you understand how much Aetna pays for your out-of-network care. At the same time, we want to make it clear how much more you will need to pay for this care. See our introduction about how your out-of-pocket costs will be higher.
When you choose to see an out-of-network doctor, we pay for your health care using one of three methods. Your plan will state which method should be used. The methods are:
Click on any link above to learn about the way these methods work based on the type of benefits you are using. You can also see examples that show how much Aetna will pay – and how much you will pay – when you choose to use out-of-network doctors.