Hi, I'm David with Aetna, and today I'm here to talk to you about something called the Aetna Performance Network.
The Aetna Performance Network is part of your health benefits and insurance plan. It helps you make smart choices about your care so you can get the most from your health care dollars.
Think of it this way – you'd never step into a car dealership, point at the first car you see and say "I'll take it!" would you? Well, maybe this guy would, but not you! You'd do some research and make sure you make the right choice for such a big purchase.
Taking care of your health is an even bigger deal than buying a car. Doesn't it make sense to be just as thoughtful about choosing your doctors and hospitals?
In other words, if you had access to all the information you needed to make smart health care decisions that would help you spend your money wisely, wouldn't you want to do it?
This is where Aetna Performance Network comes in.
Here's how it works. Let's say these are all the doctors and hospitals in your area. Aetna has negotiated rates with some of these providers to help keep your costs down. That group is "in-network."
But, all the doctors and hospitals in Aetna's network have very different rates, even the within the same local area. That means you could pay a lot more for the same office visit or surgical procedure, and not even realize it.
So Aetna evaluated a special group of providers. It includes top performing hospitals in your area. It also includes 20 kinds of specialists, like cardiologists, who typically treat at these hospitals. When you use one of these specialists or hospitals, you will pay a lower percentage of your medical costs. It helps you be sure that you are not paying more than you have to for care.
Keep in mind that you can go to any specialist or hospital you want and still get care. But using Aetna Performance Network specialists and hospitals is a smart choice.
We make sure that every plan member has reasonable access to Aetna Performance Network specialists and hospitals. We also give you tools to find them as quickly and easily as possible.
DocFind is an important tool to know. You can even use it now before you pick your plan. Visit the open enrollment DocFind site and search by location, name and more. Then, just look for the blue circle with the check mark. That tells you the specialist or hospital is in the Aetna Performance Network. Some specialists also have a blue star next to their name. That means they have met additional quality standards.
Got a medical procedure coming up? As an Aetna member, you can use the Member Payment Estimator to figure out the estimated cost. It uses real-time plan information to figure out how much you will owe.
Once you're a member, you'll have access to these and lots of other helpful tools through your secure member website, Aetna Navigator.
Choosing a specialist and hospital are important decisions. But it's easy to be SMART about it when you use tools like DocFind and Member Payment Estimator, and when you choose providers in the Aetna Performance Network.
Health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company, Aetna Health Insurance Company of New York and/or Aetna Life Insurance Company (Aetna). In Florida by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
This material is for information only. Health benefits and health insurance plans contain exclusions and limitations. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Information is believed to be accurate as of the production date; however, it is subject to change. For more information, refer to www.aetna.com. Policy forms issued in OK include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-23 and/or GR-29/GR-29N.
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