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Frequently Asked Questions
(FAQs)
Benefits

Below are frequently asked questions about health benefits and insurance coverage from Aetna Life Insurance Company (Aetna*). To view an answer to a question listed below, please click the question under the desired category.

  1. Do the Aetna Advantage Plans offer dental coverage?
  2. What health care services are covered under the Aetna Advantage Plans?
  3. Are maternity benefits covered under the Aetna Advantage Plans?
  4. What is a Non-Specialist (Primary Care Physician)?
  5. What is a Formulary?
  6. What does "Generic drugs" mean?

1 Do the Aetna Advantage Plans offer dental coverage?
Yes, dental coverage is offered in certain states. Dental coverage is available only in combination with an applicable medical plan and is never offered as a stand alone product.

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2 What health care services are covered under the Aetna Advantage Plans?
For specific plan benefits, please use the "Request a Quote" function on the navigation bar.

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3 Are maternity benefits covered under the Aetna Advantage Plans?
Maternity benefits are not currently available in most states. Complications of pregnancy are normally covered in most states. A newborn is automatically covered under the policy for 31 days and can be added to the policy during this time.

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4 What is a Non-Specialist (Primary Care Physician)?
A primary care physician (PCP) is trained to manage your entire health care program. Your PCP plays many roles - primary caregiver, health care advisor and consultant, coordinator of specialty care and patient advocate. PCPs can be:
  • Family/General Practitioners (Doctors who treat patients of all ages)
  • Internists (Doctors who treat adults and may have a subspecialty)
  • Pediatricians (Doctors who treat children)

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5 What Is a Formulary?
A formulary is a list of preferred medications put together by Aetna to help you to access quality, cost-effective medications. Some of Aetna's prescription drug benefit plans use a formulary. Our Preferred Drug Guide gives information about medications covered under the Aetna Advantage Plans.

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6 What does "Generic drugs" mean?
Generic drugs are medications that contain the same active ingredients in the same amounts as brand-name products, although generics may be a different color, shape or size. Generic drugs are medications that have been approved by the Food and Drug Administration (FDA) as safe and effective. A generic drug can be substituted for a brand-name drug when rated as an equivalent by the FDA and where permitted by law and the prescriber.

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Aetna
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This managed care plan does not cover all of your health care expenses. Read your contract carefully to determine which health care services are covered. To contact the plan if you are a member, call the number on your ID card; all others call 1-888-98-AETNA (1-888-982-3862).

* In Pennsylvania the Individual HMO plan is offered by Aetna Health Inc.