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Aetna HMO Plan at a Glance

More for your money - Medical plan with extras like discounts on eyewear, gyms, massage weight loss programs and more

A health plan for the way you live.  Aetna's HMO* plan offers an extensive national network of participating providers and facilities.  These providers assist with coordinating your care, eliminating the hassle of doing so yourself. And with an affordable copay per type of service, why wouldn't you choose the Aetna HMO?

*Network names will vary based upon your state of residence.  In New Jersey, Pennsylvania, New York, Delaware, or Washington, D.C., the network name is Aetna HMO.  All other areas nationally, the network name is Aetna Select.

How the Aetna HMO Plan Works

Step 1 - Choose a PCP

  • A Primary Care Physician (PCP) is a doctor selected by you to provide basic health care services and assist in arranging for specialized services when needed.   
  • You can choose any PCP from Aetna's network - it's your choice.  Plus, you'll feel good knowing that anyone you choose meets our standards.
  • Choosing a doctor is a personal decision - that's why each member of your family can have his or her own PCP.
  • Change your PCP anytime.  Call Member Services at 1-877-STATENJ or visit our  Aetna Navigator® member website.
  • You must choose a PCP and see network providers to receive benefits from this plan.

Step 2 - Visit your PCP for care

  • Go to your PCP for your basic health care needs…..check-ups, acute illness or injuries.
  • Your PCP will help you decide if you need care from another doctor.  If specialty care is required, your PCP will more than likely issue an electronic referral eliminating the need for any paperwork.
  • Sometimes you may need care that requires approval from Aetna before you get it.  This is called precertification.  Your PCP and and specialists will handle this process for you.

Step 3 - Pay your copay

  • When you visit your PCP or a specialist, you pay a copay.  The majority of time this is a flat dollar amount.
  • Your Plan Design and Benefits Summary lists your covered services and your copay amount.

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