Out of Network is a managed care plan made up of a network of doctors, hospitals and medical professionals. If you have covered dependents, you must select a PCP for each of them as well. You are covered in full after a co-payment for most medical services, including preventive care, as long as you use an HMO provider. If you see a healthcare professional or specialist other than your PCP and want the HMO to consider the expense, you must be referred by the Primary Care Physician. In most instances, if you use providers who are not affiliated with the Aetna US Healthcare HMO with Catastrophic Out of Network, you will have to pay the entire bill yourself.
Limited coverage is available for expenses incurred out of network.
Out of Network has their own prescription drug plan. See their plan materials for information. Click here to view comparison chart of medical insurance plans. This is a brief summary of benefits available. For Plan details, including limitations and exclusions, please refer to the Plan booklets.