We make it easy for you to get started and get the most out of your plan. When you receive your Welcome Kit and membership card, simply register on the member website and select a primary care doctor. They’re the most important person in getting you the right care at the right time. They get to know you, guide your health decisions, support and solve all your care needs — including referrals to any other in-network specialists.
At our website texashealthaetna.com you can:
- Activate your member profile
- Download the free Anytime-MD app
- Select a primary care doctor
- See which doctors, specialists and pharmacies are in your network
- Get an overview of your benefits
- Check on claims
- Compare costs of treatments and prescriptions
- Use your many member discounts and savings
Take your member ID card with you to all doctor and hospital visits and pharmacies. If you have any questions that aren’t answered on the website, simply call 1-800-822-4346 and one of our team members will be happy to help.
View the network map to see all the Texas Health Aetna locations near you.
The best way to find Texas Health Aetna providers is to use our online provider directory search tool. Here’s how:
- Visit the provider search tool.
- Enter a name, specialty, procedure or condition — or enter a ZIP code or city and state to search within a certain area.
- You can also choose from the list of common searches for providers, conditions and procedures.
- Select HMO from the drop-down menu under Employer Plans-Care Plus.
- Once you make your selection, your results will appear.
- Providers listed under the “Best Results for Your Plan” tab will offer you the lowest out-of-pocket expense.
First, choose a primary care doctor who belongs to the Texas Health Aetna network.
Your PCP* provides basic and routine care, including preventive exams and screenings. When you need specialty care, your PCP can refer you to network specialists. He or she will give you a referral. This referral form is important.
*In Texas, PCP is known as physician (primary care).
You have your own care team, led by your PCP.
Your team includes doctors, nurses, health coaches and other clinicians. One of their goals is to help you stay healthy and improve your health, not just treat you when you’re sick.
Your team communicates and coordinates.
They can access your electronic health record to see services and medications you’ve received, check lab results and view the “big picture” of your care – and your health.
You get better care for chronic conditions.
Your team creates a personalized care plan and helps you stay on track with medications, treatments and actions you can take that are designed to help you live healthier. They stay in touch to monitor your progress and adjust your plan as needed.
The plan pays benefits for in-network care only.
Remember, you'll save money and get more coordinated care when you stay in the Texas Health Aetna plan network. In emergencies, you'll have coverage for out-of-network care. But, if you go out-of-network for routine or non-life-threatening care, just know that you'll be responsible for the entire cost.
You need a referral from your PCP to see a specialist.
A referral is good for up to 60 days. Your specialist might ask for more referrals from your PCP to continue treating you. Except for emergencies, it’s important to get authorization before receiving treatment at a hospital or before outpatient surgery. Your PCP or specialist can help with that.
You pay a flat fee (copay) for most covered outpatient services.
You may need to meet a deductible first, then pay the appropriate copay.
View the plan design to see how the plan pays for covered services.
Once you enroll, we will reach out to you.
First, you'll receive your member welcome package along with your ID card. The package is full of tips on how to get the most from your Texas Health Aetna benefit plan. You'll also get a welcome phone call so that we can ensure you have all the information you need as a new plan member.