Aetna Medicare Advantage PPO Extended Service Area (ESA)
The Exchange’s benefits team is aware of communications to Exchange retirees stating providers will no longer accept Aetna Medicare Advantage after the first of the year. If you are notified that your doctor or hospital is no longer accepting Aetna, please note that this change does not impact Exchange retirees. While these messages have become an increasingly routine part of end-of-year negotiations between healthcare providers and insurance companies, Exchange retirees are largely unaffected as the Aetna Medicare Advantage PPO Extended Service Area allows beneficiaries to see any provider of their choice. Specifically, there is no difference regarding out-of-pocket costs for Exchange retirees receiving in-network or out-of-network care when seeing providers that are (1) eligible to receive payment under Medicare and (2) willing to bill and accept payment from Aetna.
Any confusion is typically quickly resolved by informing the healthcare provider that you are covered by the Aetna Extended Service Area plan, which pays for out-of-network medical care and provides the same benefits as original Medicare and more including many preventive services. If necessary, you may also share Aetna’s “For Your Doctor” information sheet, available here.
If you have any questions, please contact Aetna by calling the number on the back of your insurance card and pressing 1 for Medicare Advantage or reach out to your Exchange Benefits team at Benefits@aafes.com or 800-519-3381.
Reminder: If the medical provider refuses to bill Aetna as an out-of-network provider, email Exchange Benefits, Benefits@aafes.com, with the provider information. The Benefits team will reach out to Aetna for assistance.
HQ Exchange Benefits Team