Here’s a plan that lets you visit any doctor and hospital in or out of the Aetna network — and you don’t need a referral
With the Aetna Elect Choice EPO (Open Access) offered by the City of New York, you get access to tools, tips, programs and services. Use them to find network doctors, estimate cost and more. You'll get benefits such as:
100% preventative in-network care coverage
No plan deductible
$0 copay when you visit a PCP or in-network provider for annual checkups, certain screenings and immunizations
Large national network of doctors and hospitals
100% coverage for Emergency care worldwide
An available pharmacy option
Enrollment in Aetna health benefits and insurance plans puts you in reach of cost-saving features and benefits for good health and exceptional member services.
“17,000 Aetna members in the NY area are already taking advantage of our great health benefits.”*
*Based on current membership data. Limitations and exclusions apply
Aetna Prescription Drug Plan
The Aetna national pharmacy network provides members with access to over 60,000 pharmacies.
And with no annual maximum limit on your coverage, here’s what you’ll pay for a 30-day supply:
You’ll also get access to online tools and member services like Aetna Navigator® to make it easy for you to get answers to your health care questions — 24/7 including:
Find a doctor
Compare costs for office visits, tests and procedures
Store and share your personal health history
Track your health goals
Get instant access to claims and Explanation of Benefits statements
Research prescription drugs
Find and print ID cards and forms
Plus — your membership includes access to a wide variety of products and services. All these extras come with your coverage, so you can use them immediately by registering with Aetna Navigator®.
You can use City of New York’s custom DocFind® search tool. This is the most up-to-date resource for finding participating doctors, hospitals, pharmacies and other medical providers and services.
You don’t have to choose a PCP, but you may want to. That’s because PCPs do more than provide checkups. They know you, your medical history, and they can help guide you and direct your care.
Your copay information is printed on your Aetna member ID card. You can also look in your member enrollment materials. See the Summary of Benefits Chart on pages 4 – 5 in this brochure (PDF), as well as in the Certificate of Coverage. If you can’t find the information you need, you can call Member Services at 1-800-445-8742. For the hearing impaired, call (TDD) 1-877-301-5038.
An emergency medical condition means your symptoms are sudden and severe. If you don’t get help right away, an average person with average medical knowledge will expect that you could die or risk your health. For a pregnant woman, that includes her unborn child. You do not have to get approval for emergency services.
Plan members, including covered dependents away from home, are covered for emergency and urgent care when outside their normal or home service area. (For a description of what Aetna considers an emergency, see previous question.)
You can get emergency and urgent care from a doctor, a walk-in clinic, an urgent care center or an emergency facility. In case of an accidental injury or life-threatening medical emergency where you are admitted to an inpatient facility, you (or someone on your behalf) should notify your PCP (if you have one) as soon as possible.
You can print a temporary ID card from your secure member website.
You can also display a digital copy of your Aetna ID card through the Aetna Mobile app.
Find what you need — wherever, whenever — with Aetna Mobile. To download your free Aetna Mobile app
*Standard text messaging rates may apply.
Go to www.aetna.com and log in or register. The Claims tab shows a quick view of the most recent claims on file. Each claim line includes the date of service, and patient and provider name. Click on the “details” link to access the Claim Details screen and view more information about the selected claim. There is also a link to search for other claims on file. Or you can call Member Services at 1-800-445-8742. For the hearing impaired, call (TDD) 1-877-301-5038.