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Plan Disclosures

Choose the disclosure that applies to your plan.

These disclosure documents describe Texas Health Aetna health benefits and health insurance plans. Find your plan type.

Medical

Note about employer-funded plans: State mandates do not apply to most self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefits administrator. Plan documents may supersede the information on this website.

Dental

Texas Health Aetna members receive dental benefits from Aetna. Aetna provides certain management services to Texas Health Aetna. Please refer to aetna.com for more information.

Important benefits for women

Women’s Health and Cancer Rights Act of 1998

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:

  • All stages of reconstruction of the breast on which the mastectomy was performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance;
  • Prostheses; and
  • Treatment of physical complications of the mastectomy, including lymphedema.

Benefits will be provided to a person who has already undergone a mastectomy as a result of breast cancer while covered under a different health plan. Coverage is provided in accordance with your plan design and is subject to plan limitations, copays, deductibles, coinsurance and referral requirements, if any, as outlined in your plan documents. For more information, please contact Member Services at the number on your ID card, or the links below.

Centers for Medicare & Medicaid Services fact sheet
U.S. Department of Labor website

The Partnership

Together, Texas Health Resources and Aetna are taking a new approach to the way health care is offered. With this innovative partnership, these two industry leaders aim to provide more efficient and effective member care at a more affordable cost. By joining the right medical professionals with the right technology, members receive the benefit of quality, personalized health care.

Texas Health Aetna
612 E. Lamar Blvd., Suite 100
Arlington, TX 76011

Texas Health Aetna Logo Texas Health Aetna Logo

Health benefits and health insurance plans are offered and/or underwritten by Texas Health + Aetna Health Plan Inc. and Texas Health + Aetna Health Insurance Company (Texas Health Aetna). Each insurer has sole financial responsibility for its own products. Texas Health Aetna are affiliates of Texas Health Resources and of Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Texas Health Aetna.

Self-funded plans are administered by Texas Health + Aetna Health Insurance Company.

This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Health benefits and health insurance plans contain exclusions and limitations. Providers are independent contractors and not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability are subject to change and may vary by location. If you are in a plan that requires the selection of a primary care physician and your primary care physician is part of an integrated delivery system or physician group, your primary care physician will generally refer you to specialists and hospitals that are part of the delivery system or physician group. Information is believed to be accurate as of the production date; however, it is subject to change.

Physicians on the medical staff practice independently and are not agents or employees of the hospital or Texas Health Resources.

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Texas Health + Aetna Health Plan Inc. and Texas Health + Aetna Health Insurance Company (Texas Health Aetna) are affiliates of Texas Health Resources and of Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Texas Health Aetna.

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Texas Health + Aetna Health Plan Inc. and Texas Health + Aetna Health Insurance Company (Texas Health Aetna) are affiliates of Texas Health Resources and of Aetna Life Insurance Company and its affiliates (Aetna). Texas Health Resources provides certain management services to Texas Health Aetna.

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Are you interested in becoming a participating provider with Texas Health Aetna?

Please send an e-mail to the North Texas Network Team.

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