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Frequently Asked Questions (FAQs)

General information

How does it work?

The goal at Texas Health Aetna is simple: provide personalized care by combining the clinical expertise of Texas Health with the stability of health care coverage from Aetna to create an affordable, high-quality, integrated solution. This starts when you select a primary care physician, who will lead your personalized care team that will help you every step of the way. This primary care physician will refer you to specialists and hospitals within the Texas Health Aetna network as needed. Your personalized care team will help you keep track of prescriptions, lab results, health history and more. Additionally, you have 24/7 access to your electronic health records for review at your convenience.

Texas Health Aetna also offers a virtual care platform that allows you to speak to a local physician about a specific health issue, whether it’s simple or complex, within minutes. The virtual care ER Doc app requires no copays for members and can be accessed via a mobile device or your member portal 24 hours a day. Not only does this platform provide immediate answers, but it saves you from unnecessary visits to the emergency room or urgent care facility.

Why should I choose a primary care* physician when I enroll?

Our proactive, personalized services make it easy for members to receive the care they need, while being able to clearly understand the details of their care and coverage. This all starts when you select a primary care physician. We provide members with access to more than 1,700 primary-care physicians across 1,200 locations so you have plenty of options that fit your needs. Texas Health Aetna strives to provide forward-thinking primary care physician that not only personalize your care, but ensure preventative measures are taken to avoid extended complications and costs.

*In Texas, PCP is known as physician (primary care).

What should I expect once I enroll?

Once you enroll, you will 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, as well as answer any additional questions you may have. We will then reach out to via phone and welcome you to the Texas Health Aetna family and verify you received all of the information you need as a new plan member and address any questions you may have. We also highly encourage you to start navigating around the patient portal and download the ER Doc app. The Texas Health Aetna ER Doc is our free, trusted care companion for our members and the front door of our integrated care delivery model with Texas Health Resources.

Seeking care

How do I find providers who are part of my care team?

Just click here to find doctors in the Texas Health Aetna network

What if I’m in the middle of care or treatment with a physician outside the Texas Health Aetna network?

You can work with your current physician and request transition-of-care coverage and upon approval, you can stay with your current out-of-network physician for a limited time at the highest benefit level. Transition-of-care coverage is for your current physician only and does not cover health care facilities, durable medical equipment (DME) or prescription drugs so you’ll need to use Texas Health Aetna network facilities, DME vendors and pharmacies while you’re in treatment with your current physician. We are more than happy to help you transfer to a new physician within the Texas Health Aetna network before your grace period ends saving you added time and stress.

How can Texas Health Aetna network plans help me cope with my chronic condition, such as diabetes or high blood pressure?


Whether you’re at risk, recently diagnosed or are trying to get a condition under control, your personalized care team is there to help. The goal of your care team is to ensure you get the right treatment and level of care, at the right time. Some of the ways our care teams do this include:

  • Building a personalized care plan for your health needs
  • Educating you about your condition and preventative tips
  • Monitoring your progress and adjust your treatment plan as needed
  • Checking in with you to confirm you’re taking your medicine, refilling prescriptions and following your plan
  • Encouraging you to be actively involved in your care and call if you’re having any trouble  
  • Offering you resources to help you throughout your health care journey

What if I'm in an emergency situation and not at home and need care?

If your health or life is in serious danger, call 911 or go to the nearest hospital. You’ll be covered as though you stayed within the network.

The Partnership

Leveraging the strengths of two leading organizations, Texas Health Aetna is blurring the lines of traditional health care plans and health systems to create a truly integrated solution that’s simple to navigate while putting the member’s experience first. The jointly-owned local health plan is committed to providing affordable, high-quality health care services and delivering customized care to members throughout the Dallas-Fort Worth metroplex.

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

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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 Texas Health Aetna Network Team.

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