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Frequently Asked Questions (FAQs)

General information

How does it work?

First, choose a primary care doctor to lead your care team. Your doctor and other health care providers in the network will generally refer you to specialists and hospitals that are affiliated with the Texas Health Aetna network. Then, electronic health records help keep you and your care team on the same page. That’s because they can keep track of your prescriptions, lab results, health history and more. Having this big-picture view of your health also helps them spot any gaps in your care. And if they find that you’re at risk for certain conditions, they can build a personalized care plan to treat you.

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

The doctor you pick will lead your care team. That’s important because you should see your doctor not only when you’re sick, but also for your annual wellness exam, including preventive screenings. Your doctor can also help you find care programs tailored to your needs. He or she can guide you on important health decisions. And coordinate your care across other specialties and facilities in your network.

What happens after I enroll?

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.

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 doctor outside the Texas Health Aetna network?

You can work with your current doctor and request transition-of-care coverage. If we approve your request, you can stay with your current out-of-network doctor for a limited time at the highest benefit level. However, transition-of-care coverage is for your current doctor only. It doesn’t 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 doctor. And before your grace period ends, we can help transfer you to a new doctor within the Texas Health Aetna network.

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, were just diagnosed or are trying to get a condition under control, your care team can help.
 
They want you to get the right treatment and the right level of care, at the right time. So, they may:

  • Build a personalized care plan for you
  • Educate you about your condition
  • Monitor your progress and adjust your treatment plan
  • Check in with you to be sure you’re taking your medicine, refilling prescriptions and following your plan
  • Encourage you to be actively involved in your care and call if you’re having any trouble  
  • Offer you resources to help you throughout your health care journey

What if I'm 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.

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

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

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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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Join Our Network

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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