Are you choosing a Primary Care Physician?

One of the best ways to make sure you're getting excellent health care is to have a primary care physician (PCP) with whom you can build a long-term relationship-someone who knows your medical background and understands what's important to you. Traditionally PCPs fall into three specialties - Family Medicine (treating patients of all ages), Internal Medicine (treating adult patients) or Pediatrics (treating children from birth through adolescence). Women will often choose a Gynecologist or Obstetrician (OB/GYN) for their primary care needs. When you have a physician you know and trust, you feel comfortable talking about anything. And, all your basic care-including routine exams, preventive care and treatment for illnesses or injuries- goes more smoothly and easily. Your PCP also knows when it's best to refer you to a specialist.

Is your doctor In Network?

Doctors, hospitals and other health care professionals who belong to the Aetna network agree to charge lower rates for TRS members. When you use in-network providers, your benefits and your share of expenses are based on the provider’s negotiated rate for a given service. And there are no balance bills with in-network providers.

What’s more, your plan pays benefits at a higher level when you stay in the network.

Staying in the Aetna network can help keep you from being balance billed. When scheduling services, ask questions like:

Does the doctor belong to the Aetna network?

Ask this question when you are considering a new or alternative doctor for primary or specialty care.

 

Do the other doctors and/or health professionals involved in my care belong to the Aetna network?

Don’t assume everyone involved in your care belongs to the network just because your doctor does. Be sure to ask.

In addition to primary care doctors, specialists, surgeons and anesthesiologists, stay in the Aetna network when you get health care at laboratories, imaging centers, urgent care centers, physical therapists, outpatient surgery centers and substance abuse facilities.

You can find in-network providers for a full range of health care services by using DocFind®, the provider search tool, at www.trsactivecareaetna.com. Click on “Find a Doctor or Facility if you are enrolled in a TRS-ActiveCare plan,” log in and choose “I want to . . . Find a Doctor, Dentist or Facility.” You’ll see a list of provider types, conditions and procedures.

Do you want a doctor who is close to home or work?

Keep in mind that most doctors' appointments are scheduled during the day, Monday through Friday. So you should consider where you are during these times. At work? At home? Helping out at your children's school? You can use the provider locator to narrow your search by type of specialty or doctor's name. You can then further narrow your search by choosing the distance acceptable from your work or home zip code.