03.01.2015
•
Views
Aetna Medicare SM Plan (HMO) (PPO) Provider Directory This directory provides a list of Aetna Medicare SM Plan (HMO) (PPO) providers. Please refer to the Service Area Map at the back of this directory for the service area applicable to this directory. This directory is current as of 08/2009. Some plan providers may have been added or removed from the list after this directory was printed. To get the most up-to-date information about Aetna Medicare (HMO) (PPO) plan providers in your area, you can visit www.aetnamedicare.com or call our Customer Service Department at 1-800-282-5366, 8 am to 8 pm, 7 days a week. TTY/TDD users should call 1-888-760-4748.
Section 1 – Introduction This directory provides a list of Aetna Medicare (HMO) (PPO) plan providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. With the standard Aetna Medicare Health Maintenance Organization (HMO) plan you will have to choose one of our plan providers that are listed in this directory to be your Primary Care Physician (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care coverage from your PCP. The “plan providers” listed in this directory have agreed to provide you with your health care coverage. You may go to any of our plan providers listed in this directory, however some services may require a referral. If you have been going to one plan provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-plan providers. In cases where noncontracting providers submit a bill directly you, you should not pay the bill, but submit it to Aetna Medicare for processing and determination of your financial liability, if any. Your PCP will issue referrals to participating specialists and facilities for certain services. For some services, your PCP is required to obtain prior authorization from Aetna. You must use network providers except for urgent care or out-of area urgent care/renal dialysis. Except for those benefits described in your plan documents as directaccess benefits, or in an emergency, you will need to obtain a referral from your PCP before seeking covered non-emergency specialty or hospital care. Check your Evidence of Coverage for details. With the Aetna Medicare Open Access (HMO) plans, you are not required to choose a primary care physician (PCP) and are free to visit network providers without a referral to receive covered services. Although selecting a PCP is not required, you will benefit by receiving care from a doctor that has a deeper understanding of your health care needs and may be able to assist with important medical decisions. With the Aetna Medicare Preferred Provider Organization (PPO) Plan, you have the flexibility to choose either network providers at lower out-ofpocket costs, or out-of-network providers at a higher cost sharing level. If you select a PCP from our network, you must notify us of your selection in order to have the lower primary doctor visit copay. By having a PCP coordinate your care, you’ll also benefit by receiving care from a doctor that has a deeper understanding of your health care needs and may be able to assist with important medical decisions. Note: If you do not select a PCP, you’ll be responsible for the higher specialist copay when receiving services from a PCP. Certain healthcare services, such as hospitalization or outpatient surgery, require precertification with Aetna. This means the service must be approved by Aetna before it will be covered under the plan. Check your Evidence of Coverage for a complete list of services that require this approval. When you are to obtain services requiring precertification from a participating provider, the provider is responsible to precertify those services prior to treatment. If your plan covers out-ofnetwork benefits and you may self-refer for covered services, it is your responsibility to contact Aetna to precertify those services which require precertification. If you need emergency care, you are covered 24 hours a day, 7 days a week, anywhere in the world. Whether you are in or out of an Aetna Medicare service area, we simply ask that you follow the guidelines below when you believe you need emergency care. ■ Call the local emergency hotline (ex. 911) or go to the nearest emergency facility. If a delay would not be detrimental to your health, call your PCP. Notify your PCP as soon as possible after receiving treatment. ■ If you are admitted to an inpatient facility, you or a family member or friend on your behalf should notify your PCP or Aetna as soon as possible. If you are traveling outside of the Aetna Medicare (HMO) (PPO) plan service area, you are covered for emergency and urgently-needed care. Urgent care may be obtained from a private practice physician, a walk-in clinic, an urgent care center or an emergency facility. If, after reviewing information submitted to us www.aetnamedicare.com I
-
Page 1:
Aetna Medicare SM Plan (HMO) (PPO)
-
Page 5 and 6:
Hospitals and Skilled Nursing Facil
-
Page 7 and 8:
Hospitals and Skilled Nursing Facil
-
Page 9 and 10:
Hospitals and Skilled Nursing Facil
-
Page 11 and 12:
Hospitals and Skilled Nursing Facil
-
Page 13 and 14:
Hospitals and Skilled Nursing Facil
-
Page 15:
Hospitals and Skilled Nursing Facil
-
Page 18 and 19:
Institutes of Excellence ARIZONA Ba
-
Page 20 and 21:
Institutes of Excellence Westcheste
-
Page 22 and 23:
Institutes of Excellence Transplant
-
Page 24 and 25:
Brazoria Primary Care Physicians BR
-
Page 26 and 27:
Chambers Primary Care Physicians CH
-
Page 28 and 29:
Fort Bend Primary Care Physicians A
-
Page 30 and 31:
Fort Bend Primary Care Physicians A
-
Page 32 and 33:
Galveston Primary Care Physicians A
-
Page 34 and 35:
Harris Primary Care Physicians DEER
-
Page 36 and 37:
Harris Primary Care Physicians Aetn
-
Page 38 and 39:
Harris Primary Care Physicians Aetn
-
Page 40 and 41:
Harris Primary Care Physicians Aetn
-
Page 42 and 43:
Harris Primary Care Physicians Aetn
-
Page 44 and 45:
Harris Primary Care Physicians Aetn
-
Page 46 and 47:
Harris Primary Care Physicians Inte
-
Page 48 and 49:
Harris Primary Care Physicians Aetn
-
Page 50 and 51:
Harris Primary Care Physicians Aetn
-
Page 52 and 53:
Harris Primary Care Physicians or 6
-
Page 54 and 55:
Harris Primary Care Physicians Aetn
-
Page 56 and 57:
Harris Primary Care Physicians Aetn
-
Page 58 and 59:
Harris Primary Care Physicians Aetn
-
Page 60 and 61:
Harris Primary Care Physicians Aetn
-
Page 62 and 63:
Jefferson Primary Care Physicians A
-
Page 64 and 65:
Jefferson Primary Care Physicians G
-
Page 66 and 67:
Montgomery Primary Care Physicians
-
Page 68 and 69:
Montgomery Primary Care Physicians
-
Page 70 and 71:
Montgomery Primary Care Physicians
-
Page 72 and 73:
Montgomery Primary Care Physicians
-
Page 75 and 76:
Obstetricians and Gynecologists / W
-
Page 77 and 78:
Obstetricians and Gynecologists / W
-
Page 79 and 80:
Obstetricians and Gynecologists / W
-
Page 81 and 82:
Obstetricians and Gynecologists / W
-
Page 83 and 84:
Obstetricians and Gynecologists / W
-
Page 85 and 86:
Obstetricians and Gynecologists / W
-
Page 87:
Obstetricians and Gynecologists / W
-
Page 90 and 91:
Brazoria Specialists BRAZORIA ALVIN
-
Page 92 and 93:
Brazoria Specialists Krell, Blair,
-
Page 94 and 95:
Brazoria Specialists White, Lucile
-
Page 96 and 97:
Fort Bend Specialists Shanmugam, Ga
-
Page 98 and 99:
Fort Bend Specialists Physical Ther
-
Page 100 and 101:
Fort Bend Specialists MTin-U, Caesa
-
Page 102 and 103:
Fort Bend Specialists Parr, Thomas
-
Page 104 and 105:
Fort Bend Specialists MPickron, Tho
-
Page 106 and 107:
Galveston MSchneider, Franz Emil, M
-
Page 108 and 109:
Harris Specialists MPyle, James G.,
-
Page 110 and 111:
Harris Specialists CROSBY Chiroprac
-
Page 112 and 113:
Harris Specialists or 13114 FM 1960
-
Page 114 and 115:
Harris Specialists Chowdhury, Sumit
-
Page 116 and 117:
Harris Specialists or 6720 Bertner
-
Page 118 and 119:
Harris Specialists Sokhon, Kozhaya
-
Page 120 and 121:
Harris Specialists Noojin, Jane Ann
-
Page 122 and 123:
Harris Specialists Hickman, Jennife
-
Page 124 and 125:
Harris Specialists Family Practice
-
Page 126 and 127:
Harris Specialists MRance, Ronald M
-
Page 128 and 129:
Harris Specialists or 6565 Fannin S
-
Page 130 and 131:
Harris Specialists Hasbun, Rodrigo
-
Page 132 and 133:
Harris Specialists MGonzalez, Penel
-
Page 134 and 135:
Harris Specialists MNguyen, Thuan K
-
Page 136 and 137:
Harris Specialists or 12121 Westhei
-
Page 138 and 139:
Harris Specialists MRamanathan, Ven
-
Page 140 and 141:
Harris Specialists Lagrone, Don M,
-
Page 142 and 143:
Harris Specialists Me Fletcher, Ste
-
Page 144 and 145:
Harris Specialists or 1635 North Lo
-
Page 146 and 147:
Harris Specialists MWest, Heather F
-
Page 148 and 149:
Harris MHarvey, Gregory P., MD 1315
-
Page 150 and 151:
Harris Specialists or 2211 Norfolk
-
Page 152 and 153:
Harris Specialists MStiernberg, Cha
-
Page 154 and 155:
Harris Specialists MHarrell, John S
-
Page 156 and 157:
Harris Specialists Chaney, Michael
-
Page 158 and 159:
Harris Specialists MMacTavish, Lawr
-
Page 160 and 161:
Harris Specialists MEstrada-Y-Marti
-
Page 162 and 163:
Harris Specialists MLidsky, Martin
-
Page 164 and 165:
Harris Specialists MHuynh, Tam T.,
-
Page 166 and 167:
Harris Specialists Geis, Richard C.
-
Page 168 and 169:
Harris Specialists MKrishnan, Rames
-
Page 170 and 171:
Harris Specialists Cardiology MAgar
-
Page 172 and 173:
Harris Specialists or 18951 Memoria
-
Page 174 and 175:
Harris Swick, Todd J., MD 21703 Kin
-
Page 176 and 177:
Harris Specialists or 23920 Katy Fr
-
Page 178 and 179:
Harris Specialists MVarner, Holly K
-
Page 180 and 181:
Harris Specialists or 3301 Plainvie
-
Page 182 and 183:
Harris Specialists Mallari, Dianne
-
Page 184 and 185:
Harris Specialists Rheumatology MAl
-
Page 186 and 187:
Harris Specialists MOnorato, Michel
-
Page 188 and 189:
Harris Specialists MNahas, Cesar, M
-
Page 190 and 191:
Jefferson Specialists Infectious Di
-
Page 192 and 193:
Jefferson Specialists Bencowitz, Ha
-
Page 194 and 195:
Jefferson Specialists Rizzo, Corey
-
Page 196 and 197:
Liberty Specialists Pulmonology MTi
-
Page 198 and 199:
Montgomery Specialists Infectious D
-
Page 200 and 201:
Montgomery Specialists MIrwin, Jame
-
Page 202 and 203:
Montgomery Specialists Pulmonology
-
Page 204 and 205:
Montgomery Specialists MWoo, Lilian
-
Page 206 and 207:
Montgomery Specialists Payne, Krist
-
Page 208 and 209:
Montgomery Specialists MSimmons, Je
-
Page 210 and 211:
Montgomery Specialists Physical The
-
Page 212 and 213:
Montgomery Specialists Urology MBer
-
Page 214 and 215:
Brazoria Behavioral Health Provider
-
Page 216 and 217:
Galveston Eating Disorder Specialis
-
Page 218 and 219:
Harris or 7007 North Frwy Suite 300
-
Page 220 and 221:
Harris Behavioral Health Providers
-
Page 222 and 223:
Harris Evans, Charlotte A., MA 1704
-
Page 224 and 225:
Harris Behavioral Health Providers
-
Page 226 and 227:
Harris Bhaskaran, Vatsala, MD 11550
-
Page 228 and 229:
Harris Behavioral Health Providers
-
Page 230 and 231:
Jefferson Behavioral Health Provide
-
Page 233 and 234:
Eye Care Providers www.aetnamedicar
-
Page 235 and 236:
Eye Care Providers Fort Bend Dang,
-
Page 237 and 238:
Eye Care Providers Fort Bend MHambu
-
Page 239 and 240:
Eye Care Providers Galveston Le, Ro
-
Page 241 and 242:
Eye Care Providers Harris Crookston
-
Page 243 and 244:
Eye Care Providers Harris MBaze, El
-
Page 245 and 246:
Eye Care Providers Harris or 915 Ge
-
Page 247 and 248:
Eye Care Providers Harris or 915 Ge
-
Page 249 and 250:
Eye Care Providers Harris Zarzour,
-
Page 251 and 252:
Eye Care Providers Harris De La Pen
-
Page 253 and 254:
Eye Care Providers Harris Hemani, H
-
Page 255 and 256:
Eye Care Providers Harris Lee, Fran
-
Page 257 and 258:
Eye Care Providers Harris Olumba, M
-
Page 259 and 260:
Eye Care Providers Harris Sims, Dav
-
Page 261 and 262:
Eye Care Providers Harris Wheat, Jo
-
Page 263 and 264:
Eye Care Providers Harris Garza, Da
-
Page 265 and 266:
Eye Care Providers Harris Harter, P
-
Page 267 and 268:
Eye Care Providers Jefferson Hall,
-
Page 269 and 270:
Eye Care Providers Montgomery Peter
-
Page 271 and 272:
Eye Care Providers Montgomery Liu,
-
Page 273 and 274:
Dental Providers Primary network de
-
Page 275 and 276:
Dental Providers Fort Bend STAFFORD
-
Page 277 and 278:
Dental Providers Harris DEER PARK A
-
Page 279 and 280:
Dental Providers Harris Aetna Prima
-
Page 281 and 282:
Dental Providers Harris Aetna Prima
-
Page 283 and 284:
Dental Providers Harris Aetna Prima
-
Page 285 and 286:
Dental Providers Harris Aetna Prima
-
Page 287:
Dental Providers Montgomery MONTGOM
-
Page 290 and 291:
TEXAS MAIL ORDER AETNA RX HOME DELI
-
Page 292 and 293:
WAL-MART PHARMACY .................
-
Page 294 and 295:
Pharmacies H E B PHARMACY..........
-
Page 296 and 297:
Pharmacies BIOSCRIP PHARMACY ......
-
Page 298 and 299:
MEDICINE SHOPPE PHARMACY ..........
-
Page 300 and 301:
Pharmacies WALGREENS* .............
-
Page 302 and 303:
Pharmacies SEABROOK PHARMACY ......
-
Page 304 and 305:
Pharmacies Liberty CVS PHARMACYe ..
-
Page 306 and 307:
Pharmacies West Orange WAL-MART PHA
-
Page 308 and 309:
Acute Rehabilitation Facility Other
-
Page 310 and 311:
Dialysis Center Other Participating
-
Page 312 and 313:
Dialysis Center Other Participating
-
Page 314 and 315:
Dialysis Center Other Participating
-
Page 316 and 317:
Durable Medical Equipment Other Par
-
Page 318 and 319:
Durable Medical Equipment Other Par
-
Page 320 and 321:
Durable Medical Equipment - NATIONA
-
Page 322 and 323:
Home Health Care Agency Other Parti
-
Page 324 and 325:
Independent Lab - NATIONAL Other Pa
-
Page 326 and 327:
Laboratory Other Participating Prov
-
Page 328 and 329:
Laboratory Other Participating Prov
-
Page 330 and 331:
Physical Therapy Other Participatin
-
Page 332 and 333:
Skilled Nursing Facility Other Part
-
Page 334 and 335:
Urgent Care Center Other Participat
-
Page 336 and 337:
Index of Providers Speaking Additio
-
Page 338 and 339:
Index of Providers Speaking Additio
-
Page 340 and 341:
Index of Providers Speaking Additio
-
Page 342 and 343:
Index of Providers Speaking Additio
-
Page 344 and 345:
Index of Providers Speaking Additio
-
Page 346 and 347:
Index of Providers Speaking Additio
-
Page 348 and 349:
Index of Providers Speaking Additio
-
Page 350 and 351:
Index of Providers Speaking Additio
-
Page 352 and 353:
Index of Providers Speaking Additio
-
Page 354 and 355:
Index of Providers 1 Page 1960 Fami
-
Page 356 and 357:
Index of Providers Balasubramanyam,
-
Page 358 and 359:
Index of Providers Bucker, Blythe,
-
Page 360 and 361:
Index of Providers Cianciulli, Denn
-
Page 362 and 363:
Index of Providers Dong, Phuong L.,
-
Page 364 and 365:
Index of Providers George, William
-
Page 366 and 367:
Index of Providers Heimlich, Myron
-
Page 368 and 369:
Index of Providers Johnson, Mark A.
-
Page 370 and 371:
Index of Providers Lacson, John Pro
-
Page 372 and 373:
Index of Providers Lykos, Tammy Lay
-
Page 374 and 375:
Index of Providers Middleton, Nicol
-
Page 376 and 377:
Index of Providers Nock, Shoshana,
-
Page 378 and 379:
Index of Providers Pham, Vang T., O
-
Page 380 and 381:
Index of Providers Roman, Joe, III,
-
Page 382 and 383:
Index of Providers Shoemaker, James
-
Page 384 and 385:
Index of Providers Tamirisa, Sriniv
-
Page 386 and 387:
Index of Providers Velazquez, Franc
-
Page 388:
Index of Providers Yllana Shepperd,
-
Page 392:
Health insurance plans are offered