Doctor Visits and Hospital Stays
This section provides information needed when you, your spouse, or your child must visit the doctor or hospital, or are referred to a specialist
If it is NOT AN EMERGECY, your least costly options depend on your status and age.
- For an inpatient non-emergency hospital admission, where you will be in the hospital admission, where you will be in the hospital for 18 hours or longer, you must notify the insurance company at least three (3) working days prior to admission in order to obtain Pre-Certification for the hospitalization. You, your doctor or the hospital must call the insurance company at 1-800-239-9697. The insurance company will ask you why you are planning to go into the hospital and will certify your visit over the phone.
- For an inpatient emergency admission, you must notify the insurance company by phone within one (1) working day of admission to the hospital. You, your representative, your doctor, or the hospital must call the insurance company at 1-800-239-9697.
- Pre-Certification or Notification for hospitalization is required by the insurance company. if you do not follow this procedure, the first $200 of the hospital bill will be your responsibility.
Preferred Provider Network
In all cases, it costs less to go to a hospital or doctor in the PREFERRED PROVIDER NETWORK (you can use any other hospital or doctor worldwide outside the Preferred Provider Network, at possibly slightly higher expense).The University of Michigan Health System in Ann Arbor is part of this network. To find other “Preferred Providers” and to find Aetna-network pharmacies, visit their web site Aetna or call 1.800.239.9697.
*In many cases, the doctor/hospital will bill the insurance company directly. If so, either you will not receive a bill at all or you will be billed for the portion of the services that the insurance company does not cover, such as the deductible.