What are my out-of-pocket costs if I visit a nonparticipating doctor?
You will be responsible for the deductible and coinsurance specified in your plan. Also, because the physician does not have a pre-negotiated contract with Aetna, you may be responsible for the amount in excess of the plan’s allowed amount up to the provider’s billed charges). In addition, you may have to file a claim form for reimbursement of the covered services. In case of emergency services, you may use participating or non-participating providers at the in-network level of cost share and Aetna will hold you harmless for any balance bill amount.
