What services require prior approval or a doctors referral?
For members with HMO or Elect Choice EPO plans: All specialty services (for instance, specialist physicians, physical therapy, speech therapy) require referrals from your primary care doctor, except for ob/gyn care and some radiology or lab services. Prior approval by Aetna is not required for these types of services. All inpatient admissions and certain other services require approval of Aetna, except for normal maternity admissions, which require notification only. For members with QPOS or Managed Choice POS plans: To receive the higher benefit level under your plan of benefits, you should get a referral from your primary care doctor for all specialty services (except for programs such as ob/gyn, lab and X-ray). Prior approval by Aetna is not required for referrals. You may also visit any recognized provider, without a referral, but, your benefit will be at a reduced level. All inpatient admissions and certain other services require prior approval, except for normal maternity admissi
