Aetna

Your Aetna card might say HMO, PPO, EPO, or Medicare Advantage. All four work here at Moses Medical, 871B Westchester Ave in the Bronx. If you got Aetna through your job or enrolled in a Medicare Advantage plan after turning 65, we are in-network for your plan.

The plan type on your card matters because it affects how much you pay and whether you need a referral. Aetna HMO members need their primary care doctor to write a referral before seeing a specialist. PPO and EPO members can book specialist visits directly. If you are not sure which type you have, flip your card over. It is printed on the front.

What Aetna Pays For

We bill Aetna for the following services at our practice:

• Primary care visits including annual physicals, sick visits, and chronic disease checkups
• Internal medicine for conditions like diabetes, high blood pressure, and thyroid problems
• Cardiology for heart screenings, EKGs, and cholesterol management
• Dermatology for skin exams, rashes, acne, and mole checks
• Behavioral health including therapy and psychiatric care
• Pain management for back, joint, and nerve pain
• Podiatry for diabetic foot care, heel pain, and ankle injuries
• Ophthalmology for medical eye exams and glaucoma screening
• ENT for sinus, ear, and throat conditions
• Women’s health for gynecological exams and reproductive care
• Lab work drawn on-site the same day
• X-rays and imaging ordered and completed in our building
• Physical therapy for rehab after injuries or surgery
• Medical weight loss with physician-supervised plans

Medicare Advantage members often have extra benefits beyond what Original Medicare covers. These can include hearing aids, dental visits, and fitness programs. Ask us or call Aetna at 1-800-872-3862 to find out what your specific plan includes.

Checking Your Benefits

Before your first visit, pull out your Aetna ID card and look for two things: plan type and group number. Bring the card and a photo ID to check-in.

If you have an HMO plan and need a specialist, start with a primary care visit here. Your doctor writes the referral the same day in most cases. PPO members can skip that step and book directly with any specialist in our office.

Our front desk runs your benefits electronically when you arrive. We will tell you your copay amount before you see the doctor. If a service requires prior authorization, our staff files the request with Aetna so you do not have to make those calls.

Getting More From Aetna

If you work and get Aetna through your employer: Schedule your annual wellness visit. Aetna covers it at zero copay on most plans. This is separate from a sick visit. It includes age-based screenings, blood work, and immunization updates. A routine blood panel costs nothing. A missed diagnosis costs a lot.

If you are on Aetna Medicare Advantage: You are entitled to an Annual Wellness Visit that includes a personalized prevention plan. You also likely have coverage for ophthalmology exams and podiatry visits that Original Medicare limits. Use them.

For everyone: Staying in-network saves real money. An in-network specialist visit on an Aetna PPO might cost you a $30 copay. The same visit out-of-network could run $150 or more after coinsurance. On HMO plans, out-of-network care is not covered at all except in emergencies.

If you have a heart condition or a family history of heart disease, read our guide on when to see a cardiologist. Our cardiology team sees Aetna patients regularly.

Call (646) 741-2111 to book an appointment, or walk in during office hours. We are on Westchester Ave near the 2/5 trains at Longwood Ave.