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Aetna PPO

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Old 07-26-2013, 03:31 PM
Buckeyephan Buckeyephan is offline
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Unhappy Aetna PPO

Just got rejected by The Villages Health Care since they won't accept my Aetna PPO which worked extremely well in Ohio. My other option with State Teachers Retirement is a Med Mutual plan which has a yearly out of pocket max which is over $6,000 more per year than Aetna. The woman at colony said to fill out the packet and see if the doctor would accept us as patients before we make a change.

I looked through old posts and am still unclear about the quality and availability of in-network doctors. Sorry if this topic has been beaten to death. Feeling a bit unloved right now.
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Old 07-26-2013, 03:49 PM
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Interesting...

I guess "Marcus Welby" only works for the right insurance companies.

Be interesting to see if you had UnitedHealth Care if they would except your insurance....oh yeah BTW may just be a coincidence that UnitedHealth Care is renting space in all the three Village Squares.
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Old 07-26-2013, 05:41 PM
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Originally Posted by Buckeyephan View Post
Just got rejected by The Villages Health Care since they won't accept my Aetna PPO which worked extremely well in Ohio. My other option with State Teachers Retirement is a Med Mutual plan which has a yearly out of pocket max which is over $6,000 more per year than Aetna. The woman at colony said to fill out the packet and see if the doctor would accept us as patients before we make a change.

I looked through old posts and am still unclear about the quality and availability of in-network doctors. Sorry if this topic has been beaten to death. Feeling a bit unloved right now.
We also have Atnea PPO and Aetna is our only choice through my husbands employer. There are not many Aetna choices here in TV.
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Old 07-26-2013, 07:06 PM
jimmy D jimmy D is offline
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It is my understanding that they will take any other companies Major Med or Medicare supplement plan but will not take any PPO or Hmo but United and Preferred Care Partners. This was from my Insurance Agent and I believe her. Good Luck
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Old 07-26-2013, 09:46 PM
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We too have Aetna PPO which opened ALL medical doors in Ohio and has been our insurance for over fifty years, but was turned down by the new care centers.

I am getting very frustrated trying to find a good general practitioner for the three of us. I am not satisfied with the one we have because he is trying to do tests in office that I don't think are needed. For instance an ultra sound on my leg because he performed some test that required blood pressure cuffs on arms and legs and tests while sitting and standing. Now he says he needs an ultrasound (in house) on my leg. Maybe I am ultra suspicious...
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Old 07-26-2013, 10:21 PM
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We also have Aetna PPO and facing the same problems. Very frustrating to say the least. Still travel back to Tampa for most doctors. Never had this problem in the Tampa area.
I will tell you I used Dr. Thomas Mathew from Endoscopy Center of Ocala, located on 441 for a colonoscopy and they were great. Also took my Aetna PPO.
Hubby also just tried Dr. Majid Heydari at Aesthetic Dental across from Colony Plaza and was happy with him. He also accepts Aetna.
Would love to hear from others who have Aetna and who they use as doctors.
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Old 07-26-2013, 10:30 PM
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I'm used to driving 45 minutes to my Ohio doctors and would be willing to do the same here. Someone good in Ocala would be fine. Does that give better options?
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Old 07-27-2013, 08:07 AM
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Glad to see this thread! I'm not alone! I have Aetna PPO and I also feel unloved by the providers in TV. I honestly get irritated when I read about Marcus Welby in the paper. Sounds so good...but only for the few with the right insurance. Medicare is still a few years off for me....so...I wait.
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Old 07-27-2013, 08:30 AM
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We also have Aetna PPO and it has been a challenge. However, we have found Dr.'s that takes our plan. One is Dr. Nalini Yelamanchi, Internal Medicine, with an office in Colony. She is very good, we like her very much.
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Old 07-27-2013, 09:59 AM
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Quote:
Originally Posted by graciegirl View Post
We too have Aetna PPO which opened ALL medical doors in Ohio and has been our insurance for over fifty years, but was turned down by the new care centers.

I am getting very frustrated trying to find a good general practitioner for the three of us. I am not satisfied with the one we have because he is trying to do tests in office that I don't think are needed. For instance an ultra sound on my leg because he performed some test that required blood pressure cuffs on arms and legs and tests while sitting and standing. Now he says he needs an ultrasound (in house) on my leg. Maybe I am ultra suspicious...
Maybe he has an ultra fetish.
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Last edited by DaleMN; 07-27-2013 at 10:00 AM. Reason: just for fun
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Old 07-27-2013, 11:33 AM
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Quote:
Originally Posted by Wendy View Post
We also have Aetna PPO and it has been a challenge. However, we have found Dr.'s that takes our plan. One is Dr. Nalini Yelamanchi, Internal Medicine, with an office in Colony. She is very good, we like her very much.
Thank you Wendy for posting! I appreciate your input.
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Old 07-27-2013, 11:54 AM
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I too have Aetna Medicare PPO. But this area is considered an extended service area(ESA) which is printed on my Aetna id card. Essentially what this means is that any Medicare certified doctor can accept this and will be paid as an in network doctor. I have had no problems with it. TV hospital is not a participant, but does accept it and is paid as in network. My spouse also has it and was told by the doctor that she can't accept out of network rates, but did submit the first office visit and was paid as in network so she no longer has a problem with it.
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Old 07-27-2013, 02:03 PM
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I was an Aetna PPO here for many years and did not have a problem. There was a couple of years when I had to switch a specialty doctor because Aetna dropped Leesburg hospital. I did have to go to Ocala for some specialty doctors but that was before we had so many doctors here in TV.

Then I went on Medicare and became Managed Care instead of PPO. Since Medicare is the Primary and Aetna is the secondary I have had no problems at all.

Dental care was probably the worst since there were only two or three dentists in the program and we did not care for any of them.

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Old 07-27-2013, 03:46 PM
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Aetna providers tend to be in higher population density areas than we are. They handle claims (and provider agreements) for a number of Federal employee plans. I had coworkers who loved it. *But* They had a total of three in network providers within 2 hours of where I lived before TV.

You could call or write Aetna and suggest that they need to sign up more docs in this area. If enough people contact them, they might listen. Or they might not.
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