How Aetna coverage works here
When you schedule with Guzman & Baker and use your Aetna insurance, our billing team submits claims to Aetna directly. You pay your share at the time of service. Your share depends on the type of Aetna plan you have and where you are in your plan year. Common cost-sharing structures include:- Copay — A set fee per session (for example, $40 per outpatient mental health visit).
- Coinsurance — A percentage of Aetna’s allowed amount that you pay after your deductible is satisfied.
- Deductible — An annual threshold you pay out of pocket before Aetna begins sharing costs.
Common Aetna plan types
Aetna PPO
Preferred Provider Organization plans offer the broadest flexibility. You can see any licensed provider, though you pay less when using Aetna in-network providers like Guzman & Baker.
Aetna HMO
Health Maintenance Organization plans limit coverage to a specific network. A referral from your primary care provider may be required. Confirm with Aetna before scheduling.
Aetna Select
A narrower network plan that keeps costs lower by limiting covered providers to a curated list. Verify that Guzman & Baker participates in your specific Select network.
Aetna HDHP / HSA-compatible
High-deductible plans paired with a Health Savings Account. You will likely pay the full session fee until your deductible is met. HSA funds can be used to cover these costs.
Using your Aetna member ID
Your Aetna member ID is the unique identifier that connects your insurance record to your claims. You will find it on the front of your Aetna insurance card. You need this number to:- Verify your benefits by phone or online
- Register on the Aetna member portal at aetna.com
- Provide to our office when scheduling so we can confirm your coverage
If you have lost your Aetna card, log in to your account at aetna.com or the Aetna Health app to access a digital version of your member ID card.
How to verify your Aetna benefits
Verifying your benefits before your first session helps you understand your costs and avoid unexpected bills.Locate your Aetna member ID card
Find the front and back of your Aetna insurance card. You will need your member ID, group number, and the member services phone number.
Call Aetna member services
Call the number on the back of your card and ask to speak with an advocatw about your behavioral health or mental health benefits.
Ask about your specific benefits
Request the following information:
- Is Guzman & Baker Behavioral Health Services (NPI: 1669265328) in my Aetna network?
- What is my copay or coinsurance for outpatient mental health sessions?
- What is my deductible, and how much remains?
- Is prior authorization required for outpatient therapy?
- Are there session limits per calendar year?
Verify online (optional)
Log in to your Aetna member account at aetna.com to view your benefits summary, review your deductible progress, and confirm network providers.
What to complete prior to your first appointment
Submit the following in your secure patient portal prior to your first session:- Your Aetna insurance card (front and back)
- Complete additional intake forms (sent to you before the appointment in your patient portal)
- A form of payment for your copay or cost-share amount
If prior authorization is required by your plan, our office can assist with submitting that request. Contact us as early as possible so authorization is in place before your first session.