About In and Out-of-Network Providers

When you use a provider (doctor, hospital, pharmacy, or other health care facility) in our network, you get covered services at a reduced cost. Plus, your costs after our benefit payment are lower than for a doctor who is not part of our network. Seeing an in-network provider will save you money.

You don’t have to choose a primary care doctor and you can self-refer to see a specialist. But you may want to find a primary care doctor you’re comfortable with in order improve your health outcomes.

To receive in-network benefits, make sure that the provider you see is in-network at the time you make the appointment. Just confirm that the address where you’ll be seen is the address on file. Be sure to have your FSBP ID card on hand at the time of your appointment.

Generally, you won’t need to pay an in-network provider at the time of your visit. You have no out-of-pocket costs for covered preventive care and immunizations when you see an in-network provider. In-network doctors will bill us directly and will bill you for any remaining balance after they receive our payment.

If you choose to see an out-of-network provider within the 50 U.S. states or Guam, you may be charged at least a portion of the cost of care at the time of your appointment. The provider may bill us or ask you to submit the claim.

About Overseas Providers

The FSBP considers all covered providers outside the U.S. and Guam (including Military Treatment Facilities) as if they’re in our network. We provide the same coinsurance rates as we do for in-network providers.

About Medicare and Providers

When Medicare is your primary insurer, FSBP coordinates benefits with Medicare. We generally pay the balance of covered charges, whether you use an in- or out-of-network provider.

Aetna Network Provider Search

Enter the Aetna Choice POS II (Open Access) Provider search. If you are searching for a provider network in Guam, select NetCare-Guam.

Autism Spectrum Providers/ABA Listing

Below is a listing of providers who are certified or licensed to treat Autism Spectrum Disorder (ASD). Members and providers should confirm a member’s eligibility for these services by calling the member services or provider services number on the back of the member’s ID cards. View the list of ABA/ Autism Spectrum Providers.

Institutes of Excellence (IOE) Infertility Search

Certain clinics that have met our quality, safety and cost standards are in our Institutes of Excellence™ Infertility Services program. View the list of Institutes of Excellence (IOE) Infertility providers in your area.

If you need help locating in-network providers, please contact us at 202-833-4910

Provider Nomination Form

If your doctor is not part of our network, you may request they become part of the Plan’s network by completing and submitting this form. Aetna will reach out to the provider to begin the process.