Choose a PCP

• Choose a primary care physician (PCP) from the Aetna network of participating providers for your entire family, or choose a different PCP for each family member.
• By choosing a PCP, you and your doctor have an opportunity to develop a deeper understanding of your health needs to help manage your care better.
• To select a PCP, visit our DocFind^® online directory, or call
  1-800-949-3104 to order a printed directory.
• You can change your designated PCP at any time by visiting Aetna Navigator^® or by calling the Member Services number on your ID card (received after you enroll).

Visit Your PCP

• Your PCP can provide routine and preventive care and treat you for certain illnesses and injuries.
• Your PCP can help you make important medical decisions.
• Your PCP may refer you to other participating health care professionals and facilities and coordinate your follow-up care.
• Your PCP and other network providers will obtain coverage approval from Aetna (called precertification) on your behalf, prior to providing certain medical services. Precertification helps determine if the recommended services are covered under your plan.

Pay the Applicable Amount

• When you visit your PCP and other health care professionals and facilities, you will be responsible for a copay (a flat dollar amount or a percentage of covered services).
• Please refer to your Standard HMO Medical Plan Summary or your Alternative HMO Medical Plan Summary for a list of covered services and the amount you are responsible to pay.
• If your PCP requires payment at the time of service, you can pay the applicable amount and then fill out a claim form for reimbursement.

If your doctor is not currently an Aetna participating provider and you would like him/her to be considered, you may call Member Services at 1-800-949-3104. A Member Services Representative will collect the name, address, phone number, and specialty of the physician who is being nominated. If a physician is interested in joining Aetna's network, you can direct them to the Provider Line at 1-800-353-1232.

Please note that by nominating a physician, this does not guarantee that he/she will participate in the Aetna network. Acceptance into the network is contingent upon successful completion of Aetna's business participation criteria, Credentialing process, Quality Management review, physician acceptance of the contract and compensation agreements, and whether Aetna contracts with physicians in the geographic area. The application process may take up to six months following receipt of the physician's application.

Under State of Oklahoma's Transition of Care benefit, you and your covered family members may be able to continue to receive care from a doctor who is not in the Aetna network for your 2010 plan. This benefit allows for a safe transition to a network provider. You must be in an active course of treatment for one of the following conditions:

• Pregnancy (if you are in your second or third trimester as of January 1, 2010)
• Newly diagnosed or relapsed cancer currently being treated with chemotherapy, radiation therapy or reconstruction surgery
• Organ or bone marrow transplant
• Recent major surgeries that are in the follow-up period
• Acute conditions in active treatment (e.g., heart attack, stroke or unstable chronic conditions)

Examples of conditions that don't qualify for this benefit include routine exams; stable chronic conditions such as diabetes or asthma; minor illness such as colds or sore throats; and elective scheduled surgeries.

To qualify for Transition of Care, employees and covered dependents must be enrolled as a State of Oklahoma plan participant as of December 31, 2009.

If you have a qualifying condition that is documented by a physician who does not participate in your new network, you may apply for Transition of Care.

To apply for Transition of Care, open and print out this Transition Coverage Request form. You will need to submit a request prior to January 1, 2010.

Once your information is on file, you will receive a written notification telling you whether your Transition of Care request has been approved.