Recently on 12/13/2023, Aetna informed us, their Medicare agents, that Optum Health Network will no longer be in-network for Aetna HMO Medicare plans effective January 1, 2023. This contract termination will only apply to the provider network in Southern California and to these Medicare HMO plans only:

  • HMO PLUS PLAN H4982-001; 002; 004
  • HMO SELECT PLAN H0523-002; 022; 052
  • HMO PRIME PLAN H0523-061
  • DSNP-EAE PREFERRED PLAN H4982-016
  • MA Only EAGLE PLAN H4982-013

This change pertains to HMO Medicare members only. Commercial and Individual Medicare PPO plans are not being terminated.

There are many medical groups that are part of Optum Health Network in Los Angeles, Riverside, San Bernardino, Orange, and San Diego counties. In San Diego particularly, it will impact providers in Optum Care Network – North County but not Mercy Physician Medical Group.

Aetna and Optum have sent out letters to inform their members regarding this termination earlier almost at the end of the Annual Enrollment Period (AEP) before Aetna officially sent us this information.

Due to that limited time before the closing of AEP, many Aetna members found themselves in a time-pressing situation where they have to make an immediate decision about whether to stay or switch plans.

If you are impacted by this contract termination and would like to keep your Optum doctors, you need to change to another Medicare plan. If you stay with your Aetna HMO Medicare plan, you will be assigned to a new doctor by Aetna or you can ask Aetna member service to help you find a new doctor of your preference from another medical group.

If you haven’t changed your plan already during AEP, feel free to contact me so I can help you to find another Medicare plan while keeping the same doctors. The new plan will be effective on the first day of the month after the enrollment has been submitted.

Feel free to schedule an appointment with me or call me at 858-299-2672 (recorded line).

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