Providence Facilities Now Out-of-Network for Aetna Members
As a result of a failure to come to terms on a new contract, Providence clinics and hospitals are no longer in-network for most patients with Aetna PPO or Medicare Advantage plans in the Portland area as of January 1, 2025.
Women’s Healthcare Associates, LLC (WHA) is independent from Providence and our providers and clinics remain in-network with Aetna.
Please review the information below if you have Aetna coverage and are planning care, such as a surgery or birth, at a Providence facility. If you have questions about how your Aetna plan will cover care at a Providence facility, we encourage you to contact Aetna at the phone number listed on the back of your insurance card.
1. Will I still be covered at WHA?
Yes. WHA providers and clinics are independent from Providence and remain in-network with Aetna. You can continue to see your WHA provider under your current plan.
2. What if I have a planned birth or surgery at a Providence hospital?
If your situation meets certain criteria, you may qualify for extended in-network access (often called “Continuity of Care”) through Aetna.
To find out if you qualify, call Aetna at the number on your insurance card. If Aetna asks you to fill out paperwork for Continuity of Care, please contact our office and select option 3 after making your language selection. One of our financial coordinators will help you complete and submit the necessary forms.
Without prior authorization or Continuity of Care approval from Aetna, using a Providence facility may result in higher out-of-pocket costs.
3. Aetna gave me a Continuity of Care form. What should I do next?
That’s great—this is the first step in determining whether you can continue to use Providence facilities as in-network. Simply call our office and select option 3 after making your language selection to speak with a financial coordinator who will help you fill out the form. We do not charge a fee for this assistance.
4. I have Aetna insurance and need to transfer my care. What are my options?
- If you haven’t been denied Continuity of Care yet: We recommend contacting Aetna first. You may qualify for an exception that allows you to keep using Providence facilities as in-network.
- If Aetna denied your Continuity of Care request: We understand this is frustrating. WHA can help you transition to one of our offices located near Legacy hospitals, where our providers can continue to support your pregnancy or other healthcare needs in-network. Contact your WHA office >
5. What happens if I go to a Providence hospital anyway?
Because Providence is out-of-network with most Aetna plans (except for Providence employer plans), care at a Providence hospital will likely be much more expensive unless you obtain Continuity of Care approval from Aetna.
If you have already scheduled or anticipate needing hospital services at Providence, call Aetna to see if you qualify for extended in-network coverage.
Need More Help?
If you have any questions about your coverage or need guidance on completing paperwork, please call our office. Our financial coordinators are here to help you navigate these changes and make sure you understand your options. After making your language selection, press 3 to be connected.
Thank you for choosing Women’s Healthcare Associates. We appreciate the opportunity to care for you and are committed to making this transition as smooth as possible.