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Utilizing Preferred Specialist and Lab

Preferred Specialists

Aetna and UnitedHealthcare (UHC) maintain a list of specialist categories with in-network preferred providers. Because these physicians have demonstrated higher quality and efficiency of patient care, costs are less. Members are charged a higher amount for utilizing an in-network non-preferred or out-of-network provider in these specialist categories. If the specialist category needed is not on the list below, or if members live in a location where preferred specialists are not available, members are charged the in-network preferred copayment when utilizing in-network providers.

Contact the provider, Aetna, or UHC, before seeking care from a specialist to understand the cost, or use the Castlight phone app to view specialist choices and costs.

When utilizing specialists, first check if they are in a category that identifies in-network preferred specialist providers. Since a provider’s status can change, confirm the provider’s status prior to the appointment. Aetna preferred providers are listed as Aexcel with a blue star. UHC preferred providers are listed as Premium Tier 1.

Listed in the table are the categories and locations. For the most current list of categories and locations, contact Aetna or UHC.

Aetna (Aexcel) UHC (Premium Tier 1)
Categories with In-Network Preferred Specialists  

Cardiology; Cardiothoracic Surgery; Gastroenterology; General Surgery; Neurology; Neurosurgery; Obstetrics and Gynecology (OB/GYN);

Orthopedics; Otolaryngology– Ear, Nose, and Throat (ENT); Plastic Surgery; Urology;

and Vascular Surgery
Allergy; Cardiology; Endocrinology; Family Practice; Gastroenterology; General Surgery; Internal Medicine; Nephrology; Neurology; Neurosurgery–Spine; Obstetrics and Gynecology (OB/GYN); Ophthalmology; Orthopedics; Otolaryngology– Ear, Nose, and Throat (ENT); Pediatric Internal Medicine; Pediatrics; Pulmonology; Rheumatology; and Urology
Locations with Limited or No Access to Preferred Specialists  

MI; NC; NH; OR; SD; WA;

and Southeastern, Central, and Western PA

AZ, CA, DE, GA, IN, KY,

MA, MI, NC, NH, NV, OR, SC, TX, VT, and WV

Preferred Labs

Quest Diagnostics and LabCorp are the preferred labs for Aetna and UHC. They charge less and perform a wide variety of services. Aetna and UHC participants have access to the Quest lab located in McCosh Health Center. Members who utilize other in-network labs will pay more and have to meet their annual deductible. There is no coverage for out-of-network lab services.

How to Find In-Network Providers

To find an in-network provider or laboratory, independent radiology center, or urgent care center, call Health Advocate, use Castlight, or follow the steps below.

Aetna (CDHP, HMO, PHP, J-1 Visa)

  1. Go to www.aetna.com/dse/princeton.
  2. Enter the location (zip code or city/state) for the area you want to search.
  3. Select your medical plan from the list provided.
  4. Enter the name of the provider or search by category.

UnitedHealthcare (PHP)

  1. Go to princetonuniversity.welcometouhc.com.
  2. Under Wondering if your doctor is in our network?, click Find a Doctor.
  3. Under See if your doctor or hospital is in the network, click Search the network: The Choice Plus Plan.
  4. Change the address to your local area.
  5. Enter the physician specialty or facility/clinic.