Frequently Asked Questions

If you're interested in quality healthcare, greater value, and excellent customer service, you should consider the KelseyCare Aetna health plan. The KelseyCare Aetna plan makes it easy to get the care you need. You can visit any Kelsey-Seybold physician at any Kelsey-Seybold location in the Greater Houston area without a referral. Conveniences include:

• Same-day and next-day appointments with primary care physicians
• 24/7 appointment scheduling with the assistance of Houston-based Kelsey-Seybold appointment representatives
• The reassurance of our After-Hours Nurse Hotline at 713-442-0427
• The ability to email your doctor's office and schedule appointments online
• Saturday appointments at four regional locations

To learn more about the KelseyCare Aetna plan and Kelsey-Seybold Clinic, visit kelsey-seybold.com/gillmanautomotivegroup and kelsey-seybold.com.

No, you can schedule an appointment directly with any Kelsey-Seybold specialist at any Kelsey-Seybold location, no referrals required. Kelsey-Seybold’s doctors have expertise in more than 65 medical specialties.

A referral also isn’t required to access Aetna’s behavioral health network.

As a KelseyCare Aetna plan member, you have access to the board-certified Kelsey-Seybold Cancer Center team within days of a cancer diagnosis. Should you require care that’s not available within Kelsey-Seybold’s nationally accredited Cancer Centers and Infusion Centers, our cancer specialists will coordinate your care with the appropriate cancer center or treatment program that offers the best outcomes for your personal situation. This includes MD Anderson,  Baylor College of Medicine, St. Luke’s Health, and Texas Children’s Hospital.

As a KelseyCare Aetna member, you also have access to more than 7,000 credentialed, contracted affiliate specialists. Affiliate specialists include doctors from Texas Children’s Hospital, Baylor College of Medicine, and other highly regarded physician organizations. A referral from your Kelsey-Seybold physician is required to see an affiliate specialist.

Yes, and it covers most of the Greater Houston-Galveston area. Please click below for a full list of eligible zip codes.

https://www.kelseycare.com/aetna/documents/kelseycare-aetna-service-area-map.pdf

• Direct benefit and claim questions to the Aetna Customer Service unit at the phone number shown on your Member ID card.
• Call the KelseyCare Concierge at 713-442-9593 for personalized assistance and answers to all your questions about Kelsey-Seybold.

• Yes. Call the Aetna Health Information Line at the phone number shown on your Member ID card to speak with a nurse when needed.
• As a KelseyCare Aetna member, you also have access to Kelsey-Seybold’s 24-hour Contact Center and After-Hours Nurse Hotlineby calling 713-442-0427. The After-Hours Nurse Hotline is staffed by Kelsey-Seybold registered nurses who can access your secure electronic medical record (EMR) and page your Kelsey-Seybold physician when needed. You can call the After-Hours Nurse Hotline after 5 p.m. on weeknights and anytime on weekends and holidays to ask questions or discuss concerns regarding symptoms or illnesses you or a family member may be experiencing.

Yes, you’ll continue to have access to the member login at Aetna.com.

Your KelseyCare Aetna plan providers will file your claims with Aetna for you.

• Emergencies are covered worldwide.
• Contact Aetna at the phone number shown on your Member ID card for more information about participating Urgent Care clinics outside of the Greater Houston area.
• Emergency care and Aetna in-network urgent care clinics are a covered benefit. Please refer to your Summary of Benefits and Coverage (SBC) for details.
• As a KelseyCare Aetna member, you have access to Virtual Care, 7 days a week, 365 days a year.
  • VideoVisitNOW (copays apply) provides on-demand care for adults 18+ from 7 a.m. to 9 p.m., Monday – Friday and 10 a.m. to 9 p.m. on weekends and holidays. Wait times average 20 minutes or less!
  • Scheduled Video Visits (copays apply) provide pre-scheduled Video Visits with primary care and specialty care providers for adults 18+ and children 0 – 17 years old from 8 a.m. to 5 p.m., Monday – Friday. Video Visits for primary care only are available on Saturdays from 9 a.m. to 2 p.m.

Please refer to your Summary of Benefits and Coverage (SBC).

Yes, you'll have access to Aetna's National Urgent Care Network through your KelseyCare Aetna plan, as well as Saturday sick-care appointments at four Kelsey-Seybold regional locations: Bay Area Campus in Webster, Fort Bend Campus (Fort Bend Medical and Diagnostic Center) in Sugar Land, Memorial Villages Campus at I-10 and Campbell Road, and North Houston Campus off FM 1960 and Cypress Woods Medical Drive. With the KelseyCare Aetna plan, you have many options for after-hours care, including:

• The Kelsey-Seybold After-Hours Nurse Hotline at 713-442-0427 is available weeknights after 5 p.m., and on weekends and holidays. A Kelsey-Seybold registered nurse will answer your questions, page your physician if necessary, and schedule needed appointments. If a situation appears life threatening, take immediate action and call 911.
• Saturday Sick-Care Appointments for children and adults are available from 9 a.m. to 2 p.m. at four Kelsey-Seybold locations: Bay Area Campus, Fort Bend Campus (Fort Bend Medical and Diagnostic Center), Memorial Villages Campus, and North Houston Campus. Call our 24-hour Contact Center at 713-442-0427 after 5 p.m. on Friday or on Saturday morning for a Saturday appointment.
• Urgent Care is available through Aetna at over 50 participating urgent care clinics throughout Greater Houston. Urgent care clinics treat conditions that need immediate attention, but aren’t life-threatening, such as broken bones, fractures, cuts, lacerations, sprains, strains, fevers, and minor infections.
• Emergency Room (ER) services are available when you believe you or a family member may be experiencing a life-threatening medical situation. Emergency care services include medical, psychiatric, surgical, hospital, and related healthcare services, such as ambulance service and testing, which are required to treat a sudden, unexpected onset of bodily injury or serious sickness. Examples of emergency situations include uncontrolled bleeding, seizures or loss of consciousness, shortness of breath, chest pains or severe squeezing sensations in the chest, suspected overdose of medication or poisoning, and sudden paralysis or slurred speech.

Depending on the severity of your situation:

• Contact your Kelsey-Seybold physician during normal business hours.
• Contact the Kelsey-Seybold After-Hours Nurse Hotline, available toll free at 1-800-231-6421.
• Seek care from one of the participating Urgent Care clinics available across the country.
• Go to the nearest emergency room for serious and immediate medical treatment needs.

Kelsey-Seybold After-Hours registered nurses have access to your Kelsey-Seybold electronic medical record and can counsel you on appropriate care and next steps. The nurse can page your physician and have medications called into a local pharmacy, as necessary, to treat your condition.

KelseyCare Aetna physicians coordinate in-hospital care through multiple, world-class hospital partners and hospital systems. This includes Texas Children’s Hospital, St. Luke’s Health, The Woman’s Hospital of Texas, Houston Methodist, Memorial Hermann, and HCA Houston Healthcare.

Your Kelsey-Seybold physicians will deliver and coordinate your care and treatment. They will engage specialists on your behalf, both at Kelsey-Seybold and at other top medical groups and hospitals to ensure a quality treatment plan to meet your specific care needs. Kelsey-Seybold has specialists with expertise in more than 65 medical specialties. No referral is necessary to schedule an appointment with any Kelsey-Seybold specialist at any Kelsey-Seybold location. Go to kelsey-seybold.com/bios and search “Find a Doctor” by specialty to view biographies and physician videos.

In addition, your KelseyCare Aetna plan gives you access to more than 7,000 affiliated specialists in the Texas Medical Center and in the community and will coordinate your care with these doctors based on your needs. Affiliated specialists who work with us include doctors at the renowned Texas Children’s Hospital, Texas Heart Institute, Baylor College of Medicine, and other highly regarded physician organizations. (A referral is needed to see affiliated specialists.)

As a KelseyCare Aetna plan member, you have access to our board-certified Kelsey-Seybold Cancer Center team within days of receiving a diagnosis. Should you require care that’s not available within Kelsey-Seybold’s nationally accredited Cancer Centers and Infusion Centers, our cancer specialists will coordinate your care with the appropriate cancer center or treatment program that offers the best outcomes for your personal situation. This includes MD Anderson Cancer Center, Baylor College of Medicine, St. Luke’s Health, and Texas Children’s Hospital.

• With MyKelseyOnline.com and the MyKelsey app, you have a private and secure way to connect with your Kelsey-Seybold physicians and to keep track of test results, appointments, medical history, and more.
• Sign up at MyKelseyOnline.com or call 713-442-6565 for help with setting up or using your account. With MyKelseyOnline.com, you can:
  • Email your doctor's office.
  • Request prescription refills at your Kelsey Pharmacy.
  • View most test results.
  • Make your own appointments with Kelsey-Seybold primary care physicians and an expanding list of specialists.
  • Schedule on-demand Virtual Care and appointments for other medical services, including flu shots and other vaccines/injections, and lab services.

Kelsey-Seybold Contact Center: 713-442-0427

• Available 24 hours a day, seven days a week to schedule appointments.

Kelsey-Seybold After-Hours Nurse Hotline: 713-442-0427

• Speak with a Kelsey-Seybold registered nurse after 5 p.m. on weeknights or on holidays and weekends.

KelseyCare Concierge Service: 713-442-9593 or 1-866-578-7018

• Speak with a Concierge representative for help with finding nearby clinic locations and physicians and for expert help resolving your questions and concerns about the KelseyCare Aetna plan.

MyKelseyOnline: 713-442-6565

• Call 7 a.m. to 9 p.m. for help setting up or using your MyKelseyOnline account.