Aetna Medicare Advantage Plans and Benefits

Aetna is one of the best companies when it comes to serving the healthcare benefits. This one was acquired by CVS Health four years ago. It is such a big company, serving about 39 million people. Just like any other private companies, Aetna offer Medicare Advantage plans. They offer these plans throughout the country.

If you are looking for the alternative way to get Medicare parts A and B benefits, Medicare Advantage plans are worth considering as they are the best ones. What is good about them is the fact that most of them also provide coverage for prescription drugs.

Plans

There is a range of Medicare Advantage plans offered by Aetna. Usually, they include prescription drug coverage. In addition, they usually include a few additional benefits. Below is the brief information of the available plans:

1. Health Maintenance Organization plans (HMO)

Joining a Health Maintenance Organization or HMO plan means choosing an in-network primary care physician who coordinates your healthcare. In case you have no idea who the primary care physician is, they refer to a doctor who is the primary contact for every medical matter. For instance, if you need to see a specialist or need a hospital visit, it will be needed for the primary care physician to provide a referral.

As a member, you usually will have to use the services for a certain network of doctors and healthcare facilities. However, there is an exception, which is when there is an emergency condition. For your information, HMO plans have limited out of network benefits. These plans require you to use a network of health services. Not only that, it is also a must for you to choose a primary care physician who provides referrals in case you want to see specialists. The benefits of the Aetna HMO plan include prescription drug coverage and mall order benefits; dental, vision, and hearing cover; and worldwide emergency care cover.

Details:

    • Monthly premium: Varies by plan from $0 to $99
    • Medical deductible: Varies by plan from $0 to $1,000
    • Limits out of pocket expenses: Yes

2. HMO Point of Service plans (HMO-POS)

Just like the HMO, HMO Point or Services plans, which are also known as HMO-POS, also offer the benefits of coordinated care through a primary care physician. As a member, you have a chance to choose out of network providers for a few services, even though the cost might be higher. These plans do not need for you to use in network health services. Take note that you will have to choose a primary care physician in several HMO-POS plans. The benefits of HMO-POS plan includes prescription drug coverage and mail order benefits; dental, vision, and hearing cover; and worldwide emergency care cover.

Details:

    • Monthly premium: Varies by plan from $0 to $28.20
    • Medical deductible: From $0
    • Limits out of pocket expenses: Yes

3. Preferred Provider Organization plans (PPO)

The third plan offer by Aetna is called Preferred Provider Organization plans or PPO. These plans allow every member to visit any provider even though there is no referral. When you use in network services, there will be no need for you to make a claim. On top of that, the cost is lower. With these plans, you will be able to choose a primary care physician, saving your budget. Fortunately, they do not require you to use in network health services or choose a primary care physician.  The benefits of PPO plan include prescription drug coverage and mail order benefits; dental, vision, and hearing cover; and worldwide emergency care cover.

Details:

    • Monthly premium: Varies by plan from $0 to $99
    • Medical deductible: Varies by plan from $0 to $1,000
    • Limits out of pocket expenses: Yes

In order to offers the best things for the customers, Aetna always tries their best to make something new. One of their efforts is by offering individual MAPD plans in 45 states, and Washington, D.C. Aside from that, there are actually some other plans and all of them are new. These new plans include:

    1. Prescription Drug Plan: There are a total of two new individual plans. The first one is called SilverScript Choice and the second one is SilverScript Plus. Each of them has $0 tier 1 copay at chosen pharmacies. $15 is the standard tier 1 copay.
    2. Dual Eligible Special Needs Plan (DSNP): This one is offered to a total of 14 states. It is for those who qualify for Medicate and Medicaid benefits.
    3. Medicare supplement: This one is now offered in 45 states. With it, people are allowed to customize their plans that suit their health needs.
    4. Group Medicare: This plan is available to businesses in every state in the United States (50 states in total). This one includes virtual behavioral healthcare through phone and video chat.

Benefits

A lot of benefits are offered by most Aetna Medical Advantage plans. These benefits can very, depending on the plan. These benefits include:

    • Dental, vision, hearing: Exams, eyeglasses, free checkups, and hearing aids are available with in network providers.
    • Fitness benefits: There are the Silver Sneakers fitness programs that are able to be used by any Aetna member at any of the 16,000 gyms that are spread across the nation.
    • Over-the-counter benefits: One of the privileges that the members have is to get some nonprescription drugs and health products, including vitamins and cold medications. All of them can be obtained directly from a pharmacy without having to spend any.
    • Total health benefits: These benefits include a 24-hour nurse hotline, free annual flue vaccinations, and prescription home delivery.
    • Meals-at-home program: This program is the kind of program that offers meal delivery during the recovery after staying at a hospital. Every week, there will be a total of 14 meals provided by Aetna.
    • Resources for living program: This program is a helpline that makes it possible for the members to access services and resources in their communities, including help at home, caregiver support, social support, and some other activities.

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