Medicare Advantage (MA) plans are known as supplemental plans to Original Medicare for they work to cover the gaps in standard Medicare coverage.
Aetna is known as the fourth-largest Medicare Advantage plan provider in the nation and is an affiliate of CVS Health.
Aetna offers a wide range of plan types such as HMOs, PPOs, HMO-POSs, etc.
Additional benefits such as fitness memberships, vision coverage, meal delivery coverage, and more are covered by most Aetna MA plans.
What Are Medicare Advantage Plans?
Medicare Advantage plans, otherwise known as “Medicare Part C” or “MA Plans,” are considered Medicare supplement plans. MA plans work to fill the coverage gaps in Original Medicare by wrapping Part A, Part B, and Part D insurance into one plan alongside potential coverage for dental, hearing, and vision. Medicare Advantage plans are offered through private insurance companies that have contracts with the Federal Medicare Program. Any individual that’s eligible for Original Medicare is also eligible to enroll in a MA plan. However, while Original Medicare does not require plan renewal after initial enrollment, MA plans may change annually inciting plan changes for various enrollees.
Note: To learn more about Medicare Advantage plans, visit this source.
Overview of Aetna
Aetna is considered the fourth-largest provider of MA plans in the nation with over 2.9 million Medicare beneficiaries enrolled in an Aetna MA plan. Aetna health insurance provides MA coverage to individuals in 46 states plus Washington D.C. Since 2018, Aetna has been known as a CVS Health company, allowing beneficiaries to receive the same in-network coverage at CVS walk-in clinics or MinuteClinics.
To speak with a licensed insurance agent from Aetna’s Medicare Advantage team, contact 1-855-335-1407 anytime from 8 a.m. to 8 p.m. seven days a week.
Note: To learn more about the Aetna health insurance company, visit this source.
Aetna Plan Options
Aetna supports a wide array of Medicare Advantage plan types from HMO plans to PPO plans to D-SNPs, and more. Most Aetna MA plan types include Part D (prescription drug) coverage.
Health Maintenance Organization (HMO) Plans
HMO plans are known for being cost-effective and convenient as they require a provider to have a primary care physician (PCP). This primary care physician works to coordinate a holistic healthcare experience for the patient; they guide the patient’s health and wellness by coordinating the patient’s care and various providers. The downside to this plan is that all care must be done in-network, otherwise, enrollees may face high costs. Not to mention, referrals are required if patients wish to see a different provider or specialist.
Preferred Provider Organization (PPO) Plans
PPO plans are also known to be cost-friendly and popular as they provide a patient with more flexibility over their care. A PCP is not required with this plan, nor are referrals or in-network coverage. However, it should be noted that out-of-network providers may be more expensive.
Health Maintenance Organization Point of Service (HMO-POS) Plans
HMO-POS plans are very similar to HMO plans as they require individuals to have a primary care provider (PCP) and are cost-efficient. However, they often provide greater flexibility when it comes to getting referrals for specialists or seeing providers that are out-of-network.
Dual-Eligible Special Needs Plans (D-SNPs)
SNPs are Medicare Advantage plans that cover individuals with specific diseases or illnesses. The benefits, providers, and drug coverage provided with this plan are uniquely tailored to the individuals being treated and covered under a special needs plan. In most cases, a PCP is necessary along with referrals for other providers or specialists.
Aetna provides Dual-Eligible SNPs for those eligible for both Medicare and Medicaid.
Additional Aetna MA Plan Benefits
Beneficiaries enrolled in an Aetna Medicare Advantage plan are also eligible for a plethora of additional benefits including but not limited to:
Dental Coverage: Most Aetna MA plans provide coverage for necessary dental procedures or annual preventive visits.
Vision Coverage: Most Aetna MA plans provide coverage for routine eye examinations and prescription eyewear such as glasses or contact lenses.
Hearing Coverage: Aetna has paired with NationsHearing to provide better coverage for hearing exams and the purchasing of hearing aids.
Fitness Memberships: Most MA plans provide fitness memberships through the SilverSneakers health and wellness program. This program gives MA beneficiaries access to thousands of gyms nationwide, virtual health and wellness workshops, nutrition classes, and more.
Telehealth Benefits: All Aetna MA plans will provide coverage for virtual primary care, urgent care, behavioral health care, and specialty care visits.
Prescription Mail Order Discounts: Save money through Aetna’s convenient prescription mail order service that allows individuals to order their medications in bulk for less cost.
24 Hour Nurse Line: Aetna ensures all questions and concerns are answered by providing their beneficiaries with a 24-hour hotline connection to trained nurses and providers.
Over-the-Counter (OTC) Drug Discounts: Aetna’s Medicare Advantage plans link beneficiaries with an array of discounts on OTC medications.
Meal Delivery Programs: For patients that are in recovery or require in-home care, Aetna provides them with coverage for meal delivery programs.
Note: To learn more about the additional benefits included in Aetna’s Medicare Advantage plans, visit this source.
Cost of Aetna MA Plan
A variety of factors are included when considering the cost of any MA plan such as monthly premiums, deductibles, out-of-pocket costs, copayments, and coinsurance. The cost of one’s Aetna Medicare Advantage plan is dependent on where one lives, which plan one chooses, and what one’s specific health needs are.
In 2022, Aetna is expanding its $0-premium plans to approximately 84% of their Medicare Advantage beneficiaries. Regardless of specific Aetna plan costs, all MA plan beneficiaries are required to pay their Part B premium which is projected to be approximately $158.50 per month in 2022.
How to Enroll in an Aetna MA Plan
In order to enroll in an MA plan through Aetna, a CVS Health company, one should use Aetna’s search tool to find local plans and tips for enrollment. Any eligible Medicare beneficiary is able to enroll in an MA plan during their Medicare annual enrollment period otherwise known as the initial enrollment period (IEP), switch their plan during the open enrollment period (OEP), or enroll in an MA plan during the general enrollment period (GEP). The dates for these enrollment periods are as follows:
Initial Enrollment Period
The initial enrollment period spans a total of seven months and is the same as Original Medicare’s IEP. These seven months include three months prior to an individual’s 65th birthday, the month of one’s 65th birthday, and the three months following one’s 65th birthday.
Open Enrollment Period
October 15th to December 7th is considered Medicare’s OEP and it allows beneficiaries to switch their current plan, e.g., switch from Original Medicare to an MA plan, switch from one MA plan to another, etc.
General Enrollment Period
The GEP for Medicare Advantage spans from April 1st to June 31st and is an additional timeframe for eligible individuals to register for a MA plan.
Note: To learn more about Medicare Advantage’s enrollment periods, visit this source.
How to Choose the Best Medicare Advantage Plan
Before choosing a Medicare Advantage plan, one should use the government’s Medicare Advantage plan comparison tool to evaluate and compare plans. Things to consider before deciding on the best supplemental Medicare plan:
How much are they willing to spend monthly on a premium?
What do they want their deductible to look like?
Will their prescriptions be covered under this plan?
Is additional coverage offered for services such as dental, vision, or hearing?
Will their current doctors or specialists be covered?
Where is their insurance office in case they need assistance?
Does their insurance provide transportation to and from healthcare appointments if needed?
Note: Oak Street Health provides transportation to and from healthcare appointments for patients that need assistance. They also have providers that are trained and willing to guide patients through their insurance benefits whenever needed.
There are a few different ways an enrollee can check their Medicare application status including logging into their Social Security (SSA) account, logging into their Medicare account, and more.
Good health does not come cheap. In fact, national health spending in the United States was around $3.8 trillion in 2019, and it's estimated to grow up to $6.2 trillion by 2028.
Although it’s not extremely common, occasionally healthcare providers may charge patients with Medicare Part B excess charges after their visits.