Aetna Medicare Advantage proffers an extensive scope of Medicare health care plans and diversification of vast benefits focused on achieving one’s comfort. Aetna is the fourth-largest source of Medicare Advantage plans, founded in 1853 in Hartford, Connecticut. The company paid its first Medicare claim in 1966 and started offering HMO and PPO plans in the 1970s and 1980.
Consumer Value Store(CVS) Health company for as far back 2018 and serves about 39 million people presently, Aetna has very interesting beneficial plans which include dental, vision, and hearing benefits, with each plan offering invaluable perks. The aforementioned plans are very affordable.
What is Aetna Medicare Advantage?
Aetna is a brand name used for products and services provided by one or more of Aetna’s group of companies including Aetna Life Insurance. AetnaMedicare is an HMO and PPO plan with a Medicare contract. Medicare Advantage plans are made up of Medicare Part A which is (hospital insurance), and Medicare Part B (medical insurance) and are overseen by a private insurer such as Aetna.
Aetna Medicare Advantage plans to issue all the benefits of Original Medicare and offer specialized, further benefits specially designed to enhance retiree contentment and all-around health. Aetna Medicare Advantage has had a great outcome in enhancing overall health contentment among retirees.
Merits and Demerits of Aetna Medicare Advantage
Just like every other HMO, Aetna’s plans have advantages and disadvantages that help guide and direct prospective enrollees on the right path and also according to their affordability.
Pros
- Numerous Benefits Offerings: Aetna Medicare beneficiaries in various plans, have access to special benefits such as the decentralized financial market (over-the-counter) allowance. This is an addition to the dental, eye-care/optical, and hearing plans. This advantage can also be called the additional convenience benefits.
- Efficient non-monetized premium offerings: In this, Aetna Medicare Advantage offers no monthly premium, that is, enrollees/ beneficiaries do not pay anything to Aetna Medicare. In 2024, Aetna estimates that 84% of her beneficiaries have access to this premium.
- Extensively Available: Aetna Medicare Advantage proffers plans in over 35 states with Washington, D.C. inclusive. Aetna also provides an independent drug plan in all 50 states, Washington D.C in addition.
- Wide range of Medicare beneficiaries: For every HMO to function properly, beneficiaries should be the top priority. Aetna Medicare Advantage has over 3 million Medicare Advantage plan beneficiaries.
- Drug Utilization: This is t, all Aetna Medicare Advantage drugs for each beneficiary come non-monetized for all Tier 1 and Tier 2 drugs.
Cons
- Member Satisfaction; Aetna Medicare beneficiary’s satisfaction rate dropped drastically below average in the industry. This issue of customer dissatisfaction made numbers
Aetna Medicare Advantage allows one to search for health facilitators in his/her vicinity using a ZIP code. These merits have made Aetna one of the most used Health Management Organizations especially for retirees
How much does Aetna Medicare Advantage cost?
When considering Aetna Medicare Advantage plans, costs will vary based on the specific plan, your location, and healthcare needs.
Premiums
Approximately 70% of Aetna plans in 2024 have no premium, with 84% of Medicare-eligible individuals having access to a $0 monthly premium plan.
Medicare Advantage users are still responsible for the Medicare Part B premium, which is $174.70 per month in 2024, although some plans may cover part or all of this cost.
Copays, Coinsurance, and Deductibles
Costs like copays, coinsurance, and deductibles differ based on the plan, location, and services utilized.
Considerations include coverage of the Medicare Part B premium, yearly deductibles, copayments for visits or services, in-network and out-of-network out-of-pocket maximums, provider network, additional benefits, and associated charges.
Examples of Aetna Medicare Advantage costs for three plans in the mid-range city:
Aetna Medicare Premier Plus (PPO)
Monthly premium: $0.
Out-of-pocket max: $3,700.
Copays:
- Primary care: $0.
- Specialist: $30.
- Tier 1 prescription drugs: $0.
Aetna Medicare Premier (HMO-POS)
Monthly premium: $0.
Out-of-pocket max: $3,600.
Copays:
- Primary care: $0.
- Specialist: $25.
- Tier 1 prescription drugs: $0.
Aetna Medicare SmartFit (HMO-POS)
Monthly premium: $0.
Out-of-pocket max: $3,000.
Copays:
- Primary care: $0.
- Specialist: $20.
- Tier 1 prescription drugs: $0.
To understand costs better, utilize Medicare’s plan-finding tool to compare available plans in your area. You can focus on Aetna plans or compare across carriers. Additionally, you can explore Aetna’s offerings directly on their website by entering your ZIP code.
Additional Aetna benefits?
Aetna Medicare Advantage ensures comprehensive coverage for all members, including routine vision, dental, and hearing benefits. Some plans go above and beyond by offering unique advantages not commonly found in other Medicare Advantage plans. Here are some notable features:
- Fitness Benefits: Alongside the SilverSneakers program, certain plans may provide a fitness reimbursement allowance for activities like pickleball or fitness supplies such as athletic shoes.
- Medicare Payment Card: Select plans offer a quarterly allowance that can be used for medical expenses within the network or specific over-the-counter wellness items.
- Expanded $0 Copays: Many Aetna plans feature $0 copays for lab tests and visits to primary care physicians. Starting in 2024, all plans will include a $0 copay for preventive and diagnostic colonoscopies with in-network providers.
- MinuteClinic Access: As part of CVS Health, Aetna allows members in certain plans to visit any MinuteClinic location for medical needs, paying the same copay as they would for a primary care physician visit.
- In-Home Health Visits: Some beneficiaries have the option to request in-person home health visits or telehealth consultations for added convenience.
- Concierge Services for Local Resources: Aetna’s Resources for Living program assists beneficiaries in finding necessary support, whether it’s home assistance, caregiver resources, or information on local activities.
- Meals at Home: Following a hospital stay, select plans offer the convenience of delivering healthy, fresh meals to your doorstep to aid in your recovery.
Aetna Medicare Advantage plan types
Aetna provides different kinds of Medicare Advantage plans, with varying structures, costs, and benefits. These plans cater for dental, vision, and hearing coverage, along with fitness benefits like SilverSneakers.
Aetna offers Medicare Advantage prescription drug plans (MAPDs), stand-alone prescription drug plans, and drug-free Medicare Advantage plans. The company has expanded its Aetna Medicare Eagle plan for veterans to 43 states in 2024, designed to complement VA healthcare coverage.
Aetna has introduced an Aetna Medicare SmartFit plan that offers a fitness reimbursement benefit ranging from $600 to $1,200 annually. Plan availability may vary from county to county, with additional plan types such as:
- HMO-POS Plans: This offers you more flexibility than traditional HMO plans, and allows some out-of-network care at a higher cost. While you do have a primary doctor, alongside a referral
- HMO Plans: HMO requires you to make use of some specific network of doctors and hospitals. A referral from your primary doctor to see a specialist, or out-of-network will likely be needed, and the benefits usually have limits.
- PPO (Preferred provider organization) Plans: Provide greater provider choice, with the most freedom, without you needing a primary doctor, or referrals for specialists, with the option for out-of-network care at a higher cost.
- SNPs (Special needs plans): Specialize in benefits for some specific health needs, which include Dual-Eligible SNPs for Medicare and Medicaid recipients, and Institutional Plans for those in skilled nursing or assisted living facilities requiring specialized care.
Remember to carefully consider your healthcare needs and preferences when selecting the most suitable plan for your well-being, and peace of mind.
Find the right Medicare Advantage plan
Making your research before selecting a Medicare Advantage plan for yourself is a very crucial decision. Here are some questions to ask before considering:
- Check out the plan’s premiums, deductibles, copays, coinsurance, and cost to see if you can afford them.
- It’s advised that your preferred medical provider or providers participate in the plan’s network.
- To those on medication, it’s important to know how the plan covers your prescriptions, the tier your prescription is on, and if any coverage rules apply to it.
- Make sure the plans cover vision, dental, and hearing needs
- Make sure there are extra benefits like fitness membership, transportation benefits, and meal delivery.
These are the questions to ask when doing your research or selecting the right Medicare Advantage plan. Questions like this help you know what best Medicare advantage meets your needs, and what amount of coverage you’d have.