Aetna Medicare Advantage presents an array of health care plans catering to Medicare recipients, coupled with added benefits to enhance ease and convenience. Beyond the core plans, supplementary advantages include a concierge service that aids customers in resource localization within their vicinity.
Furthermore, there are Extended Special Needs Plans (SNPs) designed to assist with personal expenditures, including items like groceries, for individuals eligible for Medicare.
What is Aetna Medicare Advantage?
Aetna, based in Connecticut, functions as a health insurance company. It is authorized by Medicare to offer Medicare Advantage (Part C) plans. Aetna’s array of Medicare Advantage plans is crafted to accommodate diverse budgets and healthcare requirements. However, it’s important to note that the availability of each plan varies by state, county, and even ZIP code.
Established in 1853 in Hartford, Connecticut, Aetna made history by processing its inaugural Medicare claim in 1966. Subsequently, during the 1970s and 1980s, Aetna diversified its offerings by introducing Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. Notably, CVS Health acquired Aetna in 2018, solidifying its position as a healthcare benefits company. Currently, Aetna’s reach extends to approximately 399 million individuals.
Aetna received an impressive 4.3 out of 5.0 stars from the Centers for Medicare and Medicaid Services for their Medicare Advantage Prescription Drug (MAPD) plans. Additionally, Aetna Medicare Advantage plans encompass a variety of options, typically featuring prescription drug coverage along with supplementary benefits.
Types of Aetna Medicare Advantage
Aetna offers four primary categories of Medicare Advantage plans, providing diverse options to cater to individual preferences and needs. These include the Health Maintenance Organization (HMO), the Preferred Provider Organization (PPO), the Health Maintenance Organization Point of Service (HMO-POS), and the Dual Eligible Special Needs Plans (D-SNP).
Each plan is tailored to offer specific advantages and flexibility for Medicare beneficiaries.
Health Maintenance Organization (HMO)
The majority of Aetna HMO plans necessitate the selection of an in-network primary care physician (PCP). Furthermore, for optimal coverage, ensure specialists or hospitals are within the network, although some plans may offer limited out-of-network benefits.
Typically, obtaining hospital or specialist care mandates a referral from your chosen PCP, ensuring a coordinated and network-aligned approach to your healthcare needs.
Health Maintenance Organization Point of Service (HMO-POS)
HMO-POS plans usually require an in-network primary care physician (PCP), in-network care, and specialist referrals, with some exceptions. Keep in mind that out-of-network visits generally incur higher costs. Interestingly, HMO-POS plans do permit visits to out-of-network dentists.
Medicare Advantage PPO plans
Typically, these plans offer flexibility for out-of-network healthcare providers, but choosing such services may result in higher costs. Be mindful of potential expenses. PPO plans to eliminate the need for a primary care physician (PCP) or referrals when seeking specialized or hospital care.
Dual-Eligible Special Needs Plan
D-SNP plans to cater to individuals eligible for both Medicare and Medicaid, providing additional support such as a dedicated care team. Typically, it aids in coordinating provider visits, crafting a care plan with your doctor, and clarifying various aspects of your plan, including medication details.
Additionally, D-SNP plans offer benefits such as prescription drug coverage, allowances for over-the-counter products, eyeglasses, hearing aids, and access to routine dental services.
Benefits of Aetna Medicare Advantage
Aetna Medicare Advantage plans typically offer a diverse range of benefits, although the specifics may differ between plans. These benefits encompass:
Dental, Vision, and Hearing
Providers within the network offer free checkups, examinations, eyeglasses, and hearing aids as part of routine dental, vision, and hearing benefits.
Fitness Benefit
Aetna members can enjoy the benefits of the SilverSneakers fitness program, gaining access to over 16,000 gyms across the nation for their fitness needs.
Over-the-Counter Benefits
Members have access to nonprescription drugs and health products, such as vitamins and cold medications, directly from a pharmacy at no cost.
Total Health Benefits
Typically, included in the benefits is a 24-hour nurse hotline, providing members with access to professional healthcare advice around the clock. Additionally, members can receive free annual flu vaccinations and have the convenience of prescription home delivery.
Meals-at-Home Program
Aetna offers the convenience of prescription home delivery, allowing members to receive their medications directly at their doorstep. Additionally, during the recovery period following a hospital stay, Aetna provides a meal delivery service, offering 14 meals per week.
Resources for Living Program
This helpline grants members access to community services and resources, covering assistance at home, caregiver support, social engagement, and other activities.
Typically, these plans not only provide coverage equivalent to original Medicare but also extend additional benefits such as dental and vision care. Individuals have the flexibility to select the plan that aligns with their unique health requirements and offers optimal value for their investment.
Pros and cons
Benefits and Drawbacks of Aetna Medicare Advantage Plans:
Pros
- Affordable choice
- Robust advantages
- Favorable feedback for member contentment
- Comprehensive coverage, incorporating dental, vision, and hearing perks
- Extra advantages like over-the-counter allowances, meal deliveries, and at-home health consultations
- Predominantly economical, with roughly 84% of Medicare recipients eligible for a zero-premium Aetna plan
Cons
Customer satisfaction figures fell below the sector norm in certain key Medicare markets. Nonetheless, Aetna’s performance in customer satisfaction fell short of the industry average in some significant Medicare markets, according to a recent survey by J.D. Power.
How Much Does Aetna Medicare Advantage Cost?
The expenses associated with an Aetna Medicare Advantage plan fluctuate based on your residing county and individual health requirements. In addition, it is important to note that, for most plans, you are required to maintain payment of your Medicare Part B premium, with a fee of $164.90 per month.
Conclusion
Aetna provides a variety of Medicare Advantage plans, which include HMO, HMO-POS, and PPO options. These plans are accessible nationwide, although individuals should verify the availability of their preferred plan in their specific location.