Humana Medicare Advantage Plans Very Popular
While other health insurers have been hurt by declines in employer-sponsored insurance enrollment, and Humana’s commercial business results did worse than anticipated, Humana Medicare Advantage Plan results for the fourth quarter of 2009 were better than expected.
Michael B. McCallister, president and chief executive of Humana, summed up 2009 as success for Humana despite a “challenging environment,” and added the company’s outlook for 2010 “Looking ahead, we see multiple revenue growth opportunities across our spectrum of products for 2010.”
While Humana Medicare Advantage plans gained 5 percent new members compared to 2008, the amount of members in its stand-alone Medicare prescription drug plans dropped by more than 1 million in 2009.
Humana is offering more than 100 Medicare Advantage plans in 2010, including the flexible affordable Humana Gold Choice PFFS. Humana Gold Choice® is a Medicare Advantage Private Fee-for-Service (PFFS) plan. That means you can see almost any doctor you choose, as long as the provider accepts Humana’s terms and conditions of payment. Most Humana Gold Choice Private Fee-for-Service plans combine all the benefits of Original Medicare, prescription drug coverage and many extras into one simple, easy-to-use plan.
The Humana Gold Choice Plan is available to anyone enrolled in both Part A and Part B of Medicare through age or disability.
Is An Aetna Medicare Part D Rx Plan (PDP) Right For Me?
When selecting a Medicare Part D plan, it is important to know that you will receive the benefits you need. You want to find out if your prescriptions are covered by the plan, if it includes doctors, hospitals and pharmacies in your area and whether your health care provider accepts the plan.
Aetna Medicare offers three different Part D plans that provide Rx coverage in each state. You can choose among the Aetna Medicare Essential, Plus or Premier Rx plan.
Aetna Medicare Part D Rx plans provide:
- More than 60,000 pharmacies in the national network
- Coverage for most Medicare Part D prescription drugs
- $0 deductible in most plans
- Convenience and savings opportunities using the prescription drug mail order program
- Predictable co-pays to help you manage prescription drug costs
- A safeguard against unforeseen changes in your prescription drug needs
The Aetna Medicare Part D RX plans have many benefits, but also some limitations.
Is My Pharmacy Included?
While Aetna Medicare Part D Rx Plans (PDP) cover most of your Part D brand-name and generic prescription drugs, you need to check the Aetna Medicare Preferred Drug List, also known as the Aetna formulary, to find out with brand-name and generic drugs are included. You can call Aetna Member Services toll-free number at 1-800-213-4599 to get the list or download it from their website.
To fill your prescription, you have more than 60,000 network pharmacies to chose from. Check with your current pharmacy to see whether it is included, and if not, call Aetna Member Services toll-free number at 1-800-213-4599 to find a pharmacy close to you.
Home Delivery
With Aetna Rx Home Delivery® Aetna offers a prescription mail service for Aetna pharmacy benefit members for their maintenance medications that treat chronic conditions such as arthritis, asthma, diabetes, high cholesterol, heart conditions, or high blood pressure. The Aetna Specialty Pharmacy service also provides convenient, mail-order services for medications that require special handling, storage or shipping. These are drugs that treat certain conditions such as hepatitis, psoriasis, rheumatoid arthritis and multiple sclerosis.
Can I Get Reimbursement If I Use An Out Of Network Pharmacy?
When you get your prescription drugs a pharmacy that is not included in the Aetna network, you may have to pay the full cost of the drug when you get your prescription. To be reimbursed for Aetna’s share of the cost of the drug (minus your copay), you have to submit a claim form to Aetna. You may need to pay an additional cost for drugs received at an out-of-network pharmacy. Make sure to submit your claim within three months after the end of the plan year.
How Often Can I Refill?
Aetna’s refill policy promotes the safe and appropriate use of medications. Follow these guidelines for getting refills on your prescriptions:
Retail Pharmacies
- You may refill a supply of 9 days or less after you have used 50 percent of the prescription.
- You may refill a supply of 10 days or more after you have used 75 percent of the prescription.
Mail Order Pharmacies
- You may refill a supply of 30 days or less after you have used 50 percent of the prescription.
- You may refill a supply of 31 to 60 days after you have used 60 percent of the prescription.
- You may refill a supply of 61 days or more after you have used 66 percent of the prescription.
Am I Eligible For An Aetna Medicare Part D Rx Plan?
Generally, you can apply for an Aetna Medicare Rx® Plan (PDP), regardless of your health, if you meet the following Aetna Medicare Rx eligibility guidelines:
- You are entitled to Medicare Part A and/or enrolled in Medicare Part B, and
- You live in the plan service area.
To join an Aetna Medicare Part D Rx® Plan (PDP):
- You must enroll during the Annual Enrollment period November 15 – December 31, or
- You must be within your initial enrollment period (starting three months before and lasting for three months after you first qualify for Medicare), or
- You must qualify for a special enrollment period, such as when you move to a new service area or into an institution, or your Medicaid eligibility changes.
Even if you don’t take a lot of prescription drugs now, getting Medicare Rx coverage when you become eligible helps you avoid penalties in the future and ensures you are covered if you need to take prescription drugs in the future.
Stay Fit With Aetna Medicare Advantage Plans
Aetna Medicare Advantage Plans cover the same kind of services as traditional Medicare Part A and Part B, but provide many additional benefits. With one monthly premium and one ID card some plans even offer a wide variety of wellness and fitness benefits.
Some plans that include wellness benefits e.g. provide the ‘Numbers To Know®’ card. It is a card that helps you monitor your blood pressure and cholesterol numbers and fits in your wallet. Another good idea to stay healthy are ‘Annual Preventive Reminders’ that remind you to get vaccinated against pneumonia or the flu, or Aetna‘s ‘Cancer Screening Reminders’.
If your plan includes fitness benefits, you may also enjoy extra benefits such as a free membership at a participating fitness center in the Aetna fitness program, or yoga, tai chi or Pilates classes.
The Senior Personal Health Improvement Training is another modern idea of Aetna to stay in shape with an online health and wellness program that helps people 60 and over to stay fit, eat right and live well.
Other wellness and fitness benefits may include health information programs or discounts on health magazines, personal trainers, nutritional counselors or dieticians.
To find out which Aetna Medicare Advantage plans with fitness or wellness programs are available to you, click on the ‘see plans’ button below.
Aetna Medicare Advantage Plans Dental Coverage
Many of the Aetna Medicare Advantage Plans offer optional dental benefits for an affordable additional premium. Two kinds of dental plans are offered:
- The Aetna Medicare Preventive Dental Plan and
- The Aetna Medicare Advantage Dental Plan
You may receive covered dental services when you select a participating primary care dentist.
Both plans include oral and emergency exams, cleaning and oral hygiene consultation. The Advantage Dental Plan adds benefits such as X-rays, restorative care like retention pins, fillings, or minor denture adjustments, and periodontic care such as scaling and root planning.
Other dental care services are partially covered for a reduced fee such as oral surgery, crowns, bridges or dentures.
Attention: when you are enrolled in a Aetna Medicare Advantage HMO plan, services received out of network are not covered. For Aetna Medicare Advantage PPO members a 50% coinsurance coverage applies for out of network services. So make sure your dentist participates in Aetna Preventive or Advantage Dental Plans program.
You can find optional dental plan information online at the Aetna Medicare Advantage website, or you can get a personal quote by clicking on the ‘see plans’ button below.
Humana Medicare Advantage Plans 2010
Nearly 4 million members nationwide have chosen Humana for their Medicare health coverage needs.
With almost 50 years of history in the health industry, Humana makes it easy for you to pick the plan that fits your lifestyle, your coverage needs, and your pocketbook. You can select between:
- Humana Medicare Advantage plans offer more benefits than Traditional Medicare, at no monthly or an affordable premium, so your health care costs are predictable. You will find many doctors in many areas in the Humana health care provider network.
- Humana Medicare supplement plans cover gaps in Traditional Medicare coverage such as deductibles and coinsurance.
- Humana Medicare prescription drug plans can help relief you from the high costs of medications. Humana offers three stand-alone drug plans that are available in most areas, so you can select the one that best fits your needs and your personal budget.
Humana Medicare Advantage plans are offered as HMO (Health Maintenance Organization), PPO (Perferred Provider Organization), PFFS or special needs plans.
Many people select the Humana Gold Plus HMO plan, because it offers broad coverage including all the benefits of Traditional Medicare and may include prescription drug coverage and many extras. The out-of-pocket costs are lower and more predictable than with other types of plans. So you will have a good idea of how much you’ll spend on healthcare during the year.
Another very popular Humana Medicare Advantage PPO plan is the HumanaChoicePPO® which gives you freedom to select the doctors, specialists, and hospitals you visit. You have the freedom to choose any doctor or hospital, but you pay less for services received from in-network providers. Predictable copayments and coinsurance make it easier for you to budget healthcare costs.
Humana Gold Choice® is a very flexible Medicare Advantage Private Fee-for-Service (PFFS) plan. You can see almost any health care provider as long as they accept Humana’s terms and conditions of payment. Most Humana Gold Choice Private Fee-for-Service plans combine all the benefits of Original Medicare, prescription drug coverage and many extras into one simple, easy-to-use plan.
In addition to Medicare health plans, Humana offers many wellness and prevention programs and services, which may save you money and make it easier for you to stay active for years to come.
