Aetna Medicare
Aetna is one of the nation’s leaders in health care benefits with more than 912,000 health care professionals serving more than 19 million medical members. They offer health care, dental, pharmacy, group life, disability insurance, employee benefits and Aetna Medicare plans.
Aetna offers a broad range of insurance including Aetna Medicare advantage plans, Aetna Medicare supplemental insurance, and Aetna Medicare Part D with a wide array of programs and services that help control rising employee benefits costs. They also strive to improve the quality of health care and provide members with access to convenient tools and east to understand information.
Aetna Medicare Plans Are Available In The Following States:
- Arkansas
- California
- Colorado
- Connecticut
- District of Columbia
- Delaware
- Florida
- Georgia
- Iowa
- Illinois
- Indiana
- Kansas
- Maine
- Maryland
- Michigan
- Nevada
- New Hampshire
- New Jersey
- New York
- North Carolina
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- Tennessee
- Texas
- Utah
- Virginia
- Washington
- Wisconsin
- West Virginia
Aetna Medicare Part D Prescription Drugs RX Plans
Aetna Medicare Rx plans offer coverage for all Medicare Part D prescription drugs, $0 deductible on generic drugs, predictable copays to help you manage costs, and savings on 90-day prescriptions through Aetna’s mail-order program.
What are the benefits of the Aetna Medicare Rx Plan?
- Coverage for a wide selection of medications used byMedicare members.
- Safe and convenient mail order service from Aetna Rx Home Delivery®.
- Use of the Aetna Specialty Pharmacy for hard to fill prescriptions.
- Receive discounts on eyeglasses, vitamins and more as part of your Aetna membership.
- Online formulary search to look up your medications.
Aetna Medicare Supplement Plans
Aetna Medicare Supplement Plans help you pay for some out-of-pocket costs not covered by Original Medicare (Part A and Part B) and give you the freedom to visit any doctor or hospital. The Medicare Supplement insurance plan is only available in certain states.
Aetna Medicare Advantage Plans
Aetna Medicare Advantage plans provide you with even better benefits than Traditional Medicare which include affordable copays and coinsurance amounts when you use in network physicians and hospitals.
Aetna offers two options for Medicare Advantage plans, one with a low monthly plan premium and one with no monthly premium. Other benefits include $0 copays, fitness benefits such as a gym membership, and allowances for hearing aids and eyewear.
What are the benefits of Aetna Medicare Advantage Plans?
Aetna Medicare Advantage Plans cover the same type of services as Original Medicare (Part A and Part B), and give you additional benefits such as vision and/or hearing coverage. You can enroll in a Medicare Advantage plan with prescription drug coverage (MAPD plan) that gives you all your coverage in one plan, with one monthly plan premium and one ID card. As an Aetna Medicare Advantage plan member, you have access to several benefits as well as discount services known as Aetna ExtrasSM that aren’t available with many plans, including Traditional Medicare and many Medicare supplement plans. Aetna calls them ‘Extras’ because most of them are available at no extra cost to you.
With Aetna Medicare HMO and PPO Plans, you can get Wellness Programs, Fitness Benefits, and savings on products and services like discounts on hearing aids, eyewear, weight management programs, vitamins and massage therapy. With an Aetna Medicare Private Fee-for-Service Plan you can get Wellness Programs including cancer screening reminder programs, and savings on products and services which include discounts on hearing aids, eyewear, weight management programs, vitamins and massage therapy.
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.
