In the private Medicare insurance market, Aetna stands as one of the major players, offering a variety of plans across all states in the United States.
Established in 1853 in Hartford, Connecticut, it is one of the longest-running insurance companies in the country and ranks among the best.
Also, as a subsidiary of CVS Health Corporation, it currently serves 39 million people, providing Medicare Advantage plans, prescription drug coverage and Medicare Supplement plans.
Aetna Medicare extends a diverse range of healthcare plans, coupled with additional benefits designed for enhanced convenience.
However, beyond Medicare, Aetna is a comprehensive insurance provider, offering employer-sponsored, Medicaid, individual and family health, supplemental, and pharmacy insurance plans.
About Aetna
Aetna is a healthcare benefits company that was acquired by CVS Health in 2018, and they currently serve 39 million people.
It is rated 4.3 out of three stars for its Medicare Advantage Prescription Drug Plans. It is also regarded as one of the largest Medicare Advantage Plan providers.
Atena provides a wide array of perks. Each Aetna Medicare Advantage plan includes vision, dental, and hearing benefits, and several plans provide additional benefits.
The plans are also low-cost, and an estimated 84% of Medicare beneficiaries have access to the $0 premium Aetna plan.
Aetna Medicare plans are well-known, and they score above average for the members’ experiences, which include customer service and health care quality.
Aetna Medicare Plan Types
There are four types of Medicare Advantage plans, and they include PPO, HMO, D-SNP, and HMO-POS plans. These plans also include extra benefits, which include:
- 24-hour nurse phone line.
- Routine dental, vision, and hearing benefits.
- SilverSneakers fitness membership gives access to over 15,000 fitness locations.
- Prescription home delivery.
Medicare Advantage PPO Plans
These plans don’t limit the policyholder’s ability to visit in-network providers; however, out-of-network services can cost more. PPO plans don’t require any referrals from PCPs for specialist or hospital care.
Medicare Advantage HMO Plans
Many Aetna HMO plans mandate policyholders to choose an in-network primary care physician. Visiting hospitals and specialists necessitates selecting in-network providers, although there may be limited access to out-of-network perks. A referral from the primary care physician is required for specialist or hospital care.
Medicare Advantage HMO-POS Plans
If you are enrolled in an HMO-POS plan, it is generally necessary to seek care from in-network providers, including an in-network primary care physician (PCP), and obtain specialist referrals, although there may be exceptions.
Out-of-network visits typically result in higher costs. Moreover, HMO-POS plans may allow visits to out-of-network dentists.
Aetna Dual Eligible Special Needs Plan
This plan might be available to people who are qualified for both Medicare and Medicaid. These plans provide additional resources, which include a personal care team to plan visits to providers, build a care plan with your doctors, and give you a better understanding of other parts of your plan, like medications.
Some other dual-eligible benefits include an allowance for over-the-counter products, prescription drugs, hearing aids, eyeglasses, and routine dental services.
Benefits Of Aetna Medicare
Aetna Medicare plans provide a wide range of benefits; however, these perks vary by plan. Some of the benefits include:
- Meals-at-Home Program: This provides meal delivery during someone’s recovery after staying in the hospital. Aetna offers 14 meals each week.
- Over-the-counter benefits: members can access some non-prescription drugs and health products like cold medications and vitamins directly from a pharmacy for no cost.
- Resources for Living program: this is a helpline that gives members access to services and resources in their community, which include caregiver support, help at home, and other activities.
- Fitness benefits: Aetna members can make use of the Silver Sneakers fitness programs at any of the gym locations nationwide.
- Total health benefits: These health benefits include a 24-hour nurse hotline, prescription home delivery, and free annual flu vaccinations.
- Dental, vision, and hearing exams, hearing aids, eyeglasses, and free checkups are available with in-network providers.
Aetna Medicare offers a variety of benefits that make that insurance plan better.
Who Is Qualified For Aetna Medicare Plans?
For you to be eligible for an Aetna Medicare Plan, you need to be enrolled in Original Medicare. The requirement for original Medicare will be based on the criteria below:
Work History
If you meet the citizenship requirement, you can receive Part A without incurring any premium costs. To qualify, you must have paid payroll taxes for a minimum of 10 years, whether as a self-employed individual or as an employee of a company.
If you qualify for Social Security, you are eligible for premium-free Part A. If you haven’t worked the required duration to qualify on your own, you can still meet the criteria if your spouse has.
Also, if you are not eligible for premium-free Part A, you have the option to enroll and pay for coverage.
Citizenship Or Residence Status
You must be a citizen of the United States to enroll in Medicare. If you are a legal resident, then you must have resided in the United States for at least 5 years.
Age, Disability, Or Health
Several Americans are eligible for original Medicare when they turn 65. This is also known as “aging into Medicare’. You don’t have to retire or get your Social Security income before you can join Medicare. As long as you meet other requirements, you can join when you are 65.
You can also be qualified for Original Medicare if you are disabled. You will be eligible if you receive Railroad Retirement Board disability payments for 24 consecutive months or Social Security disability payments.
After the 24th month, your enrollment in Medicare is automatic. The third way you can be eligible for Original Medicare is due to health diagnoses. If you meet the citizenship requirement, then you can be eligible for Original Medicare.
If you can meet the requirements listed above, then you are eligible for Aetna Medicare.
How Much Does Aetna Medicare Cost?
The cost of Aetna Medicare plans will be determined by your geographic location, plan, and health needs.
| Aetna Medicare Advantage Plan | Pricing |
| 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 get an estimate of how much your Aetna Medicare costs, you can use Medicare’s plan-finding tool to compare information among other available plans in your location. You can choose by insurance carrier to see only Aetna plans.
