As part of Aetna Medicare Advantage plans, the company offers additional benefits not included in the standard Medicare plan. In 2020, Aetna Medicare Advantage plans covered more than 2.6 million people. Along with the benefits and services provided by Original Medicare, you may be able to take advantage of additional benefits and services through Aetna medicare plans. These and other benefits, such as preventive dental care, vision screenings, health screenings, and a 24-hour nurse hotline, are available to members.
Table of Contents
- 1 Who are Aetna Medicare Advantage providers?
- 2 Why get Aetna Medicare Advantage plans?
- 3 What are Aetna medicare retiree benefits?
- 4 What is Aetna Medicare’s all-in-one coverage plan?
- 5 What are different Aetna medicare advantage plans?
- 6 Aetna Medicare Advantage provider portal
- 7 General benefits of Aetna medicare advantage plans
- 8 How much does the Aetna Medicare plan cost?
- 9 Problems with the Aetna Medicare plan
- 10 Aetna medicare advantage provider phone number & contact details
Who are Aetna Medicare Advantage providers?
TZ Insurance Solutions, a licensed insurance agency, owns and operates Aetna-MedicareAdvantage.com. Company-specific products and services marketed under the Aetna group of subsidiary companies, such as Aetna Life Insurance Company and its affiliates (Aetna).
The healthcare information at Aetna is provided solely for educational purposes. There is no substitute for a physician’s or other health care professional’s diagnosis or treatment when it comes to health information programs. Although the information shared by Aetna is considered correct and trustworthy as of the date of publication. They can also update it anytime without notice.
Aetna Medicare is a Medicare-approved HMO and PPO plan. Contracts with state Medicare programs are also in place for their SNPs. Contract renewal is a prerequisite for continued participation in their plans. The features and availability of their plans may differ depending on their service area. Exclusions and limitations are a part of health benefits and health insurance plans.
Aetna, a Health company, assists approximately 39 million people in making health care decisions through its diverse array of health insurance plans and services. The Better Business Bureau has assigned Aetna an A+ rating. The company has resolved 619 customer complaints over the last three years. Aetna’s customers consistently express positive sentiments about the company and the claims process. Aetna consistently earns high marks from consumer review sites.
The National Committee for Quality Assurance rates Aetna’s medicare advantage plans somewhere between 2.5 to 4.5. The majority of plans received ratings in the mid-to-high performance range across three categories, including customer satisfaction, the extent to which the plan covers preventative care, and the extent to which the plan covers chronic or acute conditions. The NCQA accredits the majority of plans.
Consumer Affairs has recorded 1,705 ratings for Aetna in the last year. Generally speaking, consumers give the company a 4 out of 5-star rating, with the majority of 4- and 5-star ratings accounting for the majority of feedback. Reliable coverage and competitive rates are among reviewers’ most frequently praised features of Aetna.
Why get Aetna Medicare Advantage plans?
HMO and PPO plans are available through Aetna Medicare for their members. They have also negotiated contracts with state Medicare programs and are in effect. Contract renewal is a requirement for enrollment in their programs. SilverScript is a Medicare-approved Prescription Drug Plan marketed by Aetna Medicare. Contract renewal is also a factor in SilverScript enrollment. An additional perk of signing up for the Aetna Medicare plan is that it includes extra benefits for retired individuals.
Their retiree benefits have resulted in the following fascinating facts about Aetna medicare advantage plans:
1- A 73% decrease in the occurrence of life-threatening diabetic complications
2- Spending on inpatient hospital services is reduced by 7 percent with the Aetna medicare program for retirees
3- Reduced use of emergency rooms by 33 percent
4- Members with a 90% or higher satisfaction rating
5- A 29 percent decrease in hospitalizations due to the Aetna medicare advantage program
What are Aetna medicare retiree benefits?
A Medicare Advantage plan from Aetna can provide even greater benefits for retirees. It is Aetna’s goal to make its health journey more accessible by establishing a clear, connected, and convenient path to get there. ‘In their opinion, health care is about much more than just numbers and benefits, and that it is a deeply personal issue for everyone. People can live the lives they want by selecting the best solution for their situation.
Various options are available for providing a group Medicare Advantage plan to employees. They also provide exchange solutions with a variety of plan options or a single, fully-insured defined contribution plan that can be used to provide retiree benefits to a group of participants.
They are conscious of the fact that no two customers or retiree populations are the same. Aetna, as a healthcare provider, takes a unique approach to each patient. They take a personalized approach to ensure that your benefits experience is as smooth and successful as possible. They tailor their solutions to the specific dynamics and needs of retirees in order to achieve the best possible results in meeting your stated benefit objectives.
Aetna takes pride in the ability to maintain your benefits program while reducing costs and risks. In your retirement years, if you’re looking for a company with a proven track record of implementing quality healthcare for groups of all sizes, look no further than Aetna. They’re the best in the business.
What is Aetna Medicare’s all-in-one coverage plan?
The following services and benefits are included in the Aetna Medicare Advantage plan, which is an all-in-one solution:
First, it includes Hospitalization Part A, which includes physician services, and Part B Outpatient care services. Second, in addition to the benefits provided by Original Medicare, comprehensive medical advocacy, preventive care, and wellness benefits are available.
Third, everyone has access to disease and case management support services. Fourth, additional discounts and benefits such as hearing aids, fitness, and other services are available.
What are different Aetna medicare advantage plans?
Following are different Aetna medicare advantage plans and their benefits.
Medicare Advantage PPO Plans
To avail of Aetna’s PPO plans, primary care physicians are not required, and specialists are not required to accept referrals from members of the PPO plans. It is possible that out-of-network providers are more accessible with PPO plans than with other Medicare Advantage plans, but they may also be more expensive than with other Medicare Advantage plans. HMO-POS members are eligible for additional benefits under a number of Aetna’s PPO plans, which are not available to members of the HMO-POS plans.
PPO members can seek medical attention from network doctors, healthcare providers, and hospitals through the PPO network. It is less expensive to use these facilities and personnel within your network if you make use of them yourself. In the event that you seek medical attention from a provider outside the system, you will be charged more.
Medicare advantage (D-SNP) Dual special needs plan
Membership in the Dual Special Needs Plan (DSNP) is limited to those who have specific diseases or characteristics. Specifically designed to meet the needs of this particular group of people, the benefits are available to them. If you want to avail of this plan, you must act quickly because the policy is only available in 23 states.
Advantage (HMO) plans by Aetna
The majority of health maintenance organizations (HMOs) require members to have a primary care physician who assists in the coordination of care and serves as a gatekeeper to other healthcare options. Aetna facilitates its members in this regard. If members of Aetna’s Medicare Advantage HMO need to see a specialist, it is possible that they will be required to obtain a referral.
The use of Aetna’s HMO plans, with the exception of emergency care, requires members to access health care through a predetermined network of providers. Many of these plans are reasonably priced, in addition to providing pharmacy benefits and other extra benefits.
In the majority of cases, advantage plans have HMO or PPO networks with stringent rules. Members of an HMO network are required to select a primary care physician who will coordinate a referral to a specialist if the need for one arises.
The majority of Medicare HMO networks treat patients only through network providers, with the exception of emergencies. This contrasts with the majority of Medicare PPO networks, which allow patients to see doctors from outside the network. PPO networks, on the other hand, require you to pay a higher out-of-pocket expense.
Medicare advantage HMO-POS plans
An HMO-Point of Service (HMO-POS) plan and a Medicare Medical Savings Account (MSA) are two other options that are less commonly used but are still available.
Aetna HMO-POS (point of service) plans may allow you to see health care providers who are not part of the Aetna network; however, you may be charged a higher rate for services received from out-of-network providers. It is required that all HMO-POS plan participants have a primary care provider, and some plans require that members obtain a referral before seeing a specialty provider. The majority of these plans include additional benefits such as over-the-counter medication, dental, hearing coverage, and vision, as well as home-delivered meals following a hospitalization.
When seeking medical attention from a provider outside of your HMO’s network, there are some restrictions that must be followed. Those who live outside the network can still receive some services, such as out-of-area dialysis and emergency care, but they will only be able to access a limited number of services. If you have an HMO with a point-of-service, you may be able to access certain services that are not available through the network.
Medicare Advantage Prescription Drug Plans
Medicare Advantage Prescription Drug plans are also known as Medicare Part D plans. Aetna’s Medicare Advantage Prescription Drug (MAPD) plans are plans that provide prescription drug coverage under Medicare Part D in addition to Medicare Parts A and B. With no monthly premium, Aetna’s Medicare Advantage Prescription Drug plans are available to 85 percent of Medicare-eligible beneficiaries.
Stand-Alone Prescription Drug Plans
Stand-alone prescription drug plans (PDP) cover medications outside of the Medicare coverage gap, but they do not include any other benefits such as medical coverage or hospitalization. These plans are intended to be used in conjunction with Original Medicare Parts A and B and are not intended to replace them.
Three stand-alone personal disability plans were introduced by Aetna in the first quarter of 2021, with premiums ranging from $7.15 to $69.52 per month. Premiums for SilverScript Smart Rx are the most affordable option, with premiums for 2022 plans starting as low as $7 in many states and Washington, D.C. It is the most affordable option available in all 50 states and the District of Columbia.
There are no copayments for Tier 1 drugs at preferred pharmacies in the beginning, and this is true for both plans. SilverScript Plus will begin offering Tier 2 drugs with no deductible and only $2 copays in 2022, replacing the current system. Although the most expensive plan has no deductible on any tier and additional gap coverage, the other two options do not have either of these benefits.
Medicare Supplement (Medigap) Insurance
Apart from covering some of the costs that are not covered by Original Medicare, Medicare Supplement plans (also known as Medigap plans) are also designed to cover some of the costs that are not covered by original Medicare plans, such as copayments, coinsurance, and deductibles.
You must have Medicare Parts A and B in order to purchase a Medigap policy, and you will be unable to purchase a Medigap policy if you are enrolled in Medicare Advantage coverage. It is possible to enroll in one of ten standard plans that cover a wide range of expenses; however, not all of these plans are available in all states.
Contrary to popular belief, despite the fact that Medicare.gov provides information on Medigap plans, you must purchase them directly from private insurance companies. Because it does not impose any restrictions on members’ use of a specific provider network, this type of coverage is portable and flexible.
However, please be clear that Medigap plans do not cover expenses like prescription drugs, and they cannot be used in combination with other insurance plans, such as a Medicare Advantage plan, to provide comprehensive coverage.
Aetna Medicare Advantage provider portal
You can access the Aetna Medicare Advantage provider portal to learn about and enroll in various Aetna medicare plans, services, and other benefits. You can create an account or log into the existing account to take advantage of all available services while on the go.
On the service provider’s website, you can choose from a number of different plans. The paid plans are only available to you if you meet the eligibility requirements and have an existing membership with those plans.
For example, on the service provider portal, there is a separate plan for Members who have Aetna Medicare HMO, PPO, or HMO-POS plans, as opposed to other plans. They can log in or create a new account on that website. When it comes to viewing and managing prescriptions, including mail-order delivery, and reviewing their Explanation of Benefits, Aetna Medicare SilverScript PDP members can access their personal accounts on Caremark.com through a secure connection (EOB). Members who have plans (A–N) can log in or register for an account for free, but they will not be able to take advantage of any additional benefits.
General benefits of Aetna medicare advantage plans
There are numerous benefits of Aetna medicare advantage plans. Every year, millions of Medicare beneficiaries choose to take advantage of additional benefits offered by the Aetna medicare advantage plan. All of your Original Health Insurance can be combined into a single plan with Aetna Medicare Advantage plans.
Aetna offers various health insurance plans, including Medicare Advantage plans, for individuals and businesses. Aetna’s Medicare plans include a variety of additional benefits and services that are geared toward improving the overall health and well-being of its members. In addition to the original Medicare Part A and Part B, Aetna medicare plans include the following benefits:
2- Medical expenses
3- Regular dental checkup
4- Regular vision or eyesight check-up
5- Prescription medications cost
COVID-19 and Aetna medicare advantage plans
During the hard times of COVID-19, Aetna’s medicare advantage plans introduced additional services such as at-home tests and other benefits. Medicare Advantage plans that reimbursed patients for COVID tests ordered by a health care professional and performed in an accredited laboratory were included during COVID-19. There are also free tests available online through a link provided on their website. At-home rapid COVID tests purchased online, at a pharmacy, or in a retail store are not covered by your original Medicare Program or Medicare Supplement plan.
How much does the Aetna Medicare plan cost?
Aetna has access to a diverse range of high-quality healthcare services throughout the United States. Plan options and benefits for Medicare Advantage are available in a wide range of options and at competitive prices, making it possible for members to find the coverage that best meets their needs. PPO plans are appealing to members who place a high value on choice over cost because they allow them to use any Medicare-eligible provider of their choosing without incurring additional costs.
The medicare programs offered by Aetna are reasonably priced for the average citizen. The prices of most insurance policies are subject to change at any time of the year, but they take effect at the start of the following year.
There are currently new benefits and rates available for plans for 2022. According to the review, the cost of Medicare Part D prescription drug costs will be lower in 2022 than they are currently. Customers who renew their policies will also be eligible for a substantial discount on their premiums.
Other initiatives by Aetna
Apart from medicare plans, Aetna has also taken other initiatives related to health care. These include the following:
1- Workplace health and safety
2- Green initiatives aimed at fostering healthy communities
3- Assisting others in society
4- A charitable organization that promotes health and wellness
5- Encouragement of state programs that promote health and well-being
6- Reducing racial and ethnic disparities in the healthcare
Problems with the Aetna Medicare plan
Those who have used the Aetna medicare program have reported issues with the Aetna medicare program. These include:
Quality ratings that vary
Concerns about the value of coverage
Changes to drug formularies occur regularly
Aetna medicare advantage provider phone number & contact details
Aetna medicare providers can be accessed through the following details:
You can contact Aetna at the following address: Aetna Inc. 151 Farmington Avenue Hartford, CT 06156 USA.
You can reach them at 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between the hours of 8:00 a.m. and 6:00 p.m. ET.
This is the contact information for the Corporate Contact Center. They do not have access to member accounts, but they can provide contact information for Aetna Member Services. Visit their Member Services page if you’re an Aetna member and have questions about your insurance policy coverage. Information about Aetna Member Services can be found over there.
You can also contact them via Twitter.
You can also participate in a discussion about future health coverage. The Aetna Customer Service Twitter team is available 24 hours a day, seven days a week, to assist, listen, and learn from you.
You may visit www.aetna-medicareadvantage.com for more information.
Let us now turn to the most recent Aetna developments, which will be in effect through 2022. In order to be eligible for Aetna Medicare Advantage Plans 2022, a subscriber must meet a number of requirements. You must be already in a Medicare Part B plan already, and a member within the insurance carrier’s network area are two of the most important requirements.
The good news is that patients with the end-stage renal disease will no longer be subjected to these limitations. If you are sixty-five years old or older, you can easily obtain Original Medicare Part B, which covers prescription medications. For enrollment, you must be a citizen or permanent resident of the United States for the previous five years. As an added bonus, Aetna’s Medicare Advantage plans consolidate all of your Original Medicare benefits into a single, straightforward plan. You may also be eligible for benefits that are not covered by Medicare.
It should be noted, however, that when it comes to health information programs, doctors and other qualified health care providers are essential, and there is no substitute for their expertise. Aetna may provide you with more benefits and services than Original Medicare, but you should always seek advice from your doctor before making any changes to your coverage.