Aetna Medicare

Aetna Medicare

Aetna is an insurance company founded in 1853 that sells insurance products in the U.S. As of June 2013 Aetna serves over 63 million members, including those who receive insurance through their employers. Aetna reported $35.54 billion in revenue for 2012 and its health insurance plans are offered both on public (federally-facilitated and state) as well as private exchanges.

Medicare Insurance Products from Aetna

Aetna offers three types of Medicare products1:

Medicare Advantage: you can purchase either a Medicare Advantage plan without prescription drug coverage (MA) or a Medicare Advantage plan with prescription drug coverage (MAPD) depending on your specific medical needs. You have the choice of enrolling in an Aetna HMO or PPO.

HMO plans include a network of tens of thousands of doctors, with network coverage that travels with you. Additional benefits of Aetna Medicare Advantage plans include free fitness facility memberships, $0 annual physicals, $0 copays for certain generic drugs, free blood pressure monitors for beneficiaries with high blood pressure, and a 24 hour nurse hotline.

Additional benefits in the PPO plan are similar to the HMO plan, and beneficiaries have the flexibility to visit doctors in- or out-of-network. Aetna Medicare Advantage plans also include extra discounts and coupons for services and products such as weight management programs, hearing exams, and oral health care products such as Waterpiks.

Medicare Supplement (Medigap): Aetna’s Medigap plans are not available in all states, and rates and benefits vary by area. The plans may not be cancelled if you move and are guaranteed renewable as long as you continue to pay your premium and do not provide false or incomplete information in your application. If you are a Medicare recipient under the age of 65 and you are disabled, then the following Medigap plans are available depending on your state:

  • Plan A – MD, OK, TX
  • Plan C – NJ
  • Plans A & C – MI
  • Plans A & F – NC
  • Plans A, B, & F – NY
  • Plans A, B, F, & N – CA
  • All plans offered by Aetna in CO, FL, GA, IL, KS, KY, LA, OR, PA, & TN and Basic Plan plus riders in WI

Medicare Rx (PDP): Aetna offers three categories of prescription drug plans, and cost sharing varies by region. Similar to Aetna’s Medicare Advantage offerings, their PDP plans also include extra discounts and coupons for certain services and products.

  • Aetna CVS/pharmacy Prescription Drug Plan (PDP) – includes CVS ExtraCare Health Card which provides a 20% discount off of CVS-branded items (over $1 in value). Medicare standard cost sharing applies during the coverage gap (72% on all generic drugs in formulary, 47.5% on all brand name drugs). Tier 5 drug coverage is not included during the coverage gap. This plan is not available in AK, AR, CO, ID, OR, UT, and WA.
  • Aetna Medicare Rx Premier Plan (PDP) – 0% deductible, Medicare standard cost sharing applies during the coverage gap and tier 5 drugs are included as well. This plan is available in all states except HI, ME, and NH.
  • Aetna Medicare Rx Essentials Plan (PDP) – This plan was created to cover residents of states where the Aetna CVS/pharmacy PDP is not available. Therefore only residents of AK, AR, CO, ID, OR, UT, and WA may purchase this plan. Medicare standard cost sharing applies during the coverage gap and tier 5 drug coverage is not included during the coverage gap.

Compare Aetna Medicare products with other similar offerings in your area using our Medicare and Medigap plan comparison tools.

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