2018 Aetna Medicare Basics Plan (PPO) H5521-179-0 in GA from Aetna | HealthPocket

Aetna Medicare Basics Plan (PPO)


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Zip Code30044
Applicant10/20/1983 Male
Coverage Start10/21/2018
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C)
Insurance ProviderAetna
Plan IDH5521-179-0
Plan Year2018
CMS Rating
Plan TypePPO
Annual Deductible$0.00

What To Know About This Plan
  • This is a health coverage only plan with no drug coverage
  • This plan is available for 2019. see plan

Why We Like This Plan
  • has no additional premium costs outside of your Medicare Part B premium

Costs and Other Important Information

Plan Year2018
Prescription Drugs Covered?Yes
Health Plan Deductible$0
Monthly Drug Plan Premium$0
Monthly Health Plan Premium$0

Coverage Area for Aetna Medicare Basics (PPO)


Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain screeningNot Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physicians that accept Aetna Medicare Basics (PPO) for Georgia

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Jones, Cristina
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Fitzgerald-soapes, S
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Mathew, Lekha
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Gould, Bradford
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Lalaji, Pushpa
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Renfus, Renee
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Soyoola, Emmanuel
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Chatoth, Dinesh
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Poddar, Satish
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Mafoueka Nguena, Victorine
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Querubin, Roel
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Smart, Jennifer
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Rodrigo, Irandathy
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Diaz, Ruben
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Dikkala, Venkateswara
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Cristina Jones, SLP
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  • Phone Number
    (770) 822-9115
  • Office Locations
    4799 Sugarloaf Pkwy
    Lawrenceville, GA 30044
4799 Sugarloaf Pkwy Lawrenceville GA, 30044
WellCare Advance (HMO-POS)
COST:from $0CMS Rating:
HumanaChoice R3392-001 (Regional PPO)
COST:from $0CMS Rating:
Aetna Medicare Select Plan (HMO)
COST:from $0CMS Rating:
Cigna-HealthSpring Preferred (HMO)
COST:from $0CMS Rating:
COST:from $0CMS Rating:Not Rated

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