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Aetna Medicare

The Advantages of Aetna Medicare in Providing Supplemental Health Care for Seniors

Most adults who have certain disabilities or are over the age of 65 qualify for Medicare in the U.S. The program is designed to provide seniors and disabled individuals with access to quality health care without exorbitant costs. Medicare typically covers major medical conditions and outpatient procedures, and is widely accepted by healthcare providers. However, there are some health benefits that Medicare coverage lacks. To help fill in coverage gaps, Aetna offers supplemental Medicare insurance plans.

Supplemental Medicare Insurance

Traditional Medicare is divided into Parts A and B. Aetna offers supplemental insurance, which still extends the same benefits as traditional Medicare, but with more comprehensive provisions. Under such a plan, additional benefits may be covered, such as dental, hearing aids and vision correction. The policies may also be used to help pay for Medicare deductibles and coinsurance payments, and they are transferable from state to state. To take advantage of the benefits of supplemental Medicare coverage, enrollees must use health care providers within the Aetna plan provider network.

California seniors can elect to enroll in the Aetna Medicare Select Plan. The plan is an HMO with a maximum annual out-of-pocket cost of $3,400 and an office visit copay of just $5. Specialist visits are just $10, and preventative care is covered at no cost per the provisions of The Affordable Care Act. The plan also features especially low copays and coinsurance for common medical expenses, such as ambulance transfers, emergency room visits and diagnostic testing. Reimbursements for corrective lenses and hearing aid devices are available periodically.

Prescription drug coverage is included in the Aetna Medicare Select Plan for California residents. The coverage features low copays for prescriptions purchased through Aetna network pharmacies, covering up to $2,930 annually. Tier one prescriptions have continued coverage in the gap.

Though Aetna’s Medicare Select Plan provides hearing and vision aid reimbursements, it does not provide benefits for routine dental care. This type of coverage is an optional addition to the Medicare Select Plan – available as a comprehensive dental plan or preventative coverage only.

Part D Insurance Coverage

Medicare does not cover the cost of prescription drugs for seniors. Electing to purchase Part D coverage will provide benefits for prescription drugs through companies and pharmacies contracted with Aetna. Part D plans are available individually or as a part of an Aetna Medicare health plan.

In California, Aetna offers two Medicare Part D coverage plans. The first is the Aetna Medicare RX prescription premier plan, which offers gap coverage for tier one and two prescription drugs. When used at Aetna network pharmacies, the plan offers significant discounts on prescriptions. Tier one drugs are $4, tier two are $25, tier three are $35, and tier four are $80. Enrollees with tier five prescriptions pay only 33 percent of the pharmacy cost.

Aetna’s CVS/pharmacy prescription drug plan is another Part D prescription plan that offers the most affordable monthly premiums. The plan offers lower prices on prescription drugs when purchased from a CVS pharmacy. It also charges a $0 deductible for tier one and two prescriptions, and only $320 for tiers three through five. No prescription gap coverage is available through the CVS/pharmacy prescription drug plan.

Considerations

It is important to understand that an Aetna Medicare supplement plan is invalid if the policy-holder does not continue to pay for original Medicare premiums. Furthermore, supplemental and prescription drug plans typically have separate monthly premiums from original Medicare premiums, so both must be maintained for benefits to be payable.

 
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