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What Medicare Advantage Plans Does Aetna® Offer?

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Whether you’re new to Medicare or have been enrolled for awhile, it’s a good idea to periodically review your coverage to make sure it’s still meeting your current health needs and budget. If you’re looking at Aetna’s Medicare Advantage plans to see if one might work for you, here’s what you need to know.

How Aetna’s Medicare plans work: Medicare Advantage overview

Medicare Advantage, or Part C, is another way to get your Original Medicare benefits. The main difference is that instead of getting your Part A and Part B coverage through the federal program, you get your benefits through a Medicare plan, offered by a Medicare-contracted private insurance company such as Aetna.

All of Aetna’s Medicare Advantage must offer at least the same level of benefits as Original Medicare. However, Medicare Advantage plans may also include coverage beyond Original Medicare, such as prescription drug benefits, wellness programs like Silver Sneakers®, or routine vision and dental care.

Aetna’s Medicare plans: Medicare Advantage plan types

Aetna’s Medicare Advantage plans include a wide variety to suit different needs and preferences. Aetna’s Medicare health plan options vary by location and may include all or some of the following types:

  • Aetna’s HMO (health maintenance organization) plans: Aetna’s HMO plans typically require you to use provider networks to be covered (except for out-of-area dialysis, out-of-area urgent care, or emergency services). You’ll also need a referral from your primary care doctor to see a specialist.
  • Aetna’s HMO-POS (health maintenance organization point-of-service) plans: This is a hybrid of two of Aetna’s Medicare Advantage plans. Aetna’s HMO-POS plans work like a standard HMO in most ways. However, you’re allowed to use some out-of-network providers for a higher cost, similar to a PPO.
  • Aetna’s PPO (preferred provider organization) plans: With an Aetna’s PPO plan, you’ll generally save money if you use network providers. However, you have the flexibility to go out of network, usually for higher copayments and coinsurance costs. You don’t need a referral for specialist care.
  • Aetna’s SNP (Special Needs Plans): Medicare Special Needs Plans target people with special health or situational needs, such as those who have chronic conditions, live in an institution, or have both Medicare and Medicaid (known as dual-eligibles). Aetna’s Medicare Advantage plans for dual eligibles may offer specialized coordination services or provider networks to help you manage your health-care benefits.

Costs for Aetna’s Medicare Advantage plans

Costs for Aetna’s Medicare plans vary by plan type and may depend on your specific situation – such as your prescriptions and the services you need (and how often). Your costs may also depend on whether you use in-network or out-of-network providers.

Deductibles, copayments, and coinsurance costs may all vary by plan. Some of Aetna’s Medicare Advantage plans may have a premium as low as $0, but you’ll need to keep paying your Medicare Part B premium even if your plan doesn’t have a premium.

Please note that Aetna’s Medicare Advantage plans, like all Medicare Advantage plans, each have a yearly out-of-pocket maximum. So, unlike with Original Medicare, you’ll have peace of mind knowing there’s a cap to how much you’ll pay for medical costs in a given year.

Each of Aetna’s Medicare Advantage plans has an Evidence of Coverage document with detailed information on costs and benefits that you can review for more information.

Browse Aetna’s Medicare Advantage plans

If you’re ready to find Medicare plan options in your ZIP code, you can browse Aetna’s Medicare plans from the convenience of your own computer. Simply enter your ZIP code into the plan finder tool on this page to get started. You can even enter your prescription drugs to view Aetna’s Medicare plan options that cover those medications.

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Out-of-network/non- contracted providers are under no obligation to treat Aetna members, except in emergency situations. Please call Aetna’s customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

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