Original Medicare, which is composed of Parts A and B, is administered by the U.S. government (specifically by the Centers for Medicare and Medicaid Services [CMS], which falls under the umbrella of the Department of Health and Human Services).
Beneficiaries of Original Medicare, who receive base health insurance coverage from CMS, have the option of purchasing additional, supplemental coverage from private insurance companies (such as Humana and Aetna, two of the largest private providers).
Aetna Medicare plans offer a spectrum of Medicare Advantage, Medicare Part D, and supplemental Medigap policies. This article presents the range of options available.
Aetna Medicare Part D Plans
Medicare Part D is a supplemental policy beneficiaries can purchase from private insurers which adds additional prescription drug coverage. Also known as Prescription Drug Plans (PDP), Aetna Medicare Part D plans offer the following general benefits:
- a network of over 60,000 pharmacies
- coverage for the majority of Part D drugs
- no deductible in most plans
- consistent copayments
Aetna Medicare insurance offers three different Aetna Medicare Part D plans, which are listed below from the most basic to the most advanced:
- Aetna Medicare Rx Essentials® Plan – under this basic plan, beneficiaries have access to discounted pricing for a range of prescription drugs not covered by Original Medicare;
- Aetna Medicare Rx Plus® Plan – under this plan, beneficiaries receive discounts on prescription drugs, gain enhanced coverage for generic Benzodiazepines and Barbiturates, and have no deductible for prescription drugs;
- Aetna Medicare Rx Premier® Plan – under this plan, beneficiaries receive discounted prescriptions drugs, access to coverage for generic Benzodiazepines and Barbiturates, are not responsible for deductibles on prescriptions drugs, and have access to unlimited coverage on generic drugs.
It is advisable to enroll in a Medicare Part D plan earlier rather than later (if possible), as this avoids potential late enrollment fees, and protects against the sudden need for drug coverage.
Aetna Medicare Advantage Plans
Medicare Advantage Plans are basically enhanced Original Medicare plans sold by private insurers. In addition to providing Part A and B coverage, such plans often add other coverages, such as prescription drug coverage, vision, dental, hearing, and a host of other services.
Aetna Medicare insurance offers four Aetna Medicare Advantage Plan choices, listed below from the most basic to the most advanced:
- Aetna Medicare Plan (HMO) – under this plan, beneficiaries see doctors within the company's large network. Benefits include predictable copayments, coverage for most prescription drugs, no copays for preventative care, and limited vision and hearing coverage;
- Aetna Medicare Plan (PPO) – under this plan, beneficiaries receive all of the HMO coverages, with the added benefit of being able to see medical professional outside of the company's network at low costs. This means that there is no requirement to select a single primary care physician (though rates are lower for those who do);
- Aetna Medicare OpenSM Plan (PFFS) – in addition to the benefits of the PPO plan, this fee-for-service plan gives beneficiaries the freedom to seek care at any medical facility without any network limitations. This gives recipients access to seek care anywhere in the United States which accepts Medicare;
- Aetna Medicare Dual Advantage Plan (SNP) – this Special Needs Plan is designed only for those beneficiaries who have unique coverage needs, and thus are eligible for state Medicaid insurance.
In addition to the policies listed above, the company also offers an Aetna Medicare Advantage Plan which adds Aetna Medicare Part D into a single policy.
Aetna Medicare Insurance Supplemental Plans (Medigap)
Aetna Medicare insurance offers additional supplemental plans which are only available in certain states at this time. These plans are intended to bridge some of the gaps left by Original Medicare coverage, and are available for eligible beneficiaries. The plans vary by state.
For specifics on the supplemental plans, or for more information on any of the plans above or other Medicare plans, click on any of the Medicare links. For more information specifically on Aetna's plans, reference the company's website, from which the information for this article was gleaned.
David Harris-Gershon - David Harris-Gershon – a blogger for Tikkun magazine and a freelance writer on Israel, the Middle East and America’s role in ...
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