Aetna Medicare Advantage 2021 Review

Aetna, a CVS Well being firm since 2018, is the fourth-largest supplier of Medicare Benefit plans. The corporate presents a robust array of advantages, with most plans together with dental, imaginative and prescient and listening to protection, and lots of plans providing further (and useful) perks. They’re additionally largely low value, with an estimated 80% of Medicare beneficiaries accessing a $0-premium Aetna plan and the lowest-cost stand-alone drug plan within the nation.

Though Aetna’s choices are notable, its plans rating within the “common” vary for member satisfaction and high quality of care. And should you’re wanting past HMO, PPO and Particular Wants Plans, Aetna doesn’t provide different plan varieties. Right here’s what it’s best to find out about Aetna Medicare Benefit.

Aetna Medicare Benefit professionals and cons

Aetna’s choices have benefits and drawbacks.

• A number of advantages choices: Along with dental, imaginative and prescient and listening to, Aetna Medicare beneficiaries in lots of plans have entry to advantages corresponding to an over-the-counter allowance, meal supply providers and in-home well being visits.

• Sturdy $0 premium choices: In 2021, Aetna estimates that 4 out of 5 Medicare-eligible beneficiaries within the U.S. may have entry to a $0-monthly-premium Aetna Medicare Benefit plan.

• Low-cost drug protection: Aetna presents the lowest-premium stand-alone prescription drug plan nationwide, together with in Washington, D.C.

• Broad availability: Aetna presents plans in 46 states and Washington, D.C., in addition to stand-alone drug plans in all 50 states plus Washington, D.C.

• Common star scores: The Facilities for Medicare & Medicaid Providers offers Aetna’s 2021 Medicare Benefit plans a median score of three.7 out of 5 stars, with not a single plan incomes 5 stars. (The nationwide common for all suppliers is 4.16.)

• Mediocre member love: Relating to member satisfaction, J.D. Energy discovered that Aetna Medicare Benefit scored 789 factors out of 1,000, inserting it fifth general out of 10 Medicare Benefit firms ranked and just under the business common of 800 factors.

• Restricted plan varieties: Aetna presents HMO, PPO and Particular Wants Plans, however doesn’t provide non-public fee-for-service or medical financial savings account plans.

Aetna presents a number of completely different sorts of Medicare Benefit plans, they usually fluctuate when it comes to construction, prices and advantages obtainable. Most plans provide dental, imaginative and prescient and listening to advantages, worldwide emergency care, and health advantages by way of SilverSneakers.

Typically, Aetna presents Medicare Benefit Prescription Drug plans, or MAPDs, in addition to stand-alone prescription drug plans and Medicare Benefit Plans with out drug protection. New this 12 months, the corporate is providing Aetna Medicare Eagle MA-only plans in 27 states, designed for veterans to enrich their VA well being care protection.

Plan availability could fluctuate by county. Different plan choices could embody the next varieties:

Whereas a lot of Aetna’s Medicare Benefit plans embody Half D drug protection, the corporate additionally sells stand-alone Half D prescription drug plans. These plans are supposed to accompany Medicare Half A and Half B and don’t present medical protection.

Aetna presents three stand-alone prescription drug plans in 2021, with common month-to-month premiums that vary from $7.15 to $69.52:

• SilverScript SmartRx: Common premium of $7.15. Provides Tier 1 generic drug protection with a $0 deductible and $0 copays. That is the lowest-cost stand-alone drug plan nationwide.

• SilverScript Alternative: Common premium of $28.49. Provides Tier 1/Tier 2 protection of generic and brand-name medicine, with $0 copays for Tier 1.

• SilverScript Plus: Common premium of $69.52. Provides hole protection and a $0 deductible for all tiers, plus a $0 copay for Tier 1 medicine and $2 copay for Tier 2 medicine on a 30-day provide.

Aetna Medicare Benefit presents most MA members entry to routine imaginative and prescient, dental and listening to protection. Lots of its plans provide different advantages as effectively, a lot of which aren’t obtainable in different Medicare Benefit plans. Listed below are a couple of standouts:

Aetna additionally presents some distinctive profit packages which might be obtainable for only some plans in choose areas, together with the next:

Aetna members can contact their plan’s customer support in a wide range of methods:

Aetna presents Medicare Benefit Prescription Drug plans in 46 states and Washington, D.C., together with 1,793 counties. By way of stand-alone prescription drug plans, Aetna has plans in all 50 states and D.C.

Aetna expanded its Twin Eligible Particular Wants Plan to 23 states, and the corporate presents Aetna Medicare Eagle MA plans — a brand new providing — in 27 states.

General, Aetna is the fifth-largest well being insurer within the nation, and it’s the third-largest when it comes to for-profit well being plans. Practically 2.7 million Medicare beneficiaries are enrolled in an Aetna Medicare Benefit plan, and the corporate added 210,000 new members for the 2021 plan 12 months.

Prices for Medicare Benefit plans will rely in your plan, your geographic location and your well being wants. One of many prices to contemplate is the plan’s premium, and Aetna has expanded its providing of $0-premium plans. The corporate estimates that 4 out of 5 Medicare-eligible beneficiaries may have entry to a $0-monthly-premium Aetna Medicare Benefit plan in 2021. Aetna additionally presents the bottom premium stand-alone prescription drug plan product nationwide.

Whilst a Medicare Benefit person, you’ll nonetheless be liable for paying your Medicare Half B premium, which is $148.50 in 2021, though some plans cowl half or all of this value.

Different out-of-pocket prices to contemplate embody:

• Whether or not the plan covers any a part of your month-to-month Medicare Half B premium.

• The plan’s yearly deductibles and some other deductibles, corresponding to a drug deductible.

• Copayments and/or coinsurance for every go to or service. As an example, there could also be a $10 copay for seeing your major physician and a $45 copay for seeing a specialist.

• The plan’s in-network and out-of-network out-of-pocket maximums.

• Whether or not your medical suppliers are in-network or out-of-network, or how typically you could exit of community for care.

• Whether or not you require additional advantages, and if the plan costs for them.

To get a way of prices, use Medicare’s Plan Finder to match data amongst obtainable plans in your space. You’ll be able to choose by insurance coverage provider to see solely Aetna plans, or evaluate throughout carriers. You can too store immediately from Aetna’s web site by coming into your ZIP code.

If you need Medicare’s tackle Aetna’s plans, look no additional than the Facilities for Medicare & Medicaid Providers’ personal star scores, which rank every plan from finest (5 stars) to worst (1 star). The company bases these scores on plans’ high quality of care and measurements of buyer satisfaction, and scores could change from 12 months to 12 months.

Based mostly on the latest 12 months of knowledge, Aetna’s Medicare Benefit plans get a median score of three.7, and the corporate’s prescription drug plans (Half D) get a median rating of three.8. The common star score for plans from all suppliers was 4.16. Though two of Aetna’s prescription drug plans rating a 5 — in Georgia and Pennsylvania — none of its Medicare Benefit plans rank above a 4.5. You’ll be able to examine the Medicare Plan Finder for star scores of plans obtainable in your space.

There are a couple of firms that weigh in on well being plans or on the power of the corporate in query, and we’ve included three right here:

Discover the correct Medicare Benefit plan

• What are the plan’s prices? Do you perceive what the plan’s premium, deductibles, copays and/or coinsurance might be? Are you able to afford them?

• Is your physician in-network? You probably have a most popular medical supplier or suppliers, be certain they take part within the plan’s community.

• Are your prescriptions lined? Should you’re on medicine, it’s essential to know how the plan covers it. What tier are your pharmaceuticals on, and are there any protection guidelines that apply to them?

• Is there dental protection? Does the plan provide routine protection for imaginative and prescient, dental and listening to wants?

• Are there extras? Does the plan provide any additional advantages, corresponding to health memberships, transportation advantages or meal supply?

You probably have further questions on Medicare, go to Medicare.gov or name 1-800-MEDICARE (1-800-633-4227, TTY 877-486-2048).