Description: The article is about aetna login. The passage introduces the benefits of choosing the Medicare program and how to enroll in the Medicare Advantage plan. The Medicare program has many benefits and great features,different people can choose different plans.
Today you’ll learn about the Medicare program and how to enroll in the Medicare Advantage plan,we want to help you make an informed decision about your coverage,we’ll cover these important topics to help you understand more about Original Medicare,Medicare Advantage and Medicare Part D.
You might not know this,Aetna paid the very first Medicare claim in 1966. With over 160 years in business,we are covering more than 43 million members throughout the US and. We’re guided by four main values integrity,excellence,inspiration and caring.
you should have received an enrollment kit when you arrived,if not please ask one of the Aetna representatives for one. Your enrollment kit has an application, the overall CMS star ratings,a summary of benefits and a multi-language insert. How do you qualify for a Medicare Advantage plan?
First you’re required to have both Medicare Part A and Part B,you must continue to pay your Medicare Part B premium. Second you have to live in the plan service area,finally you can’t have end-stage renal disease ESRD,there may be some cases where this doesn’t apply, you should check with your plan if you have questions about ESRD.
Let’s get started with some Medicare basics. There are four parts to Medicare Part A,it covers some Hospital skilled nursing facility,home health and hospice care,you will pay no premium for Part A. Part B covers some doctors and medical services,durable medical equipment,hospital outpatient services,laboratory tests,x-rays and mental health services. You should pay a premium for Part B.
It might be paid out of your Social Security,that premium can change each year. Part A and Part B are Original Medicare,Part C is called Medicare Advantage. Part D helps you cover prescription drug costs. Medicare Advantage is provided by private insurance companies like Aetna.
It is approved for the Centers for Medicare and Medicaid Services CMS. Most Medicare Advantage plans combine Medicare Part A Part B and Part D into one MAPD plan. There are some MA plans that don’t include Part D.
With a Medicare Advantage plan,you’re still enrolled in Medicare,but your Part A hospital and Part B medical coverage are from Aetna,they are not Original Medicare. Medicare Advantage plans are sometimes referred to Part C plans,they include everything that original medicare covers and may add other benefits such as prescription drug coverage.
Aetna is one of the private insurance companies approved by Medicare that offers MA plans,Medicare Advantage is not a medicare supplement plan,it is often called Medigap plans although supplement plans can be used to fill in the gaps in Original Medicare coverage.
Generally you can enroll in Medicare Advantage only at specific times of the year,the main enrollment time is the annual enrollment period AEP,this is when anyone can enroll or disenroll from a medicare plan. AEP runs from October 15th to December 7th each year,coverage begins on January 1st of the following year.
There are also special enrollment periods,you may be able to join switch or drop a medicare plan,for example if you move out of your plans service area or have Medicaid or qualify for extra help,you may be able to enroll during a special enrollment period. When you choose Medicare Advantage,there are several types of plans that can be included.
With a health maintenance organization HMO,you’ll use doctors in the network, you might need a referral to see a specialist. A health maintenance organization with a point of service HMO – POS means you’ll use doctors in the network but you may also go out of the network. However you will probably have a higher copay or coinsurance. With a preferred provider organization PPO,you can use doctors and hospitals out of the network but often for higher copay.
In Medicare Part D,your prescription drug option includes a late enrollment penalty,the late enrollment penalty may apply if you don’t have creditable coverage when your initial enrollment period is over. There’s a period of 63 days or more in a row when you don’t have Part D or other creditable prescription drug coverage. If you get extra help,you don’t need to pay a late enrollment penalty.
When you enroll in a Medicare plan they will let you know if you owe a late enrollment penalty,if you don’t agree with the penalty,you can send a reconsideration request form to the government,you can get the form from your plan.
Here are some key terms you’ll hear today. Cost share is the amount that you pay when you get health care services or prescriptions. Deductible is the amount that you must pay for health care or prescriptions before Original Medicare,your Medicare Advantage plan,your prescription drug plan or your other insurance begins to pay.
Co-payment is the amount that you have to pay as your share of the cost for a medical service or supply,this includes doctor’s visits,hospital outpatient visits or a prescription drug on the formulary. A co-payment is a set amount not a percentage. For example you might pay ten or twenty dollars for a doctor’s visit or prescription drug.
Coinsurance is your share of the cost for services or prescription drugs after you pay any applicable deductible,coinsurance is a percentage like 20 percent. Total drug cost is the amount of money that both you and the plan spend on a prescription drug. Premium is the monthly payment to Medicare,an insurance company or a Medicare plan for health or prescription drug coverage.
True out-of-pocket costs means the payments that count toward your Medicare drug plan. Troop costs determine when your catastrophic coverage begins. Creditable coverage is another source of drug coverage that expected to pay at least as much as Medicare standard prescription drug coverage.
Aetna has over 60,000 pharmacies in our network and more than 20,000 offer preferred cost sharing,with that pharmacies you can probably find a participating pharmacy close to you. To find a network pharmacy online,you can go to www.aetnamedicare.com/findpharmacy. Aetna has over 20,000 pharmacies offering preferred cost-sharing,we want you to pay the lowest price possible for your drugs. When you choose to get your drugs at one of these retail pharmacies,you’ll typically pay a lower amount.
With so many retail pharmacies with preferred cost-sharing,finding one is easy. We also have many local independent pharmacies,you can visit our online network directory at www.aetnamedicare.com/findpharmacy. To locate network pharmacies including those that offer preferred cost-sharing other pharmacies are available in our network as well,please note that members who get extra help are not required to fill prescriptions at preferred network pharmacies.
Every Part D plan has a network and a formulary. A formulary is a list of all the drugs that the plan covers. Sometimes our formularies change,if we change a formulary we will normally give you a 60 day advance notification,we also post notices of formulary changes to our website,you can view our formularies at www.aetnamedicare.com/formulary. You can call 18772386211 for more formulary information.
Part D is the Medicare prescription drug program,your Part D coverage has four basic phases,the deductible phase,the initial coverage period,the coverage gap and catastrophic coverage. In the deductible phase you will pay cost of formulary drugs until you reach your yearly deductible,you should stay in this stage until you’ve paid your yearly deductible amount if applicable. During the initial coverage period,you should pay your plan copay or coinsurance,your plan pays what remains until the combined costs reach a yearly specified amount,for 2017 that amount is $3,700.
Once your yearly drug cost reaches that amount,you will move into the coverage gap phase,this is commonly known as the doughnut hole. While you’re in the coverage gap,you’ll pay 40 percent of the brand drug cost and 51 percent of the generic drug cost. You can check the benefits of your Part D coverage,some plans may offer additional coverage while you’re in the gap.
After your total yearly drug cost reaches your true out-of-pocket limit,you will begin catastrophic coverage,this is the final phase. For 2017 the true out-of-pocket limit is four thousand nine hundred fifty dollars. In this phase you should pay a small copay for generics or brand drugs or a five percent coinsurance. There are also some important Part D terms you should know.
Formulary is a list of drugs covered by your plan. Drug tier means that each drug belongs to a tier which determines how much you’ll pay for that drug. Network is the pharmacies where you can get your prescription drugs. Transition process is that when you can get a one-time fill of a drug that isn’t covered on the formulary. Initial coverage limit is the combined amount that you and your plan pays for prescription drugs before you enter the coverage gap or doughnut hole.
Your plan may also have drug coverage rules which are made with the safety of your health in mind,for example some drugs require prior authorization that means your doctor must first show a medical need for you to use the drug before the plan covers it.
Quantity limits restrict how much medication you can get at one time. You may have to try another drug on the plans formulary before you can move up a step to a more expensive drug. This is step therapy. If you need help with your Medicare costs,you may get extra help.
This is the name of a Medicare program that helps paying some Medicare prescription drug costs such as monthly plan premium,yearly deductible,coinsurance,co-payments. Many people with Medicare are surprised to find out they qualify for extra help. You can find out more by contacting Medicare Social Security or your state Medicaid office or by visiting the www.medicare.gov website. More help is available to find benefits that you may miss out.
Benefits check up can find federal state and private benefit programs to help you save money on prescription drugs,utilities,taxes meals and more,you can find out more at www.benefitscheckup.org/aetna. Now we will look at special benifits. Aetna offers you special programs to help you keep up your good health,our informed nurse line gives you 24-hours access to a registered nurse who is ready to give you information among various topics.
Nurse health coaches promote better patient well-being through a variety of means including better nutrition,stress management and health assessments. We offer an in-home health assessment,we’re a dedicated medical professional,we can discuss your health concerns at no extra cost to you,our fitness benefits include gym memberships or memberships to fitness programs such as silver sneakers. Aetna provides 24/7 online support at www.aetnamedicare.com,you can find a doctor,search our drug plan list and even compare plans and costs.
Our secure member website Aetna Navigator lets you review claims to get a new ID card and more. Every year the Centers for Medicare and Medicaid Services CMS give overall performance star ratings to all Medicare health and prescription drug plans,they use a scale of one to five stars with five stars being the highest quality, it’s called the 5-star quality rating system.
Ratings are based on member satisfaction surveys,health plans and health care providers,these CMS star ratings will help you compare plans based on quality and performance. You can find Aetna plan star ratings in your area at www.aetnamedicare.com/en/compare – plans – enroll/star – ratings/html.
We’ve made enrollment easy for you,you can enroll today by first reviewing your enrollment kit and picking a plan that best fits your needs,you can complete the enrollment form and submit it to us. If you’d like to take more time to consider your plan options,you can enroll with that no later at www.aetnamaedicare.com.
After you complete your enrollment form,your enrollment request goes through a short process. We will review it to make sure all the the information is complete. It will then send CMS for confirmation. When that complete,we will send you a letter confirming your enrollment in the plan.
Once the enrollment process is finished,you’re a member of Aetna and we’ll send you your membership ID card usually 10 to 15 days after your confirmation letter. You’ll receive your evidence of coverage often referred to your EOC,you’ll receive letters or phone calls from Aetna or our partners to help you better understand the benefits that come with the plan. Finally if a Medicare Part D prescription drugs is part of your plan,you’ll receive a formulary with its list of medications and drug tiers.
We want you to know that if you have a question,we’re here to help you when you need us,you’ll find our members services number on your plan ID card. Member Services is ready to help you better understand your claims,your benefits,how to use your plan,how to find a doctor,how to get doctor and specialist referrals if they are needed for a service,how to access Aetna translation services.
With an Aetna Medicare coverage plan,you will receive benefits that go beyond Original Medicare,our MA plans offer the same benefits as Medicare Part A and Part B,you will also receive added benefits such as prescription drug coverage,fitness benefits and more. You should consider the benefit options that are best for your lifestyle and budget then you can choose the right Aetna medicare advantage for you.
Your on-site representative will now explain more about your local Aetna Medicare Advantage plans,that’s what our agents are best at. They are good at providing helpful and important information so you can make the decision that’s right for you. If you have any questions about what we’ve reviewed,you can contact us.