Aetna Medicare Select (HMO) H1609-021 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Florida. This plan includes additional Medicare prescription drug (Part-D) coverage. The Aetna Medicare Select (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $3,450 (MOOP).
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Aetna Medicare Choice Plan (PPO) H9431-005 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Oregon. This plan includes additional Medicare prescription drug (Part-D) coverage. The Aetna Medicare Choice Plan (PPO) has a monthly premium of $19.00 and has an in-network Maximum Out-of-Pocket limit of $7,550 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $7,550 out of pocket. This can be a extremely nice safety net.
Aetna Medicare Explorer Value (HMO) H3152-082 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in New Jersey. This plan includes additional Medicare prescription drug (Part-D) coverage. The Aetna Medicare Explorer Value (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $7,550 (MOOP). Basic - Pay a $5 copay for cleanings, fillings and X-rays when you visit your primary care dentist (PCD). PPO - After a $20 deductible per member, cleanings, fillings, and X-rays are covered at 100% with network dentists. Why choose the Aetna Open Access plan? Large nationwide Aetna Network. You pay a copay when you receive care from network providers – NO REFERRALS NEEDED You pay the entire cost if you receive care from a non-network provider, except in a health emergency Preventive Care covered 100% Aetna Health Connections, Disease Management, Informed Health Line, and Beginning Right Maternity programs included at no extra cost. $20 copay/visit, deductible doesn't apply 90% coinsurance. None Specialist visit $40 copay/visit, deductible. Doesn't apply 90% coinsurance None Preventive care /screening /immunization No charge 90% coinsurance, except no charge for flu & pneumonia vaccines You may have to pay for services that are not preventive. Ask your provider if the services.
Aetna Medicare Choice Plan (PPO) is a Local PPO. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of 'preferred' providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.
Aetna Medicare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Aetna Medicare Choice Plan (PPO) you still retain Original Medicare. Backblaze mac uninstall. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Aetna Medicare and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Aetna Medicare except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST
80s fashion sketches.
2021 Aetna Medicare Medicare Advantage Plan Costs
| Name: | |
|---|---|
| Plan ID: | H9431-005 |
| Provider: | Aetna Medicare |
| Year: | 2021 |
| Type: | Local PPO |
| Monthly Premium C+D: | $19.00 |
| Part C Premium: | $3.90 |
| MOOP: | $7,550 |
| Part D (Drug) Premium: | $15.10 |
| Part D Supplemental Premium | $0 |
| Total Part D Premium: | $15.10 |
| Drug Deductible: | $0 |
| Tiers with No Deductible: | 0 |
| Gap Coverage: | Yes |
| Benchmark: | not below the regional benchmark |
| Type of Medicare Health: | Enhanced Alternative |
| Drug Benefit Type: | Enhanced |
| Similar Plan: | H9431-006 |
Aetna Medicare Choice Plan (PPO) Part-C Premium
Aetna Medicare plan charges a $3.90 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H9431-005 Part-D Deductible and Premium
Aetna Medicare Choice Plan (PPO) has a monthly drug premium of $15.10 and a $0 drug deductible. This Aetna Medicare plan offers a $15.10 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Aetna Medicare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $15.10. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Aetna Medicare Gap Coverage
In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Aetna Medicare plan does offer additional coverage through the gap.
Premium Assistance
The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Aetna Medicare Choice Plan (PPO) medicare insurance offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $3.80 for 75% low income subsidy $7.50 for 50% and $11.30 for 25%.
| Full LIS Premium: | $0 |
|---|---|
| 75% LIS Premium: | $3.80 |
| 50% LIS Premium: | $7.50 |
| 25% LIS Premium: | $11.30 |
H9431-005 Formulary or Drug Coverage
Aetna Medicare Choice Plan (PPO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
2021 Aetna Medicare Choice Plan (PPO) Summary of Benefits
Additional Benefits
| No |
|---|
Comprehensive Dental
| Diagnostic services | $0 copay |
|---|---|
| Diagnostic services | $0 copay (Out-of-Network) |
| Endodontics | $0 copay |
| Endodontics | $0 copay (Out-of-Network) |
| Extractions | $0 copay |
| Extractions | $0 copay (Out-of-Network) |
| Non-routine services | $0 copay |
| Non-routine services | $0 copay (Out-of-Network) |
| Periodontics | $0 copay |
| Periodontics | $0 copay (Out-of-Network) |
| Prosthodontics, other oral/maxillofacial surgery, other services | $0 copay |
| Prosthodontics, other oral/maxillofacial surgery, other services | $0 copay (Out-of-Network) |
| Restorative services | $0 copay |
| Restorative services | $0 copay (Out-of-Network) |
Deductible
| $0 |
|---|
Diagnostic Tests and Procedures
| Diagnostic radiology services (e.g., MRI) | $0-295 copay |
|---|---|
| Diagnostic radiology services (e.g., MRI) | 45% coinsurance (Out-of-Network) |
| Diagnostic tests and procedures | $0-15 copay |
| Diagnostic tests and procedures | 45% coinsurance (Out-of-Network) |
| Lab services | $0 copay |
| Lab services | 45% coinsurance (Out-of-Network) |
| Outpatient x-rays | $0 copay |
| Outpatient x-rays | 45% coinsurance (Out-of-Network) |
Doctor Visits
| Primary | $0 copay |
|---|---|
| Primary | 45% coinsurance per visit (Out-of-Network) |
| Specialist | $45 copay per visit |
| Specialist | 45% coinsurance per visit (Out-of-Network) |
Emergency care/Urgent Care
| Emergency | $90 copay per visit (always covered) |
|---|---|
| Urgent care | $45 copay per visit (always covered) |
Foot Care (podiatry services)
| Foot exams and treatment | $45 copay |
|---|---|
| Foot exams and treatment | 45% coinsurance (Out-of-Network) |
| Routine foot care | Not covered |
Ground Ambulance
| $260 copay |
|---|
| $260 copay (Out-of-Network) |
Hearing
| Fitting/evaluation | $0 copay |
|---|---|
| Fitting/evaluation | 45% coinsurance (Out-of-Network) |
| Hearing aids | $0 copay |
| Hearing aids | $0 copay (Out-of-Network) |
| Hearing exam | $0 copay |
| Hearing exam | 45% coinsurance (Out-of-Network) |
Inpatient Hospital Coverage
| $420 per day for days 1 through 4 $0 per day for days 5 through 90 |
|---|
| 45% per stay (Out-of-Network) |
Medical Equipment/Supplies
| Diabetes supplies | 0-20% coinsurance per item |
|---|---|
| Diabetes supplies | 0-20% coinsurance per item (Out-of-Network) |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 45% coinsurance per item (Out-of-Network) |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item |
| Prosthetics (e.g., braces, artificial limbs) | 45% coinsurance per item (Out-of-Network) |
Medicare Part B Drugs
| Chemotherapy | 20% coinsurance |
|---|---|
| Chemotherapy | 45% coinsurance (Out-of-Network) |
| Other Part B drugs | 20% coinsurance |
| Other Part B drugs | 45% coinsurance (Out-of-Network) |
Mental Health Services
| Inpatient hospital - psychiatric | $1,871 per stay |
|---|---|
| Inpatient hospital - psychiatric | 45% per stay (Out-of-Network) |
| Outpatient group therapy visit | $40 copay |
| Outpatient group therapy visit | 45% coinsurance (Out-of-Network) |
| Outpatient group therapy visit with a psychiatrist | $40 copay |
| Outpatient group therapy visit with a psychiatrist | 45% coinsurance (Out-of-Network) |
| Outpatient individual therapy visit | $40 copay |
| Outpatient individual therapy visit | 45% coinsurance (Out-of-Network) |
| Outpatient individual therapy visit with a psychiatrist | $40 copay |
| Outpatient individual therapy visit with a psychiatrist | 45% coinsurance (Out-of-Network) |
MOOP
| $11,300 In and Out-of-network $7,550 In-network |
|---|
Option
| No |
|---|
Optional supplemental benefits
| No |
|---|
Outpatient Hospital Coverage
| $0-325 copay per visit |
|---|
| 45% coinsurance per visit (Out-of-Network) |
Preventive Care
| $0 copay |
|---|
| 0-45% coinsurance (Out-of-Network) |
Preventive Dental
| Cleaning | $0 copay |
|---|---|
| Cleaning | $0 copay (Out-of-Network) |
| Dental x-ray(s) | $0 copay |
| Dental x-ray(s) | $0 copay (Out-of-Network) |
| Fluoride treatment | $0 copay |
| Fluoride treatment | $0 copay (Out-of-Network) |
| Oral exam | $0 copay |
| Oral exam | $0 copay (Out-of-Network) |
Rehabilitation Services
| Occupational therapy visit | $30 copay |
|---|---|
| Occupational therapy visit | 45% coinsurance (Out-of-Network) |
| Physical therapy and speech and language therapy visit | $30 copay |
| Physical therapy and speech and language therapy visit | 45% coinsurance (Out-of-Network) |
Skilled Nursing Facility
| $0 per day for days 1 through 20 $184 per day for days 21 through 100 |
|---|
| 35% per stay (Out-of-Network) |
Transportation
| Not covered |
|---|
Vision
| Contact lenses | $0 copay |
|---|---|
| Contact lenses | $0 copay (Out-of-Network) |
| Eyeglass frames | $0 copay |
| Eyeglass frames | $0 copay (Out-of-Network) |
| Eyeglass lenses | $0 copay |
| Eyeglass lenses | $0 copay (Out-of-Network) |
| Eyeglasses (frames and lenses) | $0 copay |
| Eyeglasses (frames and lenses) | $0 copay (Out-of-Network) |
| Other | $0 copay |
| Other | 45% coinsurance (Out-of-Network) |
| Routine eye exam | $0 copay |
| Routine eye exam | 45% coinsurance (Out-of-Network) |
| Upgrades | $0 copay |
| Upgrades | $0 copay (Out-of-Network) |
Wellness Programs (e.g. fitness nursing hotline)
| Covered |
|---|
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST
Coverage Area for Aetna Medicare Choice Plan (PPO)
(Click county to compare all available Advantage plans)
| State: | Oregon |
|---|---|
| County: | Clackamas,Marion,Multnomah,Polk,Washington, Yamhill, |
Go to top
Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
Jump to:
Aetna Medicare Select (HMO) H1609-021 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Florida. This plan includes additional Medicare prescription drug (Part-D) coverage. The Aetna Medicare Select (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $3,450 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $3,450 out of pocket. This can be a extremely nice safety net.
Aetna Medicare Select (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.
Aetna Medicare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Aetna Medicare Select (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Aetna Medicare and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Aetna Medicare except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST
2021 Aetna Medicare Medicare Advantage Plan Costs
| Name: | |
|---|---|
| Plan ID: | H1609-021 |
| Provider: | Aetna Medicare |
| Year: | 2021 |
| Type: | Local HMO |
| Monthly Premium C+D: | $0 |
| Part C Premium: | $0 |
| MOOP: | $3,450 |
| Part D (Drug) Premium: | $0 |
| Part D Supplemental Premium | $0 |
| Total Part D Premium: | $0 |
| Drug Deductible: | $0 |
| Tiers with No Deductible: | 0 |
| Gap Coverage: | Yes |
| Benchmark: | not below the regional benchmark |
| Type of Medicare Health: | Enhanced Alternative |
| Drug Benefit Type: | Enhanced |
| Similar Plan: | H1609-022 |
Aetna Medicare Select (HMO) Part-C Premium
Aetna Medicare plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H1609-021 Part-D Deductible and Premium
Aetna Medicare Select (HMO) has a monthly drug premium of $0 and a $0 drug deductible. This Aetna Medicare plan offers a $0 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Aetna Medicare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Aetna Medicare Gap Coverage
In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Aetna Medicare plan does offer additional coverage through the gap.
H1609-021 Formulary or Drug Coverage
Aetna Medicare Select (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
2021 Aetna Medicare Select (HMO) Summary of Benefits
Additional Benefits
| No |
|---|
Comprehensive Dental
| Diagnostic services | $0 copay |
|---|---|
| Endodontics | Not covered |
| Extractions | $0 copay |
| Non-routine services | $0 copay |
| Periodontics | $0 copay |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
| Restorative services | $0 copay |
Deductible
| $0 |
|---|
Diagnostic Tests and Procedures
| Diagnostic radiology services (e.g., MRI) | $0-150 copay |
|---|---|
| Diagnostic tests and procedures | $0-150 copay |
| Lab services | $0-150 copay |
| Outpatient x-rays | $0-100 copay |
Doctor Visits
| Primary | $0 copay |
|---|---|
| Specialist | $20 copay per visit |
Emergency care/Urgent Care
| Emergency | $120 copay per visit (always covered) |
|---|---|
| Urgent care | $40 copay per visit (always covered) |
Foot Care (podiatry services)
| Foot exams and treatment | $20 copay |
|---|---|
| Routine foot care | $20 copay |
Ground Ambulance
| $270 copay |
|---|
Hearing
| Fitting/evaluation | $0 copay |
|---|---|
| Hearing aids | $0 copay |
| Hearing exam | $20 copay |
Inpatient Hospital Coverage
| $200 per day for days 1 through 5 $0 per day for days 6 through 90 |
|---|
Medical Equipment/Supplies
| Diabetes supplies | 0-20% coinsurance per item |
|---|---|
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item |
(Click county to compare all available Advantage plans)
| State: | Oregon |
|---|---|
| County: | Clackamas,Marion,Multnomah,Polk,Washington, Yamhill, |
Go to top
Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
Jump to:
Aetna Medicare Select (HMO) H1609-021 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Florida. This plan includes additional Medicare prescription drug (Part-D) coverage. The Aetna Medicare Select (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $3,450 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $3,450 out of pocket. This can be a extremely nice safety net.
Aetna Medicare Select (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.
Manage multiple Logitech personal collaboration devices. with Logi Tune. Available in desktop and mobile app versions, Logi Tune provides an elegantly intuitive dashboard for easy setup, control and customization. Test your headset mic and sound, customize EQ, and adjust sidetone to hear your own voice at just the right volume. Logic Pro includes a real-time tuning system, for use with the included software instruments. Learn how you can tune instruments connected to your Logic Pro system with the Tuner utility or plug-in. You'll learn about some different options for using in auto tune in Logic soon. It can also be used as a creative effect, such is the case in a lot of modern hip-hop and RnB music, often dubbed the 'T-Pain effect'. After you get the auto-tune nailed, you will be ready to go on and mix your tracks in Logic Pro X!
Aetna Medicare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Aetna Medicare Select (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Aetna Medicare and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Aetna Medicare except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST
2021 Aetna Medicare Medicare Advantage Plan Costs
| Name: | |
|---|---|
| Plan ID: | H1609-021 |
| Provider: | Aetna Medicare |
| Year: | 2021 |
| Type: | Local HMO |
| Monthly Premium C+D: | $0 |
| Part C Premium: | $0 |
| MOOP: | $3,450 |
| Part D (Drug) Premium: | $0 |
| Part D Supplemental Premium | $0 |
| Total Part D Premium: | $0 |
| Drug Deductible: | $0 |
| Tiers with No Deductible: | 0 |
| Gap Coverage: | Yes |
| Benchmark: | not below the regional benchmark |
| Type of Medicare Health: | Enhanced Alternative |
| Drug Benefit Type: | Enhanced |
| Similar Plan: | H1609-022 |
Aetna Medicare Select (HMO) Part-C Premium
Aetna Medicare plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H1609-021 Part-D Deductible and Premium
Aetna Medicare Select (HMO) has a monthly drug premium of $0 and a $0 drug deductible. This Aetna Medicare plan offers a $0 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Aetna Medicare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Aetna Medicare Gap Coverage
In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Aetna Medicare plan does offer additional coverage through the gap.
H1609-021 Formulary or Drug Coverage
Aetna Medicare Select (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
2021 Aetna Medicare Select (HMO) Summary of Benefits
Additional Benefits
| No |
|---|
Comprehensive Dental
| Diagnostic services | $0 copay |
|---|---|
| Endodontics | Not covered |
| Extractions | $0 copay |
| Non-routine services | $0 copay |
| Periodontics | $0 copay |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
| Restorative services | $0 copay |
Deductible
| $0 |
|---|
Diagnostic Tests and Procedures
| Diagnostic radiology services (e.g., MRI) | $0-150 copay |
|---|---|
| Diagnostic tests and procedures | $0-150 copay |
| Lab services | $0-150 copay |
| Outpatient x-rays | $0-100 copay |
Doctor Visits
| Primary | $0 copay |
|---|---|
| Specialist | $20 copay per visit |
Emergency care/Urgent Care
| Emergency | $120 copay per visit (always covered) |
|---|---|
| Urgent care | $40 copay per visit (always covered) |
Foot Care (podiatry services)
| Foot exams and treatment | $20 copay |
|---|---|
| Routine foot care | $20 copay |
Ground Ambulance
| $270 copay |
|---|
Hearing
| Fitting/evaluation | $0 copay |
|---|---|
| Hearing aids | $0 copay |
| Hearing exam | $20 copay |
Inpatient Hospital Coverage
| $200 per day for days 1 through 5 $0 per day for days 6 through 90 |
|---|
Medical Equipment/Supplies
| Diabetes supplies | 0-20% coinsurance per item |
|---|---|
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item |
Medicare Part B Drugs
| Chemotherapy | 20% coinsurance |
|---|---|
| Other Part B drugs | 20% coinsurance |
Mental Health Services
| Inpatient hospital - psychiatric | $200 per day for days 1 through 5 $0 per day for days 6 through 90 |
|---|---|
| Outpatient group therapy visit | $15 copay |
| Outpatient group therapy visit with a psychiatrist | $15 copay |
| Outpatient individual therapy visit | $20 copay |
| Outpatient individual therapy visit with a psychiatrist | $20 copay |
MOOP
| $3,450 In-network |
|---|
Option
| No |
|---|
Specialist Copay On Aetna
Optional supplemental benefits
| No |
|---|
Outpatient Hospital Coverage
| $0-200 copay per visit |
|---|
Preventive Care
| $0 copay |
|---|
Preventive Dental
| Cleaning | $0 copay |
|---|---|
| Dental x-ray(s) | $0 copay |
| Fluoride treatment | $0 copay |
| Oral exam | $0 copay |
Rehabilitation Services
| Occupational therapy visit | $25 copay |
|---|---|
| Physical therapy and speech and language therapy visit | $25 copay |
Skilled Nursing Facility
| $0 per day for days 1 through 20 $178 per day for days 21 through 100 |
|---|
Transportation
| Not covered |
|---|
Vision
| Contact lenses | $0 copay |
|---|---|
| Eyeglass frames | Not covered |
| Eyeglass lenses | Not covered |
| Eyeglasses (frames and lenses) | $0 copay |
| Other | $20 copay |
| Routine eye exam | $0 copay |
| Upgrades | Not covered |
Wellness Programs (e.g. fitness nursing hotline)
| Covered |
|---|
Reviews for Aetna Medicare Select (HMO) H1609
| 2019 Overall Rating |
|---|
| Part C Summary Rating |
| Part D Summary Rating |
| Staying Healthy: Screenings, Tests, Vaccines |
| Managing Chronic (Long Term) Conditions |
| Member Experience with Health Plan |
| Complaints and Changes in Plans Performance |
| Health Plan Customer Service |
| Drug Plan Customer Service |
| Complaints and Changes in the Drug Plan |
| Member Experience with the Drug Plan |
| Drug Safety and Accuracy of Drug Pricing |
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating |
|---|
| Breast Cancer Screening |
| Colorectal Cancer Screening |
| Annual Flu Vaccine |
| Improving Physical |
| Improving Mental Health |
| Monitoring Physical Activity |
| Adult BMI Assessment |
Managing Chronic And Long Term Care for Older Adults
| Total Rating |
|---|
| SNP Care Management |
| Medication Review |
| Functional Status Assessment |
| Pain Screening |
| Osteoporosis Management |
| Diabetes Care - Eye Exam |
| Diabetes Care - Kidney Disease |
| Diabetes Care - Blood Sugar |
| Rheumatoid Arthritis |
| Reducing Risk of Falling |
| Improving Bladder Control |
| Medication Reconciliation |
| Statin Therapy |
Member Experience with Health Plan
| Total Experience Rating |
|---|
| Getting Needed Care |
| Customer Service |
| Health Care Quality |
| Rating of Health Plan |
| Care Coordination |
Member Complaints and Changes in Aetna Medicare Select (HMO) Plans Performance
| Total Rating |
|---|
| Complaints about Health Plan |
| Members Leaving the Plan |
| Health Plan Quality Improvement |
| Timely Decisions About Appeals |
Health Plan Customer Service Rating for Aetna Medicare Select (HMO)
| Total Customer Service Rating |
|---|
| Reviewing Appeals Decisions |
| Call Center, TTY, Foreign Language |
Aetna Medicare Select (HMO) Drug Plan Customer Service Ratings
| Total Rating |
|---|
| Call Center, TTY, Foreign Language |
| Appeals Auto |
| Appeals Upheld |
Ratings For Member Complaints and Changes in the Drug Plans Performance
| Total Rating |
|---|
| Complaints about the Drug Plan |
| Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement |
Aetna Copay Plans
Member Experience with the Drug Plan
| Total Rating |
|---|
| Rating of Drug Plan |
| Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
| Total Rating |
|---|
| MPF Price Accuracy |
| Drug Adherence for Diabetes Medications |
| Drug Adherence for Hypertension (RAS antagonists) |
| Drug Adherence for Cholesterol (Statins) |
| MTM Program Completion Rate for CMR |
| Statin with Diabetes |
Aetna Medicare Copays
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Aetna Chiropractic Copay
Coverage Area for Aetna Medicare Select (HMO)
Aetna Copay Amounts
(Click county to compare all available Advantage plans)
| State: | Florida |
|---|---|
| County: | Clay,Duval,Marion,St Johns,St Lucie, |
What Is The Copay For Aetna
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Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
