Aetna Medicare Advantage Plan 2014 HMO Preview:
Aetna is offering two types of Medicare HMO Plans in 2014:
1. The Aetna Medicare Traditional HMO
2. The Aetna Medicare Open Access HMO
The Aetna MedicareTraditional HMO:
Referrals are not needed for certain services that are considered “direct access”:
- ER and urgent care
- Routine eye exams
- Flu and pneumonia shots
- Annual mammograms
The Aetna Medicare Traditional HMO requires a member select and use a primary care physician (PCP).
The PCP coordinates care and provides referrals to other health care providers in the Aetna Medicare Plan (HMO) network.
Getting a referral is easy. If the PCP cannot treat the condition, the doctor can issue a referral to an Aetna Medicare Plan (HMO) network specialist.
The Aetna Medicare Open Access HMO:
- It allows members to go to any Aetna Medicare Plan (HMO) network provider they choose for covered services without a primary care provider (PCP) referral.
- PCP selection is not required, but is recommended.
- Members receive the same benefits as the Traditional HMO plan.
ALL 2014 Aetna Medicare HMO Plans include:
- Routine physicals
- Annual Wellness exams
- Routine gynecology exams
- Prostate cancer screenings
- Flue and pneumonia vaccines
- Colorectal screenings
- Bone density exams (bone mass measurement)
- All Plans have a maximum out of pocket amount
- Aetna Health ConnectionsSM Disease Management
- Healthy Outlook Program
- National Medical Excellence Program
- Case Management Services
- Annual Preventative Reminders
- Numbers to know
- Informed Health Line
- Doc Find
Here is a partial list of benefits covered in the plans:
- Primary care
- Specialty care
- Inpatient hospitalization
- Home health care
- Skilled nursing care
- Outpatient services
- Ambulance services
- Urgently needed care
- Hearing aid and/or eyewear reimbursements are covered in some plans.
All plan include a monthly health club membership that includes two options:
o Tier 1 clubs – no copay
o Tier 2 clubs – nominal annual copay
- Members are covered for urgent and emergency medical care 24 hours a day, seven days a week, anywhere in the world.
- Optional Supplemental Benefits that provide coverage for dental, hearing, and/or vision are available for an extra cost with some HMO Plans.
Some plans include a Transportation benefit (24 one-way trips) per year that can be used for travel for defined health care needs.
MedicareBob™’s Favorite Benefit for Aetna’s 2014 Medicare Advantage HMO Plans:
I really like “Aetna’s Travel Advantage Program” that is included in Aetna 2014 Medicare HMO Advantage Plans.
The Travel Advantage Program Fact Sheet:
o It covers members who are temporarily traveling to another Medicare HMO service area for up to 12 consecutive months.
o It provides access to the same benefits that members receive in their home service area.
o Member must contact Member Services to elect the Travel Advantage Program.
o Members must contact Member Services when they return to their home service area.
o Members must use Aetna Medicare HMO network Providers.
TO LEARN MORE CALL ME, 1-800-525-0299.
Robert Bache aka “MedicareBob™”
President / Producer
Senior Healthcare Direct
Direct Toll Free: 1-800-525-0299
Company Toll Free: 1-855-368-4717
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