Aetna Medicare Advantage Plan 2014 HMO Preview:

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
  •   Mammograms
  •   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
  •   Surgery
  •   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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