Aetna Advantage Plan 2024 Login and Providers List

Aetna Advantage Plan 2024 health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See FEHB Facts for details.

Enrollment in this Plan is limited: You must live or work in our geographic service area to enroll.

Enrollment codes for this Plan:

Z24 Aetna Advantage Plan – Self Only

Z26 Aetna Advantage Plan – Self Plus One

Z25 Aetna Advantage Plan – Self and Family

If you lose or drop your FEHB coverage and go 63 days or longer without prescription drug coverage that is at least as good as Medicare’s prescription drug coverage, your monthly Medicare Part D premium will go up at least 1 percent per month for every month that you did not have that coverage.

For example, if you go 19 months without Medicare Part D prescription drug coverage, your premium will always be at least 19 percent higher than what many other people pay. You will have to pay this higher premium as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the next Annual Coordinated Election Period (October 15 through December 7) to enroll in Medicare Part D.

To Enroll, contact Aetna or UHC directly

Aetna: 314-920-7962

UHC: 877-714-0178

BENEFIT

COVERAGE OPTIONS & DETAILS

2024 MEDICARE ADVANTAGE PLANS – AETNA & UHC

Aetna Medicare Advantage Plan Options PPO Plan – $500 deductible and $3,400 out-of-pocket maximum; Aetna National PPO Network. Street HMO Plan – $0 deductible and $2,800 out-of-pocket maximum; Aetna Medicare HMO Network. Enhanced HMO Plan – $0 deductible and $1,200 out-of-pocket maximum; Aetna Medicare HMO Network. UHC Medicare Advantage Plan Options Advantage PPO Plan #12875– $0 deductible and $4,000 out-of- pocket maximum; UHC LPPO Network. Advantage PPO Plan #12876– $0 deductible and $4,500 out-of- pocket maximum; UHC LPPO Network. Advantage Nationwide PPO – $0 deductible and $3,400 out-of- pocket maximum. UHC NPPO Network. No plan design changes for 2024! Please see second page for updated monthly rates.

AETNA MEDICARE ADVANTAGE PLANS

You always pay the deductible and copayment ($). The coinsurance (%) shows what you pay after the deductible. The plan summaries below are for January 1, 2024-December 31, 2024.

	Aetna ESA PPO	Aetna Street HMO	Aetna Enhanced HMO
2024 Monthly Premium	$14	$14	$250.50
Network	Aetna National PPO	Aetna Medicare HMO	Aetna Medicare HMO
Deductible	$500	None	None
Annual Out-of- Pocket Maximum	$3,400	$2,800	$1,200
Office Visit Primary Specialist Routine Vision	$0 per visit $25 per visit $0 per visit	$5 per visit $40 per visit $0 per visit	$10 per visit $20 per visit $20 per visit
Inpatient Treatment	$200/day (days 1-5) $0 unlimited addtl days	$275/day (days 1-5) $0 unlimited addtl days	$150/day (days 1-3) $0 unlimited addtl days
Emergency Room	$120	$90	$50
Urgent Care	$25	$65	$25
Skilled Nursing Facility	$20/day (days 1-20) $178/day (days 21-100)	$20/day (days 1-20) $178/day (days 21-100)	$0/day (days 1-20) $25/day (days 21-40) $0/day (days 41-100)
Outpatient Surgery	$150 per visit	$275 per visit	$250 per visit
Laboratory Services	$0	$0	$0
Diagnostic X- Rays/Tests	20%	20%	20%
Durable Medical Equipment	20%	20%	20%
Vision (contacts, eye glasses, lens)	$265 reimbursements every 12 months	$250 reimbursement every 12 months	$100 reimbursement every 24 months
Hearing Aid	$2,500 reimbursement every 12 months	$1,000 reimbursement every 12 months	$375 reimbursement every 36 months
Dental*	$1,000 annual benefit $0 Deductible 100% Preventative 50% Basic & Major	$1,000 annual benefit $0 Deductible 100% Preventative 50% Basic & Major	$750 annual benefit $0 Deductible 100% Preventative
Prescription Drugs Retail 30-day supply
Preferred Generic	$15†	$15†	N/A
Generic	$20†	$20†	$0
Preferred Brand	$47	$47	$25
Preferred	$100	$100	$55
Specialty	33%	33%	25%

Medicare’s Low Income Benefits

For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. Information regarding this program is available through the Social Security Administration (SSA) online at www. socialsecurity.gov, or call the SSA at 800-772-1213, (TTY: 800-325-0778).

Income-Related Monthly Adjustment Amount (IRMAA) The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an amount you may pay in addition to your FEHB premium to enroll in and maintain Medicare prescription drug coverage. This additional premium is assessed only to those with higher incomes and is adjusted based on the income reported on your IRS tax return. You do not make any IRMAA payments to your FEHB plan.

Refer to the Part D-IRMAA section of the Medicare website:

https://www.medicare. gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/monthly-premium-for-drug-plans

to see if you would be subject to this additional premium.

You can get more information about Medicare prescription drug plans and the coverage offered in your area from these places:

• Visit www.medicare.gov for personalized help.

• Call 800-MEDICARE 800-633-4227, TTY 877-486-2048.