Aetna Medicare Advantage plan types

Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they are called MAPD plans.

Aetna case management consists of registered nurses, social workers, behavioral health professionals and pharmacists who help members navigate the health care system and access services.

Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum.

Aetna Medicare Advantage HMO and PPO plans cover routine preventive care including an annual wellness visit, screening mammograms, and prostate cancer screenings.

A member’s cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy.

All MAPD plans have a prescription drug component.

You can find a quick list of tools for Aetna Medicare plans on https://www.aetnamedicare.com/en/for-producers.html, which includes information about plans, medications, and doctors.

Low-Income Subsidy (LIS) is a Medicare financial assistance program that helps to reduce prescription drug costs.

The difference between LIS and the Medicare Savings Program (MSP) is LIS helps reduce prescription drug costs and MSP helps with Medicare plan premiums, as well as deductibles, copayments and coinsurance associated with medical services.

A full dual eligible means an individual has Medicare but is only eligible for assistance with Medicare premiums and sometimes cost-share through the Medicare Saving Program

LIS Medicare drug plan premium and deductible costs are based on income level.

Full benefit duals meet state Medicaid eligibility requirements and are entitled to receive the Medicaid services they need.

One of Aetna’s Model of Care goals is to improve use of preventive health services.

The Aetna DSNP care manager and a care team provide a single point-of-contact to help coordinate all Medicare and Medicaid covered care and services that the member needs.