Aetna Medicare Advantage Plans Review
Aetna Offers Low-Cost Medicare Advantage Plans With Plenty of Perks
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Aetna is one of the largest and most well-known health insurance carriers in the United States. Just under 40 million people rely on Aetna for their insurance, and that number continues to grow every year. If you are in the market for a Medicare Part C carrier, Aetna is a trusted and reliable option. In today’s review, we will take an in-depth look at Aetna’s Medicare Advantage (Part C) plans, including the pros and cons, pricing, and additional benefits.
Pros About What We Like
- Easy, comprehensive plan finder: Aetna makes it easy to find a plan that matches your needs online or over the phone. You just need to answer a few simple questions about your location, your desired plan, and a few identifying details — and that’s it! Then, you will be presented with the best plans for you.
- Low premiums and deductibles: While premiums and deductibles vary by plan and location, most of Aetna’s Part C plans offer very low premiums and deductibles when compared to competitors. Many Aetna plans even have $0 premiums, with partial or full coverage of your Part B premium, plus $0 annual deductibles.
- Varied benefit options: Like many Medicare Advantage carriers, Aetna adds extra benefits that go above and beyond what is offered with Original Medicare. You can get prescription drug, dental, vision, and hearing coverage, as well as OTC product discounts and fitness programs.
Cons About What We Don’t Like
- Costly stand-alone Part D plans: Many of Aetna’s Part C plans are automatically packaged with Part D to save you the expense of a stand-alone prescription drug plan. However, if you choose a plan without prescription drug coverage and later decide to get a stand-alone Part D plan, you will probably end up paying higher premiums.
- No PFFS plans: Though Aetna offers various plan types, it doesn’t have any Private Fee-For-Service (PFFS) plans. This means that you do not have the option to get a Part C plan without a network of health care providers.
- Not all plans cover Part B premium: Most of Aetna’s plans don’t cover all of the Part B premiums. Until you finalize your application, you may not know exactly how much you will need to pay each month for your Part B coverage.
Available Aetna Medicare Advantage Plans
All Medicare Advantage plans, including Aetna’s, are required to provide the same coverage as Original Medicare (Part A and Part B). Most Aetna plans also include Part D prescription drug coverage and extra benefits that are not covered by Parts A, B, or D.
Below are the different kinds of Part C plans that are currently available through Aetna.
HMO
Aetna’s traditional Health Maintenance Organization (HMO) functions like any HMO insurance plan; you will need to seek treatment within a network of preapproved doctors and medical facilities. You may also need prior authorization to visit a specialist or to acquire certain medical services. With a standard HMO, you do not have coverage outside of your network unless it is for medical emergencies or certain predetermined treatments. The standard HMO plan might be good for older adults and other Medicare beneficiaries who do not plan on traveling out of state often, as this can increase the risk of expensive, out-of-network treatment.
HMO-POS
Aetna’s HMO Point-of-Service (POS) plans still operate within a network. However, with the POS option, you can go outside of your network and still get partial coverage. You will be covered for most out-of-network treatments, but you will pay more than you would for in-network treatments. HMO-POS may be a good option for those who want a little extra freedom to travel out of their network of health care providers without the risk of having zero coverage.
HMO D-SNP
Aetna’s HMO Dual Eligible Special Needs Plan (D-SNP) is only available to people who are eligible for both Medicare and Medicaid. These plans are often better for beneficiaries with disabilities, low fixed incomes, or both. Typically, a D-SNP plan covers more and requires fewer out-of-pocket costs than a standard HMO or HMO-POS plan.
PPO
Aetna’s Preferred Provider Organization (PPO) allows you to see any doctor that accepts Medicare. You are not required to stay in-network to get your full coverage. That said, you still have a network in which you can save on treatment costs. As an added bonus, PPO plans generally do not require preapproval or referrals to see specialists or undergo special treatments. Aetna’s PPO plan may be better for Medicare beneficiaries who want more freedom to choose their doctor and have greater coverage wherever they go. In some cases, an Aetna PPO plan will even cover emergency care and treatments outside of the U.S.
Extra Perks and Benefits
Since most seniors are automatically enrolled in Original Medicare if they have been receiving Social Security benefits, private insurance companies add “extra” benefits to entice older adults to apply for Medicare Advantage plans. With Aetna, you can expect some or all of the following perks with your plan:
- Dental coverage
- Free or low-cost eyewear
- Hearing aid coverage
- OTC drug and product discounts
- Fitness programs and resources
- Worldwide emergency coverage (only available with some PPO plans)
Did You Know? Aetna is one of the few major carriers to offer plans with worldwide emergency coverage. You can get covered treatments even if a medical emergency occurs abroad (assuming that you have the right plan).
The availability of benefits varies based on your location and plan type, so be sure to review what perks you will actually get before finalizing your Medicare Advantage enrollment.
How Much Do Aetna Medicare Advantage Plans Cost?
Medicare Advantage costs depend on various factors, including your location, the type of plan you choose, and the treatments you need. However, to give you a better idea of what to expect, here are a few sample plans available to seniors and other beneficiaries in Miami, Florida.
| Plan name | Monthly premium* | Annual deductible | Copay** | Maximum annual out-of-pocket | Benefits |
|---|---|---|---|---|---|
| Aetna Medicare Credit (HMO) | $0 | $0 | $0 | $3,450 | Part D, dental, vision, hearing, OTC, fitness |
| Aetna Medicare Select (HMO) | $0 | $0 | $0 | $1,500 | Part D, dental, vision, hearing, OTC, fitness |
| Aetna Medicare Choice (HMO-POS) | $0 | $0 | $0 | $6,700 | Part D, dental, vision, hearing, OTC, fitness |
| Aetna Medicare Assure (HMO D-SNP) | $34.30 | $0 | $0 | $3,450 | Part D, dental, vision, hearing, OTC, fitness |
| Aetna Medicare Assure Plus (HMO D-SNP) | $0 | $0 | $0 | $3,450 | Part D, dental, vision, hearing, OTC, fitness |
| Aetna Medicare Premier (PPO) | $0 | $0 | $0 | $6,700 | Part D, dental, vision, hearing, OTC, fitness, worldwide emergency coverage |
*Premiums listed do not include Part B premiums. Depending on your plan, you may need to pay some or all of your Part B premium each month.
**These plans only offer $0 copays for certain routine visits, particularly for preventive check-ups and treatments. Not all doctors’ visits are free of copayments under these plans.
Aetna is very appealing to Medicare beneficiaries who want their coverage to kick in immediately, as opposed to other carriers with high deductibles that must be met before the coverage starts. This means that, in most cases, you will only have to pay for 20 percent of your covered treatments right from the start.
Did You Know? Though Aetna’s Medicare Advantage plans can help reduce out-of-pocket costs, it is important to remember that you cannot combine them with a Medigap plan that helps cover costs like copays, deductibles, and coinsurance.
While the $0 premiums make many of these plans seem too good to be true, remember that Aetna usually only covers a portion of your Part B premium. As of 2023, the minimum Part B premium is $164.90. You may need to pay that much per month in premiums, despite the fact that you have a “$0 premium plan.”
Where Are Aetna Medicare Advantage Plans Available?
Currently, Aetna Medicare Advantage plans are available in all 50 states. As of 2023, Aetna serves more than 3.2 million customers with its Part C plans. This makes Aetna one of the largest and most popular Medicare Advantage carriers in the country.
FYI: Want to learn more about signing up for a Part C plan during Medicare annual enrollment? Read our Medicare enrollment guide.
Reviews and Ratings
Your experience with Medicare Advantage can be very different based on the company. It is important to look at reviews and ratings from reliable, third-party organizations and agencies. Below are ratings of Aetna from some of the country’s most reputable business and insurance rating agencies.
- AM Best: A
- Better Business Bureau (BBB): A+
- National Committee for Quality Assurance (NCQA): 3.5 out of 5
- Centers for Medicare and Medicaid Services (CMS): 4.29 out of 5
Each agency uses different factors when reviewing companies, ranging from customer satisfaction to the diversity of product offerings. Aetna generally performs well, particularly when it comes to Medicare Advantage. The Centers for Medicare & Medicaid Services (CMS) specifically rates Aetna’s Medicare Advantage plans, with a weighted average of 4.29 out of a possible 5. It is also important to note that CMS ranks many of Aetna’s individual Medicare Advantage plans at or above 4.5.
Customer Service
Aetna provides excellent customer service options, including online chat for existing customers, social media communication, mobile app chatting, customer support via phone, and other contact resources on Aetna’s website. You can reach Aetna by phone seven days a week, any time between 7 a.m. and 7 p.m. If you need additional help reaching Aetna or want to learn about their customer service options, check out their online customer service center.
Final Thoughts on Aetna Medicare Advantage Plans
Aetna is a popular choice among seniors and other Medicare beneficiaries who want low-cost, comprehensive Medicare Advantage plans. With low premiums and deductibles, Aetna makes it easy to get quality health insurance without spending a fortune every month. However, since the company does not fully cover Part B premiums, your monthly costs may be higher than expected. Additionally, if you visit the doctor often, you may find that these low costs are negated by copays, specialist fees, or other less common expenses. Nonetheless, $0 deductibles and a plethora of extra benefits make Aetna’s Medicare Advantage plans a great choice for many seniors and Medicare beneficiaries.