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
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