Here are the costs, performance and benefits of Aetna Medicare Advantage in 2021.
Aetna is fourth largest provider of Medicare Advantage plans. A CVS Health company, Aetna has been offering a wide range of benefits since 2018. Most Aetna Medicare Advantage plans include hearing, vision, and dental coverage. Many plans also offer valuable perks. These plans are also relatively affordable, with 81% of Medicare beneficiaries being able to access a $0 Aetna plan as well as the lowest-cost standalone drug plan in the nation.
Aetna Medicare Benefit plans are not only notable for their offerings, but they also score well in terms of quality and member satisfaction. Aetna does not offer any other plans, except for the HMO, PPO, and Special Needs Plans. Here are some facts about Aetna’s Medicare Advantage.
Aetna Medicare Benefit pros and cons
Aetna offers both advantages and disadvantages.
Pros
- Multiple benefits: Aetna Medicare beneficiaries have access to multiple benefits, including vision, hearing, dental and vision, and meal delivery services.
- Aetna offers strong $0 premium options: Aetna projects that in 2021 four out of five Medicare-eligible beneficiaries will have access to a $0-monthly Aetna Medicare Benefit plan.
- Aetna provides low-cost coverage for prescription drugs: Aetna is the only stand-alone Medicare prescription plan with a lowest price, available in all 50 states, as well as Washington, D.C.
- Broad availability: Aetna provides Medicare Advantage plans in 46 States and Washington, D.C., along with stand-alone drug plans for all 50 states plus Washington, D.C.
- Access to walk-in clinics: Aetna, a CVS Health company offers its members the option to visit a network or MinuteClinics in their area for the same copay. As long as they are on PPO and HMO plans that do not require a PCP visit, Aetna is eligible. This network has walk-in locations in 33 states and Washington D.C.
Cons
- Average star ratings: Aetna’s 2021 Medicare Benefit plans received an average rating from the Centers for Medicare & Medicaid Service of 3.7 stars out of 5 stars. Not one plan earned 5 stars. The national average for all providers stands at 4.06.
- J.D. Power found that member love is low. Power discovered that Aetna Medicare Advantage received 795 points out 1000, ranking it sixth out of nine Medicare Advantage companies and below the industry average 806.
- Aetna has limited plan options: Aetna offers HMO and PPO plans, but does not offer private fee for service or medical savings accounts.
Available Medicare Advantage plans
Aetna offers several different kinds of Medicare Advantage plans, and they vary in terms of structure, costs and benefits available. Most plans offer dental, vision and hearing benefits, worldwide emergency care, and fitness benefits through SilverSneakers.
In general, Aetna offers Medicare Advantage Prescription Drug plans, or MAPDs, as well as stand-alone prescription drug plans and Medicare Advantage Plans without drug coverage. Aetna has added Aetna Medicare-Eagle MA-only plans to 27 states this year. These plans are for veterans who want to supplement their VA health care coverage.
Available Part D prescription drug plans
Aetna’s Medicare Advantage plans often include Part D drug coverage. However, the company also offers stand-alone Part D prescription drugs plans. These plans do not offer medical coverage and are intended to be used in conjunction with Medicare Part A or Medicare Part B.
Aetna has three separate Medicare prescription drug plans that can be purchased in 2021. The average monthly premiums range from $7.15 to $69.52.
- SilverScript SmartRx: $7.15 average premium Provides Tier 1 generic drug coverage, with a $0deductible and $0 copays. This plan is the most affordable stand-alone drug policy in the country.
- SilverScript Choice: An average premium of $28.49 Provides Tier 1 and Tier 2 coverage for generic and brand-name medications, with $0 copays in Tier 1.
- SilverScript Plus: Average premium is $69.52 Gap coverage, a $0 deductible for all tiers and a $0 copay Tier 1 drugs. Tier 2 drugs have a $2 copay on a 30-day supply.
Additional benefits
Aetna Medicare Advantage provides routine vision, hearing and dental coverage to most members. Many of the plans also offer additional benefits that aren’t offered in other Medicare Advantage plans. These are some of the most notable benefits:
- SilverSneakers is a membership program that gives you access to community centers, gyms, online classes, discounts for healthy living, and a fitness app.
- As an additional convenience, some beneficiaries may request in-home visits or telehealth calls.
- Concierge services for local resources. Aetna’s Resources for Living can help beneficiaries locate the assistance they need.
- Benefits that are not covered by insurance include an OTC benefit. This allows you to purchase certain products, such as vitamins, online or from participating pharmacies, at no additional cost.
- Meals at home: Some plans will deliver healthy meals to your home after a hospital stay to aid you in recovering.
- Telehealth: All 2021 plans offer virtual primary care and urgent care visits. Some plans also include virtual mental and behavioral healthcare visits.
Limited-area extras
Aetna Medicare Advantage offers unique benefits that are only available to select plans in certain locations.
- Aetna’s companionship benefit: Aetna and Papa Inc. partner in six states to help college-age students connect with older adults who are looking for assistance with technology, light chores, or companionship.
- Foodsmart: Some Illinois plans include the ability to have your health and eating habits evaluated online or by phone. This will allow you to get a customized meal plan and guidance to help you make healthier food choices.
- CHF remote monitoring program. Aetna has six plans in Kentucky and Ohio. This program provides a home health care program in which high-risk individuals with CHF are eligible to receive a 5G scale, blood pressure cuff, and electronic table that allows them to monitor their weight and blood pressure at home.
- Healthy Foods debit Card: A new Healthy Foods debit debit card will be available to members of the Healthy Heart Partnership Program. It will be available in 24 of Aetna’s Dual Eligible Plans Plans and in two Pennsylvania plans for Healthy Heart Partners program members.
Aetna Medicare Advantage service area
Aetna offers Medicare Advantage Prescription Drug Plans in 46 states and Washington, D.C., which includes 1,793 counties. In terms of stand-alone prescription drug plans, Aetna has plans in all 50 states and D.C. [2]
Aetna has expanded its Dual Eligible Special Needs Plan coverage to 23 states. The company also offers Aetna Medicare Eagle MA plans in 27 states.
Aetna is overall the fifth-largest national health insurance company [3], and the third-largest for-profit health plan provider [4]. Aetna Medicare Advantage has nearly 2.7 million Medicare beneficiaries. The company also added 210,000 members to its 2021 plan year.
Cost
The cost of Medicare Advantage plans will vary depending on the plan you choose, your location and your medical needs. Aetna now offers $0-premium plans. This is one of the costs you should consider. According to the company, four out of five Medicare-eligible beneficiaries in 2021 will have access a $0-per-month Aetna Medicare Benefit plan.
For Medicare Advantage plans with a premium, the monthly consolidated premium (including Part C and Part D) ranges from $15 to $225 [5]. For Dual-Eligible Special Needs Plans (SNPs), monthly premiums range from $20.60 to $34.30 [6]. Aetna also offers the lowest premium stand-alone prescription drug plan product nationwide, with monthly premiums starting as low as $5.70 [7].
You will still have to pay your Medicare Part B premium even if you are a Medicare Advantage user. It is $148.50 per year in 2021. Some plans cover some or all of this cost.
You should also consider other out-of-pocket expenses:
- What percentage of your Medicare Part B premium is covered by the plan?
- The plan’s annual deductibles as well as any other deductibles such a drug deductible.
- Each visit will have a copayment and/or coinsurance. You might pay a $10 copay to see your primary physician and $45 for specialist visits.
- The maximum out-of pocket and in-network limits are set by the plan.
- It is important to know whether your providers are in-network and out-of-network. Also, how often you might need care outside of your network.
- Consider whether you need additional benefits and what the cost of such benefits are.
Use Medicare’s Plan Locator to get an idea of the costs and compare plans available in your area. To compare plans across multiple insurance carriers, you can choose to view only Aetna plans or select another carrier. You can also shop directly from Aetna’s website by entering your ZIP code.
The Centers for Medicare & Medicaid Services has its own star ratings that rank plans from the best (5 stars) down to the worst (1 star). These ratings are based on the quality of care provided by each plan and customer satisfaction. Ratings can change year to year.
Aetna Medicare Advantage plans have an average rating of 3.0, while prescription drug plans (Part D), get a score of 3.8 based on the most recent data. The average star rating for plans from all providers was 4.06 [8]. Two of Aetna’s prescription drug plans scored a 5 in Pennsylvania and Georgia, but none of its Medicare Advantage plans scored higher than a 4.5.
However, 87% of Aetna members with a Medicare Star Rating are in contracts rated at 4.0 or higher in 2021.
