The Aetna Medicare Advantage works in hand with the original Medicare, which consists of Part A and Part B. You get the same level of coverage provided by original Medicare as well as some additional benefits when you take up this plan. Naturally, several service providers offer these plans as well as extra covers at differing rates. It does depend on your state of residency, and this aspect also determines whether or not you stand to benefit from a Medicare Advantage policy.
Several top providers are currently floating out Medicare Advantage Plans for 2019, and it comes down to deciding which cover works best for your needs.
What Are Medicare Advantage Plans?
These are health care plans designed to pick up the slack of what Plan A and B does not cover which significantly reduces your out-of-pocket expenses. Also worth noting is that these plans share some similarities with Medigap supplemental plans, but they are not entirely the same thing.
Much like Medigap policies, private insurers offer the Advantage covers, and you typically do not take up these plans at Medicare. The way it works is that Medicare licenses these plans to the private insurers who can then set them up in policy packages. The insurer also determines the price and they may change it at whim based on competition, location, and other variables such as inflation.
It does pay off to take the time and shop around for competitive prices to end up with the best deal on an Aetna Medicare Advantage in 2019. It is also a very crucial aspect to understand the different networks within which these plans are offered, with the most common being HMOs and PPOs.
Aetna Medicare Advantage Plans
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Medicare Advantage Networks in 2019
Under the Prefered Provider Organization (PPO) network, a full coverage option is only accessible from health care facilities (hospitals, clinics, and doctor’s offices) that are within the insurance company’s network. Some level of coverage is still accessible from health care facilities outside the insurer’s provider partnerships, but in such cases, the insurer only covers a small portion of the costs.
In the case of a Health Maintenance Organization (HMO) network, you can only obtain healthcare services from the plan’s network. That means that except for emergency care you cannot receive any coverage elsewhere. During emergencies, you could get full or partial coverage at a hospital that is not within your insurer’s network. However, that is the only exception otherwise insurers restrict coverage within their specific provider partnerships.
What Can You Expect From Aetna Medicare Advantage in 2019?
Finding the most suitable coverage is of crucial importance even more than getting a great deal. It is just about time for the 2019 Medicare Advantage plans to start rolling out, and it helps to understand what they offer in relation to what you need.
Naturally, finances and medical coverage needs should guide the plan that you need. Also referred to s Medicare Part C, to reiterate, Advantage plans provide the same level of coverage you get from your primary Medicare (A and B) with a few extras. Some of the additional coverage offered include dental, hearing, or vision, and some might even include discounts on specific therapies or even exercise programs.
Individual insurers might include an HMO or PPO as well as other membership policies. These plans come with Medicare Part A, B, and in most cases the prescriptions drug Part D coverage.
Once again, it is vital to point out that costs will vary from one state to the next and also from one insurer to another.
Aetna Medicare Advantage HMO
HMO’s work in partnership with contracted providers and negotiate reduced rates for their plan members. In the case of the Aetna HMO the following rules apply:
- Members can only visit doctors/specialists within the plan’s network. However, if they choose otherwise, they must be ready to pay a higher cost for services.
- An in-network primary doctor assists in determining the level of care covered by the plan.
- A referral to a specialist must come from an HMO Advantage plan.
- Drug coverage is part of the Aetna HMO Medicare Advantage subject to changes.
Aetna Medicare Advantage PPO
Just like with other PPO’s, the Aetna Medicare Advantage in 2019 gives members the liberty to choose a doctor outside the insurer’s network. However, members stand to save more money if they use doctors within the plan’s network.
- PPOs take care of Medicare A and B costs including extra benefits such as vision and dental.
- It is not necessary to choose a primary doctor under this plan. Members also do not need a referral to see specialists in most cases, but prior authorization for out of network coverage might be required.
- Most of Aetna’s PPO plans cover prescription drugs.
Do You Need Medicare Advantage Plans?
The resounding question amongst seniors is usually whether or not they need Advantage plans.
For starters, these plans must offer Medicare Plan A and B as a minimum. That is generally Original Medicare, and also the basic requirement includes urgent and emergency medical services. It guarantees that seniors can access the help needed in the event of an accident or unexpected medical expenses.
Most providers also include Medicare Part D covering prescriptions drugs as part of the package. Depending on the insurer, the plan might also come with coverage for hearing aids, eyewear, and various medical checkups.
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Given that these are the most common of expenses that seniors incur related to their health, it makes sense to have them all compacted under one plan. However, worth pointing out is that Medicare Advantage plans do not work collaboratively with Medicare Supplement plans also known as Medigap policies.
Signing up for an Advantage plan might mean having to give up your other covers or vice versa. It is because they clash in many regards and offer much of the same coverage.
If you are still figuring out the type of Aetna Medicare Advantage plan you will need in 2019, let us help you make that decision to guarantee that you settle for the best possible health care coverage.