Aetna is the name of the company that is included in the list of one of the largest private insurance companies that offers Medicare Advantage plans. A wide range of Medicare Advantage plans are offered by the company. These plans are designed to fit any budgets and healthcare needs. Unfortunately, not every plan is available in every state.
How many states have Aetna Medicare Advantage plans? According to the Heatline, there are a total of 49 states in the United States that are offered Medicare Advantage plans by Aetna. It means there is only a state that these plans are not currently sold. Can you guess what state it is? If you guess Alaska then you are right. Medicare Advantage plans are not currently sold in this state. As Alaska is the only state where Medicare Advantage plans are not currently sold, it means they are sold in the other states in the United States such as:
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
While it is true that Aetna is available throughout the country, it should be noted that certain kinds of plans and coverage options may only be offered in particular areas. It means an Aetna plan that is available for your family member who lives in a different state as you may not be available to you.
As you already found out the amount of states that have Aetna Medicare Advantage plans, you may want to know more information about Aetna Medicare Advantage plans. Check out the following information if you are interested in the topic.
There are several types of Medicare Advantage plans offered by Aetna, as follows:
- Aetna HMO (Health Maintenance Organization) plans: With most of these plans, you will have to choose an in-network primary care physician or PCP. By doing so, you will have access to a specified network of doctors and hospitals that includes specialists. In order to see a specialist, you may have to get a referral from your PCP first. If it is an emergency case, you will be allowed to use an out-of-network doctor, ER, or hospital. The good news is that each plan includes worldwide ER and urgent care coverage.
- Aetna HMO-POS (Point-of-Service) plans: What makes these plants different compared to HMO is that they include an out-of-network option. It is possible for the plan members to access medical treatment outside their HMO network for certain treatments or under special circumstances. If you want to see an out-of-network doctor, you will have to pay more with one of these plans. Just like HMO plans, HMO-POS plans also require you to choose a PCP. Some of them will require specialist referrals from the PCP as well.
- Aetna PPO (Preferred Provider Organization) plans: These plans allow you to use any doctor, in and out of the network, provided that they accept Medicare and Aetna’s plan terms. If you want to see an out-of-network provider, you will usually have to pay more. Unlike these plans above, Aetna PPO plans do not require you to choose a PCP. Not only that, they also do not require you to get referrals if you want to see specialists.
- Aetna D-SNPs (Dual Eligible Special Needs Plans): These plans are made for those who are eligible for both Medicare and Medicaid. This kind of thing is known as being dual eligible. For those with the highest need, these plans are best for you as they offer the most comprehensive benefits. Most of them include access to a personalized care team.
Aside from these plants, Aetna also offers three standalone Part D prescription drug plans, which are:
- SilverScript Smart Rx
- SilverScript Choice
- SilverScript Plus
Aside from that, every Medicare Advantage plan offered by Aetna also includes prescription drug coverage. Besides, a mail-order prescription drug benefit is also offered. In addition, you will also get an over-the-counter medication benefit that will provide free access to a lot of products.
For those who are currently shopping for Medicare Advantage or separate Part D plans, feel free to use the find Medicare plan tool. The tool can be found at here. With this tool, you will be able to view every plan that is available in your area. In order to see which plans cover them and how much they will cost, you can enter your medications.
How much money do you have to spend to get Aetna Medicare Advantage plans? Below are some examples of the costs that you may see with Aetna’s Medicare Advantage plans in different areas of the United States in 2021:
|City/plan||Star rating||Monthly premium||Health deductible; drug deductible||Out-of-pocket max||PCP visit||Specialist visit|
|Reno, NV: Aetna Medicare Platinum Plan (HMO)||3.5||$0||$0; $100||$7,550 in network||$0||$45|
|Bothell, WA: Aetna Medicare Select Plan (PPO)||4||$99||$0; $0||$7,000 in network; $10,800 out of network||$0 copay in network; 40% coinsurance out of network||$40 copay in network; 40% coinsurance out of network|
|Wichita, KS: Aetna Medicare Assure (HMO D-SNP)||not yet available||$0||$0; $220||$7,550 in network||$0||$0|
|Miami, FL: Aetna Medicare Credit (HMO)||4||$0||$0; $0||$3,450 in network||$0||$35|
|Staten Island, NY: Aetna Medicare Elite Plan (PPO)||4||$0||$1,000; $250||$7,550 in network; $11,300 out of network||$10||$45|
What are the things that are covered by Aetna Medicare Advantage plans? For your information, coverage under Aetna Medicare Advantage plans may be different depending on the plan that you choose. However, many of them include dental, hearing, vision, and gym membership through the SilverSneakers program. In addition, some plans also offer access to nonemergency medical transportation services and meal delivery at home after a hospital stay. Once again, the benefits offered by every plan may be different. Make sure to read everything carefully so that you can get the coverage that you would use the most.