Aetna Medicare Plans
2014 Aetna Medicare Plan (PPO) — low-income subsidy
What if I need help with my drug costs?
Many people who have trouble paying for their Medicare prescription drugs can get Extra Help from the government. The Extra Help program can help you with the following costs:
- Prescription drug plan premiums
- Annual drug plan deductible
- Coinsurance for prescription drugs
Extra Help can also eliminate the coverage gap and late enrollment penalties.
How can I apply for Extra Help?
The Social Security Administration and your state Medical Assistance Office accept applications for low-income subsidies. The amount of assistance you receive, if any, depends on your income and financial resources. To see if you qualify, call:
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday
TTY users should call 1-800-325-0778. You can also apply online at http://ssa.gov.
- Your state Medicaid office
The table below tells how much you will pay for your monthly Aetna Medicare plan premium based on the percentage of Extra Help you receive. (This does not include any Medicare Part B premium you may have to pay.) The Aetna Medicare Plan (HMO) premium includes coverage for both medical services and prescription drug coverage.
|Your State and
|Aetna Medicare Plan Premium Based on Your Level of Extra Help
Aetna Medicare is an HMO/PPO/PDP plan with a Medicare contract. Enrollment in Aetna Medicare depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year.
Plans are offered by Aetna Health Inc., Aetna Health of California Inc., and/or Aetna Life Insurance Company (Aetna). Not all health services are covered. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location.
For the Aetna Medicare Plan (PPO): It may cost more to get care from out-of-network providers, except in an emergency. Precertification, or prior approval of coverage, is requested for certain services. Providers must be licensed and eligible to receive payment under the federal Medicare program.
You must have both Medicare Part A and Part B to enroll in a Medicare Advantage plan. You must have Medicare Part A and/or Part B to enroll in a Medicare prescription drug plan. You must continue to pay your Medicare Part B premium.
In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances. Pharmacy clinical programs such as prior authorization, step therapy, and quantity limits may apply to your prescription drug coverage.
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Page Last Updated: October 1, 2013