Your plan information

Boeing Aetna MA PPO transition: online video script

 

Slide 2:

Welcome! My name is Sandy and I’m here from Aetna®. There are important changes happening to your medical coverage for 2024. By way of your attendance today, you would have received detailed information by mail from both Boeing and Aetna about your new Aetna Medicare Advantage PPO ESA Plan, also called the Aetna Medicare^SM Plan (PPO). I’m here today to help you understand those changes and provide more information on your new Aetna Medicare Advantage plan option for 2024.

 

Slide 3:

Today you’ll learn a lot of great tips and insights that can help you get the most from your Aetna Medicare Advantage benefits.

 

We’ll review the following topics you see here.

• Some of you may not be familiar with Aetna® or the parts of Medicare, so we’ll cover that.

• Next, we’ll explain how the Aetna Medicare Advantage PPO ESA plan works, important information about our plan and how to use it with your doctors and hospitals.

• We’ll talk about the additional benefits you get with your Aetna Medicare Advantage PPO plan.

• And lastly, we’ll cover what to expect next and important resources.

 

You should have received or soon will receive an Aetna information kit in the mail that includes information on these topics as well. Now, let’s get started.

 

Slide 4:

So, why Aetna®?

 

Slide 5:

Aetna® is one of the country’s largest health insurers. The Aetna Medicare Advantage PPO plan was chosen as your health care plan because it combines comprehensive medical and prescription benefits with cost savings for our members, and offers you highly rated customer service and additional support programs you don’t get with Original Medicare.

 

With over 37 years of Medicare experience and over 25 years managing pharmacy benefits, you’ll see why more than 3.3 million retirees trust us to provide quality benefit coverage. Rest assured, you can too.

 

That includes over 10,000 Boeing retirees who are currently enrolled in Aetna Medicare Advantage Plans. And they’ve given the plan a 96% satisfaction rating.

 

We also make it easy to continue seeing your doctors, with over 1.1 million network providers and over 4,200 network hospitals nationwide.

 

We believe that healthier happens together^TM. That’s why we are devoted to helping Medicare Advantage members manage and improve their health.

 

Slide 6:

Before we learn about your plan, let’s spend a few moments reviewing the parts of Medicare and what it means to you.

 

Slide 7:

Original Medicare is the federal insurance program for people that are age 65 or older, and for some people with a disability or certain illnesses.

 

Medicare has 4 main parts.

 

The federal government’s Original Medicare program includes Part A and Part B, which covers things like inpatient care, skilled nursing facility care and services from doctors and other health care providers.

 

Part C is included with private medical plans called Medicare Advantage, which is the type of plan you’ll have with Aetna. Medicare Advantage includes Original Medicare Part A and Part B benefits and services, but also can include benefits that Original Medicare doesn’t — which you’ll hear about shortly. This means you don’t lose the coverage you’d get under Original Medicare and likely will have more coverage.  

 

Your Medicare Advantage plan will also include your Medicare Part D coverage — which helps cover the costs of prescription drugs.

 

“Supplement” plans are sold by private insurance companies to help cover gaps in Original Medicare. These types of plans are referred to as Med Supp or Medigap plans as they pay secondary to coverage under Original Medicare Part A and Part B.

 

Slide 8:

We think you’ll find that your new Aetna Medicare Advantage PPO plan is efficient and easy to use, and we’ll show you how.

 

Slide 9:

If you are currently enrolled in a Boeing Medicare Supplement Plan, these puzzle pieces may look familiar.

 

To better understand the new Aetna Medicare Advantage plan, I want to first give you a quick overview on Medicare Supplement plans.

 

When you go see your doctor you have to show three ID cards. One, is the red, white and blue Medicare card and the second is your medical card. You also need to show a different card for prescription drugs through Prime. The payment process involves many steps working with Medicare, your current plans, and your provider. Then after each plan pays a doctor’s claim, you’ll get at least two Explanations of Benefits, or EOBs, from Medicare and your current plan, as well as paperwork from your provider.

 

Now, let’s look at how these pieces are different for Medicare Advantage.

 

Slide 10:

If you happen to be currently enrolled in a Medicare Advantage HMO, this should look familiar. The Medicare Advantage PPO will continue to work similarly.

 

Medicare Advantage plans offer you the convenience of all of your Medicare Part A and Part B benefits and Medicare Part D prescription drug coverage in one plan, with the added convenience of using a single ID card. This is everything you get with Original Medicare plus many additional benefits — all in one package — and makes things easier.

 

You’ll also only have two monthly Explanation of Benefits — one each for medical and prescription drug services. And, you’ll have additional programs to help you reach your health goals, at no extra cost to you.

 

Slide 11:

Here’s a sample of your new Aetna card. In late December, you’ll receive your new Aetna Medicare ID card, and it will arrive in a purple envelope. You can tuck away your Original Medicare red, white and blue card — you will not need to use your Medicare ID card when seeking medical care.

 

You can call the phone numbers on your Aetna card whenever you have questions about your plan benefits, coverage and providers, or to access our 24-hour Nurse Line. Please note that starting January 1, 2024, you will call the same Member Services number for both medical and prescription drug inquiries.

 

 You will present this one card to all your providers for all medical and prescription services.

 

Slide 12:

We know the most important thing for our members is “Will my doctor take this plan?” Let’s review your freedom of access with this plan.

 

Slide 13:

With over 1,100,000 network providers and over 4,200 network hospitals, and out-of-network coverage, you can likely continue to use your doctors you know and trust. The Aetna Medicare Advantage PPO ESA plan is different than many other PPO plans. It allows you to see any provider (whether in the network or not), as long as the provider is:

 

•  Eligible to receive payment under Medicare

And

• Willing to bill and accept payment from Aetna

 

It doesn’t cost you more if your provider isn’t in our network. You will pay the same cost share for both covered in- and out-of-network medical services.

 

According to our analysis, nearly 99% of providers that Boeing retirees see are either in the Aetna network or are known to have accepted the Aetna Medicare Advantage plan in the past.

 

With the Aetna Medicare Advantage plan, no referrals are needed. When traveling outside the country you are covered in case you have an urgent need for medical care.

 

You may be wondering what to expect if you’re in the middle of an ongoing treatment. Let us know if you are so we can help you have a seamless transition. Just call us at 1-855-527-2443 (TTY: 711). We’re available Monday through Friday, 8 AM to 9 PM ET.

 

At the time of this presentation, some locations of Baylor Scott and White and affiliated providers of the Health Texas Provider Network, and all Mayo Clinic locations are known groups in the United States that do not accept the Aetna Medicare Advantage plan.  If you currently receive care at these groups, contact us for support including transitioning your ongoing care or for help finding providers in your area who accept the Aetna plan.

 

Slide 14:

The Aetna Medicare Advantage plan gives you the flexibility and confidence to choose your doctors. We’re here to help if you’d like to confirm your provider accepts the plan. You can see any provider who accepts Medicare and will accept the plan. As I shared earlier, nearly 99% of providers that Boeing retirees use are either in the Aetna network or are known to accept the plan. We are here to support you during this transition and help verify your provider accepts the plan in advance of annual enrollment. Just call us if you have questions about certain doctors or need help finding a new provider.

 

We have a special Aetna Member Services team that is dedicated to our group members, and they will be happy to help you and even call your doctor’s office on your behalf to confirm they will accept our plan.

 

Our representatives are available Monday through Friday, 8 AM to 9 PM ET. Call 1-855-527-2443 (TTY: 711).

 

Slide 15:

Let’s take a look at your medical benefits. Our Medicare Advantage plan includes:

 

• Comprehensive coverage, including 100% coverage for most preventive services, and

• Benefits that complement your doctors’ care and help you manage your total health — physical, emotional and social.

 

Slide 16 – Plan B:

Let’s review your medical benefits.

 

• Your deductible is $150, which means you’ll pay that amount first before your plan begins to provide coverage.

• Your out-of-pocket maximum is $2300, which is the most you’ll pay for medical services in a plan year.

• For all preventive care, including a physical, cancer screenings and a flu shot: You pay $0 and the plan covers 100%.

• For a primary care office visit or a specialist visit: You pay 20%.

• Inpatient hospital: You pay 20% per stay.

• Outpatient surgery: You pay 20%.

• Emergency room: You pay $80, which is waived if you’re admitted to the hospital.

• Many other services such as X-rays, or physical therapy, have a 20% cost share.

 

The difference between coinsurance and a copayment is a percentage vs. a flat dollar amount. With coinsurance, you pay a set percentage of the total cost for your portion of the health care service. On the other hand, a copayment is a set dollar amount that you pay for your portion of the cost of the service.

 

Now these are just some highlights of the various benefits. A full listing is available in your Summary of Benefits, which Aetna mailed to you. You can also visit Boeing.AetnaMedicare

 

Slide 17:

Let’s take a look at your prescription drug coverage, also known as your Medicare Part D coverage.

 

Slide 18:

Let’s go through some basic terms for understanding your drug benefits.

 

A formulary is a list of drugs covered by your plan.

 

Drug tiers are used to classify drugs. Drugs are placed into different levels in the formulary; each level, or tier, has a different cost. You might see the groups listed as generic drugs, preferred brand drugs or non-preferred brand drugs. Higher tiers usually have higher cost sharing.

 

For 2024, a majority of the drug tiers will remain the same from your current prescription coverage. However, there could be changes to your drug’s tier. We encourage you to review the formulary and speak to your doctor about alternate prescription options for a drug that costs less. If you have questions about the plan formulary, give us a call and we can help. We’re available at 1-855-527-2443 (TTY: 711), Monday through Friday, 8 AM to 9 PM ET.

 

Our network has over 65,000 participating pharmacies nationwide to be sure your filled prescriptions are covered.

 

If your drug cost or pharmacy is impacted by the change to Aetna, you may be notified in writing prior to January 1, 2024. Also, keep in mind that drug formulary lists and pharmacy networks are re-evaluated annually by all Part D prescription drug plans and changes can occur year over year.

 

As you’re transitioning to an Aetna plan from your current plan, you may get a one-time fill of a drug that has prior authorization or step therapy requirements on the Aetna plan. This allows you time to work with your doctor to request an exception or to see if a different drug that’s on the formulary will work for you.  Call the number on your ID card for details.

 

I’d like to reassure you that more than 99.5% of drugs covered under your current plan are also covered under the Aetna prescription drug plan.

 

Slide 19 – Plan B:

Let’s discuss your prescription drug benefits.

 

Your plan uses our Comprehensive Plus formulary.

 

The plan has no deductible, which means there is no amount you need to pay first before the plan begins to provide coverage. You will start in the Initial Coverage phase.

 

For a Tier 1 generic drug, 31-day supply, you’ll pay $2.

For a Tier 2 preferred brand drug, 31-day supply, you’ll pay $5. 

For a Tier 3 non preferred brand drug, 31-day supply, you’ll pay $5.

 

We would encourage you to consider mail order for your ongoing prescriptions which will provide cost savings and convenience. For a 90-day supply through our preferred mail-order pharmacy, which is CVS Caremark Mail Service Pharmacy, you’ll pay $4 for a Tier 1 drug.

 

For Tier 2 you’ll pay $8 for a 90-day supply.

 

And for Tier 3 you’ll pay $8 for a 90-day supply.

 

Your plan provides full coverage in the gap, which means once you reach this phase, you will continue to pay generally the same cost share as you did in the Initial Coverage phase. 

 

If you reach the catastrophic phase, you’ll pay $0 for your Part D drugs.  This is an improvement for 2024.

 

A summary of your prescription drug plan benefits can be accessed in your information kit that will be mailed to you. The summary as well as complete prescription drug plan details can also be accessed online at Boeing.AetnaMedicare.com

 

Slide 20:

Here are some tips to help you get started with your Aetna® prescription drug coverage for 2024:

 

Check your pharmacy:

You can use any pharmacy in the Aetna network, which includes over 65,000 pharmacies nationwide, so your pharmacy is likely included. You can confirm that your current pharmacy is part of the Aetna network by visiting Boeing.AetnaMedicare.com or by calling us.

 

Look up your medicines:

Review our formulary list to check the coverage and cost of your drugs. You can also visit Boeing.AetnaMedicare.com to access the Drug Cost Lookup Tool to estimate costs for drugs covered on the formulary. At this website you can also find the list of drugs covered under the supplemental benefits provided by Boeing.  

 

If you’d prefer to speak with someone, you can call us to review your drugs with an Aetna Member Services representative. We’re available at 1-855-527-2443 (TTY: 711), Monday through Friday, 8 AM to 9 PM ET.

 

Prior authorizations & mail order prescriptions:

To help with a smooth transition, we request transfer files from your current prescription drug carrier.

 

If you’re already using mail order with your current prescription drug carrier and you have open fills remaining, your prescription may transfer automatically to the CVS Caremark Mail Service Pharmacy. However, prescriptions for controlled substances and compound medication cannot be transferred and will require new prescriptions. To check if your prescription transferred to CVS Caremark Mail Service Pharmacy, call us at 1-855-527-2443 (TTY: 711), Monday through Friday, 8 AM to 9 PM ET. Note that your payment method will not transfer to us, so you will also need to call us after you receive your Aetna member ID card to give us that information.

 

If you have a prior authorization to take a drug on your current prescription drug coverage, many authorizations will also transition over to Aetna, if we receive the data from your current plan. You’ll receive a letter from Aetna in the mail before January 1, 2024, confirming the transfer. You can find prescription drugs requiring prior authorization in your plan formulary.

 

Slide 21:

With CVS Caremark® Mail Service Pharmacy, you have the option of having your prescriptions delivered right to your door within 10 days. Your plan offers a long-term supply at select retail pharmacies and mail order. This may be a great option if you take medications regularly. Prescription mail order saves you time and hassle and may help you save money compared to retail pharmacy costs as detailed on the prior slide. And it may help you avoid running out of your medication.

 

Refer to your plan benefit information for more details.

 

To get started:

Step 1: See if your medication is available through mail order. Some medications aren’t available through mail order. To see which drugs are available, check your plan formulary (drug list) or call us at the number on your member ID card.

 

Step 2: Choose how to sign up. You can register online through the Aetna member website or call Member Services at the number on your member ID card.

 

Let us know how you want to pay for your order. That way you can avoid processing delays. You have options such as all major credit and debit cards, electronic check and more. Call us to learn about your options. Be sure to also tell your doctor you’d like your eligible prescriptions delivered. Ask them to send an electronic prescription (e-prescribe) to our home delivery.

 

To manage your home delivery prescription orders online, log into your Aetna member website and find the Aetna Pharmacy section. Or you can call us at
1-855-527-2443 (TTY: 711), Monday through Friday, 8 AM to 9 PM ET.

 

Slide 22:

You may qualify for help with your Medicare costs if you have limited income and resources. Extra Help is a Medicare program that helps pay some Medicare prescription drug costs, such as:

• Monthly plan premium

• Yearly deductible

• Coinsurance

• Copays

• Coverage gap

 

To see if you qualify for Extra Help, you can call BeneLynk 1-888-715-0225 (TTY: 711), Monday through Friday, 9 AM to 6 PM Eastern Time or the Social Security office at 1-800-772-1213  (TTY: 1-800-325-0778), Monday through Friday, 8 AM to 7 PM. You can also call us at the number on your member ID card for help.

 

Slide 23:

We talked about the simplicity of the plan (one card, keeping your doctors), and we talked about the plan design features.

 

Now, I’d like to share with you some of the additional support programs you'll get with the Aetna Medicare Advantage PPO plan, at no extra cost to you.

 

Slide 24:

We value your total health. And we want to help you reach your full potential in life – however you define it. We’ve got you covered, wherever you are on your health journey, because healthier happens together.

 

• For those interested in maintaining their health and staying on top of their preventive care options, we offer annual physicals, eye and hearing exams, a women’s annual physical, and a cancer screening reminder. The plan also includes our Fall Prevention Program. The program helps you understand your risks of falling and how to stay safe in your home.

• For those who want to focus on wellness or need support, we have programs such as Healthy Home Visits, Resources For Living and an over-the-counter benefit.

• For those who want to manage health conditions, we have programs to help with chronic or complex conditions such as diabetes and heart disease. We also offer on-demand assistance through programs such as Teladoc®, telehealth, MDLIVE®, and our 24-hour Nurse Line.

• For those who have complex medical conditions, we offer nurse case management, help preventing you from being readmitted to the hospital, and compassionate care for advanced illnesses.

 

All of these are included at no additional cost to you and are intended to complement your current health care; they aren’t meant to replace it.

 

Slide 25:

For those who want to manage health conditions, we have programs to help with chronic or complex conditions:

 

With a Healthy Home Visit, a licensed health care professional can come to your home to review your health needs and do a home safety assessment. During the visit, they may also review your medicines, complete some health screening tests — if you wish — and recommend services that can support your health needs. Plus, you can earn a $100 gift card from the Aetna Healthy Rewards program when you tell us you’ve completed the visit.

 

The 24-hour nurse line lets you speak with a registered nurse, day or night, to get help with your health concerns.

 

With telehealth coverage, you can access care from the comfort of your own home by speaking to a licensed doctor, therapist, or board-certified psychiatrist online, by phone or on the mobile app. It’s a convenient way to receive care if an in-person visit isn’t possible or required.

 

The SilverSneakers® program lets you join any of several thousand participating locations nationwide or take online classes at home, at no extra cost to you.

 

We don’t want you to worry about how you’ll get to your medical appointments. That’s why we offer optional, nonemergency transportation to get you there and back. These rides are included with your plan at no extra cost.

 

The over-the-counter (OTC) benefit lets you use a $30 allowance each quarter to buy health and wellness products. You can shop from our OTC catalog and get home delivery. Or you can shop at select participating CVS Pharmacy® locations.

 

Slide 26:

For those who have complex medical conditions, we offer a variety of support programs.

 

Resources For Living® provides referrals to services in your area that offer help such as house cleaning and lawn care, transportation, social and recreational activities, and caregiver support. You just pay for the cost of the services you use.

 

The new Aetna Medicare Advantage plan provides support for members with multiple health conditions. According to a recent member survey, 98 percent of participating members believed their care management nurse was knowledgeable and 97 percent are satisfied with the program.

 

The readmission avoidance program provides additional follow-up care and support following an inpatient stay.

 

With the meal home delivery program, you can get healthy, precooked meals delivered to your home after an inpatient hospital stay — at no extra cost.

 

The Aetna Compassionate Care^SM Program offers support for members, their families, and caregivers during difficult and sensitive times. Care managers provide treatment and decision support for advanced illnesses. Care managers also work with you and your provider on treatment plans, continuity of care, emotional support, and facilitating advance care planning.

 

The Healthy Aging Support program helps members who are at an increasing risk for complications due to their chronic conditions. The one-to-one nurse support and eight weekly virtual group sessions help build confidence and provide you with the tools and resources to help manage your health.

 

Slide 27:

Do you have a time-sensitive medical need? Can’t make it to your doctor’s office? Your Aetna® Medicare plan includes the convenience of telehealth benefits if available through your doctor or urgent care center. Telehealth gives you access to nonemergency virtual care by phone, computer or mobile app anywhere you are — including after hours or on the weekend.

 

To use your telehealth benefit, just check with your doctor or urgent care center to see if they offer telehealth services. You’re covered for sick visits, prescription refills and after-hours or weekend care.

 

Need help with stress, relationship issues, grief and loss? With MDLIVE®, you can talk to licensed therapists and board-certified psychiatrists by appointment. Providers can even write and send prescriptions to your pharmacy.

 

With the 24-hour Nurse Line, you can talk to our registered nurses, day or night. Based on your symptoms, they can help you decide if you need a doctor or urgent care visit. Or even suggest possible treatments.

 

While only your doctor can diagnose, prescribe or give medical advice, our nurses can provide information on more than 5,000 topics. Contact your doctor first with any questions regarding your health care needs. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.

 

Need or want care from a licensed provider other than your current doctor — without an appointment? With Teladoc® you can have a doctor visit for general medical needs on your computer or by phone or mobile app 24/7 — usually within 15 minutes. Teladoc is a national network of virtual only, U.S. board-certified PCPs.

 

MinuteClinic Virtual Care^TM also allows you to speak with a health care provider 24/7.

 

Slide 28:

After you receive your member ID card, you can sign up for the Aetna Member website and Aetna Health app. 

 

With our digital tools, you can:

 

 Connect with care to:

• Find a walk-in clinic

• Search for and select a primary care provider (or PCP)

• View ratings and reviews of providers before you get care

 

Also, manage your benefits:

• View details of what your plan covers

• See how much you’ve already spent and progress towards your deductible

• Access your digital ID card whenever you need it

 

 Review your claims:

• Receive your medical Explanation of Benefits (EOB) statement once claims have been processed

• Get detailed cost breakdowns of your claims to see what your plan paid for and how much you’re responsible for

 

Plus, there are tools to help you stay healthy. You can:

• Take a health assessment

• Try health coaching

• Start a wellness program

• Get treatment options

 

Visit Boeing.AetnaMedicare.com to log in or register for an account using your member ID.

 

Slide 29:

So, what happens next?

 

Slide 30:

If Boeing and Aetna notified you that you will be automatically enrolled in the Aetna Medicare Advantage plan, you don’t need to do anything! You’ll automatically transition into the Aetna Medicare Advantage PPO plan with prescription drug coverage, effective January 1, 2024.

 

If you want to opt out of the plan, you must do so by November 22, 2023. You can opt out by accessing the Total Rewards portal by following the instructions in your enrollment guide. If you prefer, you can also call to make your election.

 

• If you retired before 2011, call the Boeing Service Center for Health and Insurance at 1-866-504-4256, Monday through Friday, 9 AM to 8 PM ET.

 

•  If you retired during or after 2011, call Boeing Worklife at 1-866-473-2016, Monday through Friday, 9 AM to 8 PM ET.

 

If you opt out of Boeing-sponsored coverage for 2024, this will not impact separate coverage you may have under Original Medicare. But you may not be able to re-enroll in the Boeing plan at a later date.

 

Slide 31:

 It’s important to confirm you’re eligible to enroll in the Aetna Medicare Advantage plan. You’re eligible to enroll in the plan if:

•  You’re entitled to and enrolled in Medicare Part A

And

• You’re enrolled in Medicare Part B

And

• You continue to pay your Part A and Part B premiums, if applicable.

 

One final note: generally speaking, CMS allows you to be enrolled in only one employer-sponsored or individual market Medicare Advantage, Medicare Supplement or Part D plan at a time.

 

If you don’t have Original Medicare Part A or Part B, or if you have non-Boeing-sponsored Medicare coverage or Part D prescription drug coverage, contact Boeing to find out your options. 

 

If you retired before 2011, call Boeing Service Center for Health and Insurance at 1-866-504-4256, Monday through Friday, 9 AM to 8 PM ET.

 

If you retired during or after 2011, call Boeing Worklife at 1-866-473-2016, Monday through Friday, 9 AM to 8 PM ET.

 

Slide 32:

Once you are enrolled in our plan for 2024, you will receive in December:

 

• A plan confirmation letter to confirm your enrollment in the Aetna Medicare Advantage PPO plan

• Your single Aetna ID card for all of your medical and prescription drug needs; you can tuck away your red, white and blue Medicare ID card in a safe place

 

In December you’ll also receive your Aetna Welcome Kit to help you get the most from your new plan. It:

• Includes information on how to access your Evidence of Coverage with plan coverage details

And

• Explains how to get a provider directory or access a provider listing online
  

 

In your materials, you may see references to an extended service area or ESA which is a part of your plan and means you have freedom of access with your doctors. You can see any doctor at the same in-network cost share, as long as they are eligible to receive Medicare payment, willing to treat you and bill Aetna, and accept payment from Aetna.

 

In January, you will also be able to sign up for your Aetna member website using your Aetna member ID.

 

Give us a call if you have questions about any of your plan materials. We’re available at 1-855-527-2443 (TTY: 711).

 

You should also expect a welcome call from Aetna to see if you have any questions about your plan or need help.

 

Slide 33:

We’ve covered a lot of information today.  Remember, if you ever have any questions, give us a call at 1-855-527-2443 (TTY: 711). We’re available Monday through Friday, 8 AM to 9 PM ET.

 

Thank you for your time today. I hope this presentation will help you get the most from your benefits.

 

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