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Have Medicare with an employer or group?

Get the most value from your plan. The following tools and references can help you manage your employer or group sponsored Medicare Plan. Since retiree plans vary, it’s important to review the information from your former employer, group sponsor or us.

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Manage your prescription

Manage your prescription

Our prescription drug list (formulary) shows:

  • The drugs we cover
  • The tier a drug is on
  • Any limits or requirements before we cover the drug
  • Mail order availability

Refer to your plan documents to find out which formulary your prescription drug plan uses. You'll need to know the formulary name and the number of tiers. You have two options to find this information:

  • Already an Aetna member? Look in your Schedule of Cost Sharing.
  • Haven’t enrolled yet? Review the Plan Benefit Summary.

 

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Choose a 2022 formulary (drug list) name to see documents

Important information


There’s a lot more information on changes to our drug list (formulary), prior authorization, step therapy, quantity limits, exceptions and transition rules.

 

Learn about drug list changes, special rules and more

 

Review Evidence of Coverage (EOC)

Review Evidence of Coverage (EOC)

Your EOC includes comprehensive plan details, and your rights and responsibilities.

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Choose an EOC from the list below to see the document

Find a doctor, pharmacy or other provider

Some members may have access to an Extended Service Area (ESA), giving them the freedom to use providers in- and out-of-network. If a provider is not part of the Aetna Medicare network, ESA members can continue to see them as long as they are licensed, eligible to receive Medicare payment and agree to accept the ESA plan. If ESA members do not live in an Aetna network service area, they can view general provider information for their area by visiting Medicare.gov.

Find Medicare Star Ratings for your plan

Find Medicare Star Ratings for your plan

Each year, Medicare rates health and prescription drug plans on a Five–Star Quality Rating System.

 

The Star Ratings measure Medicare Advantage plans based on five areas:

 

  • Staying healthy
  • Managing chronic (long-term) conditions
  • Member experience with the health plan
  • Member complaints
  • Health plan customer service

 

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Select state and plan to see your 2022 Star Ratings

Telehealth

Telehealth

Do you have a time-sensitive medical need, or can’t make it make it to your doctor’s office? Your Aetna® Medicare plan includes the convenience of telehealth benefits.   


With telehealth — you can get nonemergency virtual care by phone, video or mobile app, anywhere you are, including after hours or on the weekend.    


Many services are covered, including:
   

  • Routine care
  • Sick visits
  • Urgent care (walk-in clinics)
  • Prescription refills
  • Behavioral health services (individual and group sessions) 

If you need emergency care, call 911 or go to the nearest emergency room immediately.  
 

How to use your telehealth benefit:  


Check with your doctor to see if they offer telehealth services. If they do, just make an appointment. You’ll pay the same cost share as you would for an in-person visit. You can find those costs in your Evidence of Coverage. 

 

Remember, not all provider services are available through telehealth and certain services may require a referral or prior authorization (preapproval). You can view and download a list of services that may be covered with your plan here.

24/7 virtual care

24/7 virtual care

Should you need after hours or weekend care, your plan provides access to the following 24/7 virtual care providers: 
 

  • Teladoc®: Allows you to speak to a licensed doctor by web, phone or mobile app 24/7 — usually within 15 minutes.
  • MDLIVE®: Offers behavioral health services with licensed therapists and board-certified psychiatrists by appointment.
  • MinuteClinic Video Visit™: Allows you to speak with a health care provider 24/7. 

If you’re enrolled in an Aetna Medicare Advantage ESA or PPO plan through your former employer or group sponsor, you can also access telehealth visits with out-of-network providers. They just need to accept Medicare and your Aetna plan. If you’re in a PPO plan, it may cost you less if you use in-network providers.