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  • Evidence of Coverage (EOC)
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The plan name is listed on your member ID card.

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Other coverage information

Disclaimers

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

This information is not a complete description of benefits. Contact the plan for more information. 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.

Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.  

Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. 

You must continue to pay your Medicare Part B premium. 

The Part B premium is covered for full-dual members (those who have both Medicare and Medicaid, and meet the state’s requirements for full Medicaid benefits).  

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. 


       Y0001_4006_10829 Approved 10/27/2017
       Page last updated: Feb 26, 2018

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