Medicare in a Minute
Welcome to Medicare in a Minute — short videos to help you understand the Aetna Medicare Advantage plan offered by your current or former employer, union or trust.
What is Medicare?
Learn the parts of Medicare and how a Medicare Advantage plan adds benefits while helping manage health care costs.
This is your Medicare Minute from Aetna® about Medicare basics. What is Medicare?
The Aetna Medicare Advantage plan offered through your current or former employer, union or trust gives you more than Original Medicare.
Whether you’re becoming eligible soon or need a recap, here’s how it works.
Medicare is the federal health insurance program, mostly for people ages 65 and up, or with certain disabilities. It has four parts: A, B, C and D.
Think of Parts A and B as the foundation. Part A covers hospital stays. Part B covers doctor visits and outpatient care. Together, these are called Original Medicare.
With Original Medicare alone, you'd typically pay premiums, deductibles and about 20% of Part B services — with no limit on what you could pay each year.
That's where the Aetna Medicare Advantage plan comes in. That’s Part C, administered by Aetna and approved by Medicare. Here's what makes it different: It bundles Parts A and B together, plus gives you additional benefits beyond Original Medicare. And importantly, includes an annual out-of-pocket limit.
Depending on your specific plan, you may also have Part D. Part D helps with prescription drug costs. Check your group plan documents to see if Part D is included.
Here’s what makes this plan truly special: It’s exclusive to your group and not available to the general public. Even better, employers, unions and trusts typically contribute towards your monthly premiums. Check your group plan documents for these details.
This has been your Medicare Minute from Aetna.
Eligibility & enrollment
Know when and how to enroll in Medicare and your employer-sponsored Aetna plan for seamless coverage.
This is your Medicare Minute from Aetna® about eligibility and enrollment.
Your current or former employer, union or trust has partnered with Aetna to offer you a Medicare Advantage plan. Because it's a group plan, it's designed specifically for your group and isn't available to the general public.
Whether you’re becoming eligible soon or would like a refresher, here’s what you need to know.
In order to enroll in the Aetna Medicare Advantage plan, you must first enroll in Medicare Part A and Part B.
Your Medicare enrollment window opens 3 months before your 65th birthday, includes your birthday month, and closes 3 months after.
To enroll in Part A and Part B, visit SSA.gov, or schedule an appointment at your local Social Security office. It's best to enroll as early as possible to avoid coverage gaps, delays and potential Medicare penalties.
Next, review the materials from your employer, union or trust to confirm:
- Your group’s Aetna Medicare Advantage plan enrollment process
- Plan costs and coverage details
- Your coverage effective date
- Any additional eligibility requirements
- Whether Part D prescription coverage is included
Getting these details right is important to ensure a smooth process. Reach out to your employer, union or trust as soon as you've enrolled in Medicare Parts A and B.
This has been your Medicare Minute from Aetna.
What to expect as a new member
See the resources, support and plan materials you'll receive as a new Aetna member.
This is your Medicare Minute from Aetna® about what to expect as a new member.
After you enroll, there are several things you’ll receive. Let's walk through what comes next.
First, you'll get a plan confirmation letter welcoming you to Aetna and confirming your enrollment in the Medicare Advantage plan through your current or former employer, union or trust.
You'll also receive your Aetna member ID card in the mail. Be sure to use it whenever you visit the doctor, hospital or pharmacy, if your plan includes prescription drug coverage. Simply show your Aetna card and we'll handle the rest. You can put your red, white and blue Medicare card aside for safekeeping.
Your Welcome kit will arrive with helpful information about all the services and programs available to you. Keep it handy for quick reference.
Get connected. Register for your member website to access your digital ID card, check coverage and costs, and manage your care — anytime that works for you. You can also download our app and sign up for emails to stay informed.
If you're currently receiving medical treatment, we understand your care is important. Our continuity of care support is here to help make your transition as smooth as possible.
We're here to help. If you have questions about your plan or transition, just call Member Services. You'll find the number on your ID card. We're honored to be your partner in health, because healthier happens together®.
This has been your Medicare Minute from Aetna.
Provider access
Learn how the Aetna Medicare Advantage plan offers nationwide coverage so you can continue to see your trusted doctors, specialists and hospitals.
This is your Medicare Minute from Aetna® about provider access.
One of the most common questions about Medicare Advantage plans is: Can I continue seeing the same doctors?
The good news? With the Aetna Medicare Advantage plan offered through your current or former employer, union or trust, you can likely keep seeing the doctors you know and trust.
You'll have access to over 1 million providers and 4,300 hospitals in the national network. You’re also covered wherever you travel, nationwide. When traveling outside the country you are covered in case you have an urgent need for medical care. And here's another plus — you don't need referrals to see specialists.
With a PPO, you'll pay less when you use providers in the Aetna network. You can see out-of-network providers, too, but you'll likely pay more for those services.
However, some plans are PPO ESA plans. ESA stands for Extended Service Area. With this type of plan, you pay the same cost whether your provider is in or out of network, as long as they're eligible to receive payment under Medicare and willing to bill and accept payment from Aetna. That gives you extra flexibility and confidence when choosing your care.
Since plan details vary, check your group’s plan documents to understand your specific coverage. And if you want to confirm whether a particular doctor or hospital accepts your plan, just give Aetna Member Services a call. We’re happy to check and answer questions.
This has been your Medicare Minute from Aetna.
Prior authorization
Learn what prior authorization is, why some services require approval and how your doctor helps guide the process.
This is your Medicare Minute from Aetna® about prior authorization.
If you're enrolled in — or becoming eligible for — an Aetna Medicare Advantage plan through your current or former employer, union or trust, let's talk about prior authorization. You might also hear it called precertification or preapproval.
Prior authorization is simply the process of confirming that your plan will pay for a certain service before it happens. Most everyday care doesn't need it, but some higher-cost tests, procedures or specialized services do. Some medicines also may require prior authorization, if your plan includes prescription drug coverage.
This step helps ensure the care is covered under your group's plan and meets nationally accepted, evidence-based guidelines for medical necessity. It's one way your plan manages costs while making sure you get the right care at the right time.
Here's how the process works:
Your doctor submits the request to Aetna, explaining what service you need and why it's medically necessary. Aetna then reviews the request using your specific plan benefits and Medicare guidelines. Once the review is complete, we notify both you and your provider of the decision.
The good news? Your doctor handles all of this for you. If you're curious about which services require prior authorization, you can always review this on your member website or by contacting Aetna Member Services.
This has been your Medicare Minute from Aetna.
Additional no-cost benefits
Explore the extra programs, tools and support services included at no cost to you in your plan.
This is your Medicare Minute from Aetna® about additional benefits.
Here's some great news: The Aetna Medicare Advantage plan offered through your current or former employer, union or trust gives you access to more benefits than Original Medicare — and they're all included at no additional out-of-pocket cost to you.
Let's start with your secure member website and mobile app. This is your one-stop shop for checking benefits, finding doctors, viewing your member ID card and much more.
Have a health question? You can call the 24-Hour Nurse Line to speak with a registered nurse. Or from the comfort of your own home, you can call Teladoc Health for nonemergency issues like allergies or the flu. Teledoc can even prescribe medication if needed.
Once a year, you’re eligible for a Healthy Home Visit to assess your health and safety needs. You’ll have up to an hour of one-on-one time with a licensed clinician to discuss your health. This visit is voluntary and no additional cost to you.
If you're managing an ongoing or complex condition, a nurse case manager can help coordinate your care, review your medications, connect you with community resources, and provide support between doctor visits.
You also have access to Resources For Living®. Get connected to services in your area that offer help with things like caregiver support, transportation and social activities. You only pay for any services you use.
Keep in mind that some group plans include additional programs, so be sure to review your plan materials to see everything that's available to you.
This has been your Medicare Minute from Aetna.
Prescription drugs
Learn how Medicare Part D, prescription drug coverage, works — including the convenience of mail-order services. Note: Not all Aetna Medicare Advantage plans include prescription drug cover. Check your plan materials.
This is your Medicare Minute from Aetna® about Medicare Advantage Part D.
If your current or former employer, union or trust offers you an Aetna Medicare Advantage plan that also includes prescription drug coverage, this minute is for you.
Prescription coverage is called Medicare Part D. This can be built in with your medical benefits in one coordinated plan. Or it can be offered to you as a separate plan in addition to your medical and hospital coverage.
Here's how it works:
Your plan covers medications from an approved list called a formulary. You'll typically pay a copay or coinsurance for covered drugs.
You'll also have access to a nationwide network of pharmacies where you can fill your prescriptions. And for added convenience, medications you take regularly can be delivered right to your home by mail.
Be sure to review your group's plan materials, such as the formulary guide, to see which drugs are covered, what your costs will be, and which pharmacies are in your network. For complete coverage details, check your plan's Evidence of Coverage — or EOC.
This has been your Medicare Minute from Aetna.