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Ready for Medicare?
You’ve worked hard all your life, so we want to make sure you enjoy retirement. That’s why we’re giving you helpful information to help you understand Medicare and get the most from your health care plan.
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Understanding Medicare and what it covers
Understanding Medicare and what it covers
Medicare is the federal insurance program for people age 65 or older and for some people with certain illnesses or disabilities.
Did you know Medicare is made up of four parts? Each one covers various types of care and services. Learn more about the ABCs of Medicare.
You can apply for Medicare online at ssa.gov, or enroll at your local Social Security office.
The ${company} recommends enrolling in Medicare as early as possible to avoid a delay in the start of your Medicare coverage, which could result in out-of-pocket expenses.
Enrolling in Medicare
Happy Birthday!
This is a special one, because we get to talk about your Medicare benefits and enrollment.
All of you who are joining Medicare can now make some choices, and if you aren’t sure where to start, you’re in the right place, Aetna is here to help.
You have three months before your 65th birthday, and three months afterwards, to sign up for Medicare, Parts A and B.
This is required to get Medicare Advantage.
The good news is, you’re automatically enrolled in part A, but you must go online at ssa.gov, or visit your Social Security office to enroll in Part B.
And before we dive right in to learn exactly what Medicare covers, watch our easy to understand and informative Medicare 101 video.
By now, you’ve seen lots of TV commercials and bulk mail, mostly from insurance companies telling you how wonderful their Medicare Advantage plan is and why you should join it… that's pretty much what the enrollment period is all about.
Hopefully you now understand what Original Medicare is… and isn’t, and you may decide you need more insurance.
About one month before your 65th birthday, a detailed outline for your Aetna Medicare Advantage plan will arrive in the mail.
This plan picks up where Medicare leaves off. You receive everything original Medicare offers, in addition to some great extras.
The Aetna Medicare Advantage plan gives you access to personalized nurse support, wellness programs, and social programs. You can see any doctor that participates with Original Medicare who is willing to treat you, so you'll likely be able to keep the doctors you have now with no interruption in your care needs.
So, there it is, Medicare enrollment in a nutshell. Congratulations on your retirement, and we hope you enjoy your golden years in health.
We now return you back to your regularly scheduled birthday cake and presents.
Enrolling in Medicare
For most people, the Medicare enrollment period opens three months before they turn 65 and ends three months after their birthday. For example, if your 65th birthday falls in May, you can join Medicare between February and August of that year.
Depending on your situation, you may be automatically enrolled in Original Medicare (Parts A and B).
Call us at ${groupPhoneNumber} ${tty}, ${memberhours} or visit medicare.gov for more detailed enrollment information.
Getting to know the Medicare Advantage plan
Getting to know the Medicare Advantage plan
The IAFF-FC has teamed up with Aetna to offer four Aetna Medicare Advantage PPO plan options. Each option provides comprehensive medical, prescription, hearing and vision benefits. These benefits include plans to fit any budget.
With Aetna Medicare Advantage, you get:
- Predictable, lower costs than your current plan may have, and a yearly limit on out-of-pocket expenses
- Original Medicare Parts A and B coverage — so you’ll continue to pay your Part B premium
- Services to complement your doctors’ care — at no extra cost to you
- Continued access to your doctors — use any provider who accepts Medicare and agrees to accept the Aetna plan before treating you
If your doctor isn’t in Aetna’s nationwide network, it’s not usually a problem — you can call us and we’ll be happy to reach out to them for you. You don’t need a referral to see a specialist.
Hello and welcome to the webinar just for International Association of Fire Fighters (IAFF) retirees and spouses. My name is Julie and I’m with Aetna.
We’re here today to help you understand the four Medicare Advantage plans being offered through the IAFF Financial Corporation and Aetna. We’ll answer some of the most commonly asked questions, too.
The IAFF-FC teamed up with Aetna to design four Medicare SM Advantage PPO plans. These are highly customized group plans — just for Medicare-eligible retired IAFF fire fighters, their spouses, and their surviving widows or widowers. These plans start January 1, 2021.
Today we’ll cover:
- The Aetna and IAFF-FC plan offering
- What’s different with a Medicare Advantage plan
- How to keep seeing your current doctors
- Your new benefits, and
- What’s next
First, we’ll talk about the offering from Aetna and the IAFF-FC.
The IAFF-FC decided to team up with Aetna to design plans for their retired fire fighters. They did this to:
- Protect pension benefits
- Provide affordable, high-quality retiree health care
- Take care of those who risked their lives for us daily, and
- Work with community partners to provide personalized care
At Aetna, we’re committed to the health of you and your fellow retirees.
- We’re dedicated to improving health with a holistic focus. Our goal is to support every member in achieving their best health. We’re working on ways to increase health engagement and continue to personalize the health care experience.
- One of the most significant differences between a traditional Supplement plan and the Aetna Medicare Advantage plan is Aetna’s care and disease management programs. These programs are built into our Medicare Advantage plans at no extra cost, but are not part of traditional Supplement plans. They help to improve the health of our retirees and manage their long-term care.
- We’re committed to IAFF retirees and their families. We look forward to growing with you and helping you achieve health, happiness and peace of mind.
Now, let’s talk a little more about who we are at Aetna. Aetna is one of the country’s largest health insurers. We have over 165 years of experience in providing health benefits. We’re devoted to helping over 2 million Medicare Advantage members manage and improve their health.
We’re also a highly rated plan. The Centers for Medicare and Medicaid Services (CMS) measures the quality of Medicare Advantage plans using its Five-Star Quality Rating System. CMS does this to ensure all patients get the very best health care. Quality measurements such as these are not a part of a Medicare Supplement plan. Medicare Advantage plans are given a score called a star rating, and Aetna’s national plan received 4 out of 5 stars in 2020. This means our plan is highly rated on important measures such as:
- Member satisfaction and service
- Helping you stay healthy, and
- Helping you manage your long-term conditions
Our mission is dedicated to health. The Aetna plans are designed to build a healthier world — and we know this is especially important in retirement. We also want to simplify the health care experience and help you reach your full potential in life, however you define it.
We think you’ll find that the Aetna Medicare Advantage plans are different than plans you might be used to, and we’ll show you how easy to use they are.
Medicare is composed of four main parts:
- Original Medicare consists of Part A and Part B.
- Part A helps with hospital costs.
- Part B helps with doctor and ancillary medical costs.
- Part C and Part D are handled by private insurance companies.
- Part C includes everything covered under parts A and B, and it also includes many extra benefits beyond Original Medicare.
- Part D plans help pay for prescription drug benefits.
- “Supplement” plans are sold by private insurance companies and help cover gaps in Original Medicare. These types of plans are referred to as Supplemental or Medigap plans.
The IAFF-FC plans you can choose are Medicare Advantage plans (which are Part C) with prescription drug coverage (which is Part D).
To better understand the new Aetna Medicare Advantage plans, I want to first give you a quick refresher on how many “traditional” or supplemental plans work. When you see your doctor, you show two ID cards. One, is the red, white and blue Medicare card, and the other is your medical insurance card. Then after each visit, Medicare and the insurance plan pay a portion of the doctor’s claim, and you’ll get at least two Explanations of Benefits. Now, let’s look at how these pieces are different for Medicare Advantage.
Medicare Advantage offers you the convenience of all of your Medicare A and B benefits, so that’s everything you get with Original Medicare. Plus it has many additional benefits, all in one package. To be eligible, you have to be enrolled in Parts A and B and pay your Part B premium. You can only be enrolled in one Medicare Advantage plan at a time.
Again, we want things to be easy. With Aetna Medicare Advantage:
- You only need one ID card for all your medical and pharmacy needs.
- You get more benefits than traditional supplemental plans.
- Care advocacy and wellness benefits are included, and we’ll discuss those shortly.
- You get one monthly Explanation of Benefits for medical and one for prescription drugs.
Keep your red, white and blue Medicare ID card safe, but if you enroll in this plan you would only need to show your Aetna ID card for all medical and prescription drug costs.
Next we’ll talk about seeing your doctors. We know the most important thing for our members when reviewing health plan options is “Will my doctor take this plan?”
Aetna Medicare Advantage PPO plans provide coverage nationwide. Your doctor doesn’t have to be in our network, and you get the same benefits in or out of network. The Aetna plans also cover you when you’re traveling outside the country in case you have an urgent need for medical care. When traveling away from home, Aetna can help you find a doctor that accepts your plan.
Your plan is designed to give you the flexibility to see any provider, whether or not they are in our network. You should know that many doctors do in fact accept Medicare and accept Aetna Medicare Advantage, but there may be some who don’t.
Generally, in a PPO plan you pay more for out-of-network services, but with this type of plan you pay the same cost for any doctor or hospital, according to the costs listed on your plan benefits summary. The provider must be eligible to receive Medicare payment and accept your plan.
At any time, you can call us if you have questions about certain doctors or need help finding a new provider. Just call 1-866-246-8039 (TTY: 711). Our representatives are available Monday – Friday, 8 AM to 6 PM ET. Our Member Services team will be happy to help you, and they even call your doctor’s office on your behalf to confirm whether they will accept our plan.
Now let’s discuss the benefits you get as part of these plans, designed just for retired fire fighters and their spouses.
We’ll review the plans side by side. You’ll see there are four different plans to choose from. On the left are plans where you pay more up front with a higher premium, and on the right are plans where you pay as you use the benefits with copayments or coinsurance. The difference between coinsurance and a copayment is a percentage vs. a flat dollar amount. With coinsurance, you pay a percentage of the total cost for your portion of a 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.
The benefits you see, such as a primary care office visit or inpatient hospital stay, are just some of the commonly used benefits that we offer. You can find a full listing of benefits online at IAFF-FC.AetnaMedicare.com. Or you can call our Member Services number and request a packet with the full plan information in it.
We went over your medical benefits, so now let’s discuss prescription drug benefits.
With each Medicare Advantage plan, you can use over 66,000 network pharmacies nationwide, including over 23,000 preferred pharmacies where you may pay a lower cost for certain prescriptions. You can also get your regular maintenance prescriptions delivered to your home through the CVS Caremark Mail Service PharmacyTM program. Our online tools include a drug lookup tool and a pharmacy finder.
Prescription drug benefits through Medicare Part D can be confusing sometimes. So we want to show you the four different Part D plan phases and what you’ll pay in each phase.
- The deductible phase is first. This is the amount you pay before the plan begins to pay. Your plan may or may not have a deductible, depending on which option you choose.
- Second is the initial coverage limit phase. You will pay a copayment or coinsurance during this phase.
- Third is the coverage gap or “donut hole” phase. In this phase you may pay a different level of copayments or coinsurance. Your plan will have partial or enhanced gap coverage, depending on which you choose.
- Finally, fourth is the catastrophic phase. Very few people reach this phase. You’ll pay a smaller cost share and the plan will pay most of the cost.
Next we’ll look at what you’ll pay with each plan option you have.
Again, you can see the four different plans and what you’ll pay for a deductible and prescription drugs in each tier. The costs are lowest for tier 1, or preferred generic drugs, and they are highest for tier 5, or specialty drugs. If you want to check on the cost of a certain drug, you can call our Member Services number or go online to IAFF-FC.AetnaMedicare.com to begin enrollment and use our drug lookup tools.
We talked about the simplicity of the Aetna Medicare Advantage plans, and we talked about the benefits you’ll get. Now, I’d like to share with you some of the support programs you get with these plans.
We value your total health — physical, emotional and social. We want to help you reach your full potential in life, however you define it. So we want to support you wherever you are on your health journey.
- Our prevention programs remind you of key health screenings and activities to keep you in your best health.
- For those who want to focus on wellness, we have programs that go a step further, such as our Healthy Home Visits. In that program you can have a licensed provider come to your house to review your health needs. We also offer a 24-hour nurse line and the SilverSneakers fitness benefit.
- For those who want to prevent health challenges from getting worse, we have programs to help with complex or chronic conditions such as diabetes and heart disease. We also offer nurse care management, help to prevent you from being readmitted to the hospital, and compassionate care for advanced illnesses.
All of these are included at no extra cost to you. They are intended to complement your current health care benefits and are not meant to replace your relationship with your doctor.
Let’s talk more about a few of the programs we just highlighted. The Healthy Home Visit is completely voluntary. About 400,000 of our members choose to take part in it each year. If you decide to have a visit, a nurse will come to your home to review your health needs and do a home safety assessment. The visit doesn’t replace care from your doctors. Rather, we work with them to help meet your health needs.
- The nurse focuses on safety in your home, does a medication review, and asks about your medical and family history.
- We may recommend any of our support programs that could be helpful for you. We’ll talk about some of these programs next.
- We share the results of your visit with your primary care doctor to help coordinate your care.
- This program is available at no extra cost to you and will help you take advantage of all the benefits available to you.
To help fire fighters who risked their lives daily, we’ve also included extra hearing and vision care for you. You can get a hearing aid reimbursement of up to $2,000 every 36 months and a vision eyewear reimbursement of up to $250 every 24 months.
A popular benefit with an Aetna Medicare Advantage plan is the SilverSneakers fitness program. With this program you get a gym membership to any of over 17,000 locations nationwide. Or if you can’t make it out to the gym, you can have a home fitness kit delivered to you. Visit SilverSneakers.com to learn more or find a location near you.
Another program that’s unique to Aetna is the Resources For Living referral service. The program can connect you with resources in your local community. They can help you find services such as transportation, help around the house, home health care and more. You’d pay the cost of any services you decide to use, but our research is no extra cost to you.
If you like what you’ve heard so far, you’re not alone. Our current members are happy with their plans: 96%* of our Medicare Advantage members said they’re satisfied overall with Aetna Medicare Advantage.
*Q2 2019 Aetna Medicare Advantage plan member satisfaction survey
So what’s next if you want to enroll in an Aetna plan?
So how do you enroll?
- Call Aetna at 1-866-246-8039 (TTY: 711), Monday – Friday, 8 AM to 6 PM ET.
- Or visit IAFF-FC.AetnaMedicare.com where you can enroll yourself online.
The enrollment period has started for the IAFF-FC Aetna Medicare Advantage plans, and it ends December 4, 2020.
If you decide to enroll in an Aetna Medicare Advantage plan, you will receive:
- A plan confirmation letter in November that confirms your enrollment in the Aetna Medicare Advantage plan
- An Aetna ID card in December to use for all your medical and prescription drug needs, and
- An Aetna member handbook in December that includes information to get the most from your new plan. That handbook also includes your Evidence of Coverage with full plan coverage details and explains how to get a provider directory.
On January 1, 2021, your new Aetna plan will begin. That’s when you can start enjoying your new benefits. After January 1, you may get a call to schedule a Healthy Home Visit or be invited to participate in other health programs.
If you have more questions after watching this video, feel free to call us at 1-866-246-8039 (TTY: 711), Monday – Friday, 8 AM to 6 PM ET. Or visit us online at IAFF-FC.AetnaMedicare.com. Again, if you decide to enroll, you need to do so by December 4. Thank you for your time today.
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