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Aetna Medicare Advantage

A plan designed for Federal Retirees that focuses on the whole you – body, mind and spirt.

Reach your health potential

You’re still out there chasing what matters. At Aetna, we believe in the need to take care of the whole you — body, mind and spirit. That’s why we take a total approach to health and wellness, so you can age actively.

What it is:

The Aetna Medicare Advantage PPO with an extended service area (ESA) is a plan offered to eligible members of the Federal Employees Health Benefits (FEHB) program. It’s a nationwide plan that takes a total approach to your health by covering your doctors, hospitalization and prescription drugs in one simple plan.

How it works:

You’ll continue to pay your Part B premium with the Aetna Medicare Advantage plan. It provides the same coverage as Original Medicare but with extra benefits you wouldn’t get, such as $0 deductible and excellent prescription benefits. You’ll also get access to programs that may help you reach your health potential, such as SilverSneakers® fitness membership and more.

And you can continue to use your doctors — or any provider that is licensed to receive Medicare payment and is willing to accept the Aetna plan.

Get a comprehensive Medicare Advantage plan without having to suspend your FEHB coverage. We’ve made it easier by offering them together.

2020 Rates

These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
Table of rates.
Aetna Medicare Advantage – Monthly* Code Non-Postal
Self Only: Z24 $115.96
Self +1: Z26 $255.11
Self & Family: Z25 $307.29

*Premium will be applied to the Aetna Medicare Advantage or Aetna Advantage plan based on actual enrollment

Switch your plan, not your doctor.

Though you have a new plan option, chances are you may be able to continue seeing your doctors. This is because your new plan option is the Aetna Medicare Plan (PPO) with an extended service area (ESA). This is a type of Medicare Advantage plan. With this type of plan you pay the same cost for any doctor or hospital, according to the costs listed on the plan benefits summary. The provider must be eligible to receive Medicare payment and accept the Aetna plan.

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2020 Benefits summary when you select Aetna Medicare Advantage

Table of rates.
Key benefits What you pay
Deductible $0
Primary care physician 0%
Specialist 0%
Coinsurance 0%
Telehealth $0
Preventive Health $0
Surgical care 0%
Inpatient/outpatient hospital 0%
Retail pharmacy (30-day supply of a covered drug) Preferred generic: $2
Generic: $10
Preferred brand: $40
Non-preferred brand: $75
Specialty: 25% ($350 max.)
Mail order pharmacy (90-day supply of a covered drug Preferred generic: $4
Generic: $20
Preferred brand: $80
Non-preferred brand: $150
You might save by using mail order. You’ll pay only two copay amounts for a 90-day supply.

*By choosing this plan, retired enrollees age 65 and over agree that you have or will have Medicare Parts A and B by your effective date. You agree that you will be enrolled in our Aetna Medicare Advantage plan. We may need more information to enroll you in this plan prior to your effective date. If this is not completed, your benefits will be significantly impacted (i.e., $2,000 deductible not waived and you will pay 30% coinsurance on most services).

If Medicare Part A & B are not your primary coverage (for example, you are an active employee or retired without Medicare A&B), you will be responsible for the deductible and coinsurance. Please see the Medicare Advantage plan benefits guide (PDF) for coverage details.

*If you are covered by Medicare Part B and it is primary, your out-of-pocket costs for services that both Medicare Part B and we cover depend on whether your physician accepts Medicare assignment for the claim.

If your physician accepts Medicare assignment, then you pay nothing for covered charges.

If your physician does not accept Medicare assignment, then you pay the difference between the "limiting charge" or the physician's charge (whichever is less) and our payment combined with Medicare's payment.

Health insurance plans are offered, underwritten and/or administered by Aetna Life Insurance Company (Aetna).

This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the Plan's applicable Federal brochure(s). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. Plan features and availability may vary by location and are subject to change. Pharmacy clinical programs such as precertification, step therapy, and quantity limits may apply to your prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Discount programs are neither offered nor guaranteed under our contract with the FEHB Program, but are made available to all enrollees and their families who become members under an Aetna Health Insurance Plan. Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Information is believed to be accurate as of the production date; however, it is subject to change.

All Aetna plans include discounts on eyewear, LASIK eye surgery, gym memberships, massage therapy, acupuncture, weight-loss programs and more.

For information about our plans available through the Federal Employees Dental and Vision Insurance Program (FEDVIP), please visit our Dental PPO Plan site or our Aetna Vision Preferred site.

Postal and Non-Postal rates

  • Non-Postal rates apply to most non-Postal employees.
  • Postal rates apply to United States Postal Service employees
  • Postal Category 1 rates apply to career bargaining unit employees represented by the APWU, IT/AS, NALC and NPMHU.
  • Postal Category 2 rates apply to career bargaining unit employees represented by the NALC, NPMHU and PPO.
  • Non-Postal rates apply to all career non-bargaining unit Postal Service employees and career employees represented by the NRLCA agreement.
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