Aetna® Medicare Advantage
A plan designed for Federal Retirees. We’re here to support your well-being because healthier happens together™
Reach your health potential
We value your total health – physical, emotional and social. We want to help you reach your full potential in life; however you define it. And we want to support you wherever you are on your health journey.
What it is:
The Aetna Medicare Advantage plan is a plan offered to eligible members of the Federal Employees Health Benefits (FEHB) program who enroll in the Aetna Advantage Plan. 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 additional benefits you wouldn’t get, such as $0 deductible and excellent prescription benefits. Plus, we will reduce your Medicare Part B premium by $100 per month (up to $1,200/year). 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, as long as they are:
- Eligible to receive payment under Medicare
- Willing to bill and accept payment from Aetna
Visit Enroll Now page
Have questions? Just call Aetna Retiree Solutions at 1-866-241-0262 (TTY:711) . Visit our Enroll Now page to learn how to enroll.
Get a complete Medicare Advantage plan without having to suspend your FEHB coverage. We’ve made it easier by offering them together.
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.
|Aetna Advantage (retirees with Medicare can opt-in to Aetna Medicare Advantage (PPO))||Code||Monthly Premium*|
|Self & Family:||Z25||$331.25|
*Premium will be applied to the Aetna Medicare Advantage or Aetna Advantage plan based on actual enrollment. For Aetna Medicare Advantage, your reported income could require you to pay additional premium to the government. Click here for details.
Switch your plan, not your doctor.
Though you have a new plan option, chances are you may be able to continue seeing your doctors. The Aetna Medicare Advantage plan lets you see any provider (in the network or not), and you pay the same out-of-pocket cost for both covered medical benefits, as long as the provider is:
- Eligible to receive payment under Medicare
- Willing to bill and accept payment from Aetna
- Step 1: After clicking on Find Your Provider, choose ‘2024 Medicare plans through an employer’
- Step 2: Enter your home zip code OR city, state then select from the drop-down
- Step 3: Choose ‘select plan to find providers’
- Step 4: Choose ‘Medicare Advantage with Prescription Drug plan’
- Step 5: Under PPO section – Select ‘Aetna Medicare Advantage PPO Plan with extended service area (ESA)*’
- Step 6: Then choose ‘medical’ and click ‘continue to find care’ at the bottom right of your screen to find providers
*As a member of the Aetna Medicare Plan (PPO) with an Extended Service Area (ESA), you can receive services from any provider that is eligible to receive Medicare payment and is willing to treat you. Your cost share will be the same as in-network care. Out-of-network providers are under no obligation to treat Aetna members, except in emergency situations.
2024 Benefits summary when you select Aetna Medicare Advantage
|Key benefits||What you pay|
|Credit for Medicare Part B||You get up to $1,200 per year ($100 per month)|
|Primary care physician||0%|
|Retail pharmacy (30-day supply of a covered drug)||
Preferred generic: $2
Preferred brand: $40
Non-preferred brand: $75
Specialty: 25% ($350 max.)
|Mail order pharmacy or CVS Pharmacy® (90-day supply of a covered drug)
See Aetnafeds.com/pharmacy for a listing of all participating pharmacies.
Preferred generic: $4
Preferred brand: $80
Non-preferred brand: $150
|Out of Pocket Maximum for prescription drugs||$2,000 per calendar year|
Healthy Home Visit program
An Aetna health professional will provide you with advice in the comfort of your own home. They can also work with your doctor to help coordinate your care.
A health advocate if you need one
You may not need help today, but if you ever do, an Aetna Nurse Advocate can be a key partner in your health journey. They’ll collaborate with your doctors and help you get the most from your health plan benefits.
Help for your health conditionsThey’ll work with your doctor to:
- Create a personal treatment plan for conditions such as diabetes or heart disease
- Connect you to resources you may need
A partner in careThey can handle the challenges of navigating complex medical issues for you such as:
- Managing logistics of transitioning home from the hospital
- Coordinating health and community resources with your doctors
- Helping you and your family with any ongoing concerns
We’re committed to providing you with the resources, tools and support that help ensure you achieve your best health. All of our health advocacy and wellness programs are available to you — at no extra cost.
An overall wellness program that helps you improve your health and live the life you want. The program gives you access to exercise equipment, classes and fun social activities at thousands of locations nationwide.
Teladoc® Health telemedicine
We partner with Teladoc, who has over 700 U.S. board-certified, state-licensed health care professionals†. This virtual option provides you the added convenience of reaching health care providers online, by phone or mobile app.
Hearing aid reimbursement
Hearing aid reimbursement for retirees, to help you engage and communicate with the world around you. Reimbursement is $2,500/ every 36 months.
Resources For Living®
Aetna signature program helps you find the resources you need in your daily life. With just one call, a life consultant can help you find local resources to make life easier and support your physical and mental well-being.
Non-emergency transportation program
A program to help you make it to and from doctors or hospital appointments without always having to rely on family or friends.
Meal benefit program
After an inpatient hospital or skilled nursing facility stay, Aetna offers a meal benefit through our relationship with NationsMarket. The program offers 14 home delivered meals — convenience for when making a meal is a difficult option.
Members will get $30 every 3 months to use towards certain over the counter products. The OTC allowance can be used on items from the OTC catalog from the following categories: pain relief, cough/cold/allergy, first aid, food care, dental, etc. Members can call 1-833-331-1573 (TTY: 711) Monday through Friday, 9 AM to 8PM local time or go online http://www.cvs.com/otchs/myorder. Members can obtain a printed OTC catalog by calling Member Services at the number on your member ID card.Click to view 2024 OTC Product Catalog (PDF)
Aetna Medicare Advantage* requires 2 easy steps for retirees with Medicare Parts A & B:
Enroll as you normally would through the OPM Retirement website https://retireefehb.opm.gov/
Or you can call 1-888-767-6738 (TTY: 1-800-878-5707).
Enroll in Aetna Advantage using enrollment code Z24, Z26 or Z25.
Provide Aetna with your Medicare information to opt-in to Aetna Medicare Advantage. Once you are enrolled through the OPM site, your basic information will be transferred to Aetna. (Please allow 7–10 business days.)Then we will need the following to complete your enrollment in Aetna Medicare Advantage:
- Your original Medicare effective date for Parts A & B
- Your Medicare Beneficiary ID
You may go to www.aetnaretireehealth.com/FEHBP or call us at 1-866-241-0262 and give us this information. If you are over age 65, we’ll send you a reminder postcard.
For more information
Call Aetna Retiree Solutions at 1-866-241-0262 (TTY:711) or Connect live with our team at aetnafedslive.com
*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).
Need more information?
If Medicare Parts A & B are not your primary coverage (for example, you are an active employee or retired without Medicare Parts A and B), you will be responsible for the deductible and coinsurance. For coverage details on the Aetna Advantage plan without Medicare, please visit our plan brochure. Please see the Medicare Advantage plan benefits guide (PDF) for coverage details on the Aetna Medicare Advantage Plan.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Aetna Resources For Living℠ is the brand name used for products and services offered through the Aetna group of subsidiary companies (Aetna). The EAP is administered by Aetna Behavioral Health, LLC. and in California for Knox-Keene plans, Health and Human Resources Center, Inc.
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.
Teladoc® is not available to all members. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. Visit Teladoc.com/Aetna for a complete description of the limitations of Teladoc services. Teladoc, Teladoc Health and the Teladoc Health logo are registered trademarks of Teladoc Health, Inc. DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge on products and services offered by third-party vendors and providers. Aetna makes no payment to the third parties — you are responsible for the full cost. Check any insurance plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts. 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. Aetna's Drug Guide is subject to change. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Information is believed to be accurate as of the production date; however, it is subject to change.
Aetna Medicare is an HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat Aetna members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. The formulary, provider and/or pharmacy network may change at any time. You will receive notice when necessary. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7-10 days. You can call 1-888-792- 3862, (TTY users should call 711) 24 hours a day, seven days a week, if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery. 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. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.