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.
Visit Enroll Now page »
Have questions? Just call Aetna Retiree Solutions at 1-866-241-0262. Visit our Enroll Now page to learn how to enroll.
Get a comprehensive Medicare Advantage plan without having to suspend your FEHB coverage. We’ve made it easier by offering them together.
2020 RatesThese 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 Medicare Advantage – Monthly*||Code||Non-Postal|
|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.Find your provider »
- Step 1: After clicking on Find your provider, choose ‘2020 Medicare plans you through your 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 Plan (PPO) 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.
2020 Benefits summary when you select Aetna Medicare Advantage
|Key benefits||What you pay|
|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 (90-day supply of a covered drug||
Preferred generic: $4
Preferred brand: $80
Non-preferred brand: $150
Healthy home visit
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 comprehensive 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 to you.
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.
†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 access the tools you need to engage and communicate with the world around you. Reimbursement is $2,000/ 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 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 a hospital stay, Aetna offers a meal benefit through our relationship with GA Foods. The program offers 14 home delivered meals — convenience for when making a meal is a difficult option.
†Teladoc is not available to all members and operates subject to state regulation. Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna or plans administered by Aetna. For complete description of the limitations of Teladoc services, visit Teladoc.com/Aetna.
Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.
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 using enrollment code Z24, Z26 or Z25.
Provide Aetna with your Medicare information. Once you are enrolled through the OPM site, your basic information will be transferred to Aetna. (Please allow 7–10 business days.)In addition, 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 our Retiree Solutions service center at 1-866-241-0262 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?
Download plan benefits guide »
Click here to download the Medicare Advantage plan benefits guide (pdf)
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.
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.