Aetna Medicare Advantage Health Plan
Click on a question. Get an answer.About the Plan
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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. The Aetna Advantage Plan with the Aetna Medicare Advantage option offered through the Federal Employees Health Benefits (FEHB) program is a nationwide plan that takes a total approach to your health. This plan offers value to federal retirees with Medicare Parts A and B by offering $0 deductibles, robust prescription drug coverage, a credit that reduces Part B premiums, and access to additional programs and services such as home health visits, meals, transportation and a SilverSneakers® fitness membership.
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Federal Retirees with Medicare Parts A and B will continue to pay Part B premiums 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 deductibles and prescription benefits. You’ll also get access to programs that can help you reach your health potential, including SilverSneakers® fitness membership, hearing aid reimbursement and more.
The plan also includes a credit that reduces your Medicare Part B premiums by $75/month (up to $900/year)
You can see any provider that is licensed to receive Medicare payment.
Selecting the Aetna Medicare Advantage plan does not change your FEHBP premium or enrollment code. Retirees with Medicare Parts A and B may elect to join the Aetna Medicare Advantage plan by following the two-step enrollment process.
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Aetna Medicare Advantage is a great plan for federal retirees who are looking for a plan to help them on their health journey - body, mind, and spirit. Members who have Medicare Parts A and B as their primary coverage will have no deductible, low prescription costs, and a way to help lower your Medicare Part B premiums. The special programs included in the Aetna Medicare Advantage Plan are home health visits, an Aetna care advocate, and a SilverSneakers® fitness membership, which allows you to take control of your health while you keep moving and age actively.
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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.
*There is no additional premium to opt-in to the Aetna Medicare Advantage PlanPremiums for the Aetna Advantage Plan*: Monthly Rates Enrollment Code Non-Postal Self Only Z24 $125.00 Self Plus One Z26 $275.00 Family Z25 $331.25 -
No. This Aetna Medicare Advantage plan is a special offering that is available to you if you enroll in Aetna Medicare Advantage through the FEHB program and have Medicare Parts A and B. While it is a Medicare Part C plan, to receive benefits under the Aetna Medicare Advantage Plan, you do not suspend your FEHB plan.
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You will initially receive an ID card as a member of Aetna Advantage. After you complete the two-step enrollment process, you will receive a second ID card which indicates you are in our Medicare Advantage PPO plan. You should always present the Aetna Medicare Advantage PPO card when asked for insurance information.
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You have several options:
- Chat live with a health plan specialist or schedule an appointment for a one-on one phone consultation at AetnaFedsLive.com
- Visit AetnaFeds.com/Advantage
- Review the Federal Plan brochure and other information on this website
- Call Aetna at 1-855-277-4356 (TTY:711)
Enrollment
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All eligible federal retirees with Medicare Parts A and B who are interested in a plan that works to provide great coverage by taking a total approach to your health. All eligible federal employees are also able to enroll. However, without Medicare Parts A and B as primary, deductibles and coinsurance will apply. In addition, you must live or work in our service area to enroll.
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Aetna Medicare Advantage requires two easy steps for Retirees with Medicare Parts A and B:
Step 1: Enroll as you normally would through the OPM Retirement website 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.
Step 2: Provide Aetna with your Medicare information to opt-in to Aetna Medicare Advantage. Once you are enrolled through the OPM Retirement website, your basic information will be transferred to Aetna. (Please allow 7–10 business days.) We will need the following to complete your enrollment in Aetna Medicare Advantage:
- Your original Medicare effective date for Parts A and B
- Your Medicare Beneficiary ID
You may go to AetnaRetireeHealth.com/FEHBP or call Aetna at 1-866-241-0262 (TTY:711) and provide us with this information.
If you are not retired, you will need to follow the procedure followed by your agency. Detailed instructions and information are available at AetnaFeds.com/Enroll-Now.
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Since Aetna Medicare Advantage is a Medicare Part C plan, we need your Medicare information to complete your enrollment per CMS regulations. Providing us with your Medicare information will allow us to enroll you in the Aetna Medicare Advantage plan.
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Coverage and 2022 benefit changes for current members and annuitants begins on January 1, 2022. Coverage for new Aetna members who are actively employed joining during Open Season becomes effective on the first day of the first pay period in January 2022.
If you enroll as a newly hired Federal Employee, you have 60 days to enroll in a Federal Employees Health Benefits (FEHB) plan. Your enrollment will become effective the beginning of the pay period after your enrollments received.
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If you do not receive your ID card by your effective date, you may use a copy of your electronic enrollment confirmation. If you are enrolled in our system, you may register on our member website and print an ID card. After you register, simply click on "Get an ID card" and follow the instructions. You may use this printable version of your personal ID card if you need medical or dental care.
Doctors and Networks
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No, with the Aetna Medicare Advantage plan, the provider must be a Medicare participating provider or accept Medicare assignment. There is a good chance that you may be able to continue seeing your current health care providers.
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You can search for providers who participate with Medicare or accept Medicare Assignment on Medicare's website. Please visit Medicare.gov/PhysicianCompare to search near you. You can filter provider results by distance, gender, and hospital affiliation.
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Yes, you can visit a MinuteClinic® for urgent care with a $0 copay.
Pharmacy
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Just like with any other Aetna plan, the pharmacy you visit has access to Aetna's claim system and can determine what your cost sharing is for your covered prescription drug. In other words, they will tell you what you will owe for any prescription you have filled. If you are enrolled in the Aetna Medicare Advantage plan, your prescription copays for a 30-day supply are:
$2 per covered generic formulary drug
$10 per covered generic drug not on the formulary
$40 per covered brand name formulary drug
$75 per covered brand name drug not on the formulary
25% for specialty drugs ($350 maximum)
If you are not enrolled in the Aetna Medicare Advantage plan, the formulary and the cost of your prescriptions is different. You can see the plan brochure for details.
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Yes, mail-order pharmacy is available for maintenance medications. Your share of the cost for a 90-day prescription will be the equivalent of two retail copays.
Go to our member website and click on "pharmacy benefits" for details and forms.
What will I pay?
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Aetna Medicare Advantage is a Medicare Part C Plan. Medicare pays Aetna to administer the plan and cover your claims. Aetna Medicare Advantage provides all the benefits of Medicare Advantage and allows you to keep FEHB coverage. Once you are enrolled, you do not need to do anything, but be sure you use your Aetna Medicare Advantage ID card that you receive in the mail when you get care.
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Once you have completed the 2-step enrollment process, Medicare will have the necessary information to reduce your Part B premium. Your Social Security account will be credited $75 per month (up to $900 a year). If you pay your premium on a quarterly, semi-annual, or annual basis, you will see a reduction in your premium in the amount equal to the number of months.
While unlikely, it may take a few months to see the credit to either your Social Security check or premium statement, but you will be reimbursed for any credits you did not receive during this waiting period.
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If you have Medicare Parts A and B, you pay nothing when you visit a Medicare participating provider, or a provider that accepts Medicare assignment.
Dental and Vision
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Aetna Medicare Advantage does not include dental coverage.
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Routine eye exams are covered in-network at 100%
Member Perks
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Our member website is packed with health and benefits information. When you register, you can print temporary ID cards, check eligibility or claim status, and much more. Here are just a few of the highlights:
Cost estimator tools - Provides personalized cost information. You can estimate how much you’ll pay out of pocket for medical tests, office visits and procedures ahead of time. If Medicare is your primary coverage, these estimates may not be representative of your actual costs.
Hospital Comparison Tool – see how hospitals in your area rank by factors important to you.
Personal Health Record - A private and secure online tool that captures important health information in one place, helping you stay healthy with personalized alerts and reminders and allowing you to print and share your health history with your doctors.
Our provider search tool – helps you find doctors, hospitals and other providers that accept your plan. Using in-network providers will help you save money. The provider search tool also includes important provider credentials like education, board certification and languages spoken.
Aetna Mobile App™ - Puts Aetna's online features at your fingertips. It allows you to view your member ID card, find a doctor, look up claims, and access your Personal Health Record (PHR). The app is available on the App Store and Google Play. Just type Aetna.com into your mobile web browser.
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We’re committed to providing you with the resources, tools and support that help ensure you achieve your best health. All our health advocacy and wellness programs are included with your plan for no additional charge. Most of these programs are only available if you have selected the Medicare Advantage plan.
SilverSneakers®: An overall wellness program that may help 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®: Over 700 U.S. licensed doctors that you can meet with online, by phone or mobile app. (Available for all Aetna Medicare Advantage members.)
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 $2,500/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 treat your entire health, including your social and mental well-being.
Non-emergency transportation program: A program that ensures you make it to and from doctor or hospital appointments without always having to rely on family or friends.
Meal benefit program: Aetna offers a meal benefit through our relationship with GA Foods for members recently discharged from the hospital. The program offers 14 home delivered meals; convenience for when making a meal is a difficult option.
Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.
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All members have access to Teladoc, a convenient, lower-cost alternative to urgent care or the emergency room. Teladoc lets you access board-certified doctors by web, phone or mobile app in under 10 minutes. It's perfect for when you're traveling or when your doctor isn't available. Members simply visit Teladoc.com/Aetna or call 1-855-Teladoc to get started.
Teladoc doctors prescribe medical treatment for a wide range of conditions including cold & flu, Pink Eye, skin rash and stress/anxiety. They can even call in a prescription to your pharmacy of choice, when necessary. All Teladoc doctors:
- Are U.S. board certified internists, state-licensed family practitioners, and pediatricians licensed to practice medicine in the U.S.
- Are U.S. residents
Consultations are $49 or less for most services, depending on your plan, and do not require a referral. When you are enrolled in Aetna Medicare Advantage (MAPD) your Teladoc copay is $0.
Please note: 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.
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You must live or work in our service area to enroll in our plan. Return to the homepage to find plans available in your area. Once enrolled in the plan, covered medical services received overseas would be considered out-of-network. See Section 7 of our federal brochure for more information on how to submit overseas claims.
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Yes. You get access to great discounts on prescription eyewear, vision services, gyms, weight loss programs, chiropractic, acupuncture, massage, vitamins, electric toothbrushes, gum, mints, and more! Visit AetnaFeds.com/Perks for more information.
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 LivingSM 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.
Aetna Medicare is an HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. 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. 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.
All trademarks and logos are the intellectual property of their respective owners.
External websites links are provided for your information and convenience only and does not imply or mean that Aetna endorses the content of such linked websites or third-party services. Aetna has no control over the content or materials contained therein. Aetna therefore makes no warranties or representations, express or implied, about such linked websites, the third parties they are owned and operated by, and the information and/or the suitability or quality of the products contained on them.
Estimated costs are not available in all markets or for all services. We provide an estimate for the amount you would owe for a particular service based on your plan at that very point in time. It is not a guarantee. Actual costs may differ from an estimate for various reasons including claims processing times for other services, providers joining or leaving our network or changes to your plan. Health maintenance organization (HMO) members can only get estimated costs for doctor and outpatient facility services.
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.
Discount vendors and providers are not agents of Aetna and are solely responsible for the products and services they provide. Discount offers are not guaranteed and may be ended at any time. Aetna may get a fee when you buy these discounted products and services.
Vision care providers are contracted through EyeMed Vision Care. LASIK surgery discounts are offered by the U.S. Laser Network and Qualsight.
Natural products and services are offered through ChooseHealthy®, a program provided by ChooseHealthy, Inc. which is a subsidiary of American Specialty Health Incorporated (ASH). ChooseHealthy is a registered trademark of ASH and is used with permission.
Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.
Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor.
Google Play and the Google Play logo are trademarks of Google LLC.
Apple, the Apple logo, [iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple, Inc.
