Federal Retiree Center

Aetna offers two plans through FEHB, that were designed for federal retirees who also have Original Medicare (Parts A and B). One is the Aetna Advantage plan and the other is Aetna Direct.

By enrolling in Aetna Advantage and then opting in to the Aetna Medicare Advantage plan, you’ll have $0 medical copays and coinsurance, low prescription drug copayments and a $1,200 Medicare Part B credit.

With the Aetna Direct plan, your deductibles and coinsurance are waived for most medical services when Original Medicare is your primary coverage. In addition, you’ll get a fund that you can use to reimburse yourself for your Medicare Part B premium and for out of pocket prescription costs.

And with both of these plans, it’s likely you’ll be able to continue to use your doctors. You can visit any provider that is licensed to receive Medicare payment even if they are not in the Aetna network.

To enroll in Aetna Direct:
Visit the OPM Retirement website retireefehb.opm.gov. Or you can call 1-888-767-6738 (TTY: 1-800-878-5707) Monday through Friday, 9 AM to 6 PM in all time zones.

When using this option, please clearly state your Open Season request. To choose the Aetna Direct Plan, state you would like enrollment code N61 for Self Only, N63 for Self Plus One, or N62 for Self and Family.

To enroll in Aetna Advantage:
Step one: visit the OPM Retirement website retireefehb.opm.gov. Or you can call 1-888-767-6738 (TTY: 1-800-878-5707) Monday through Friday, 9 AM to 6 PM in all time zones.

When using this option, please clearly state your Open Season request. To choose the Aetna Advantage Plan, state you would like enrollment code Z24 for Self Only, Z26 for Self Plus One, or Z25 for Self and Family.

Step two to opt-in to Aetna Medicare Advantage: once you’re enrolled in Aetna Advantage through the OPM Retirement website, your basic information will be transferred to Aetna. (Please allow 7–10 business days.)

Visit AetnaRetireeHealth.com/FEHBP or call us at 1-866-241-0262 (TTY: 711).

We will need the following to complete your enrollment in Aetna Medicare Advantage:

• Your Original Medicare effective date(s)
• Your Medicare Beneficiary ID

Aetna Advantage monthly premium*:

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 Medicare Advantage monthly premium table of rates.

Self Only	Z24	$125.00
Self Plus One	Z26	$275.00
Self and Family	Z25	$331.25

*There is no additional premium to opt-in to the Aetna Medicare Advantage Plan

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Aetna Direct monthly premium:

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 Direct monthly premium table of rates.

Self Only	N61	$160.35
Self Plus One	N63	$351.67
Self and Family	N62	$404.39

Aetna Direct coordinates seamlessly with Medicare so there will be no paperwork for you to fill out or submit. You can see any provider in or out of network, however you should make sure that they are eligible to receive Medicare payment. When you have Original Medicare as your primary coverage, your deductible and coinsurance for most medical services will be waived.

Aetna Medicare Advantage is a Medicare Part C plan. Medicare pays Aetna to administer the plan and cover your claims. You’ll receive a new plan ID card in the mail, so be sure to use it when you get care. It will take the place of your Original Medicare ID card.

Even though you may be switching plans, you may still be able to use your same doctors. Just be sure they are eligible to receive Medicare payment . Your providers do not have to be in the Aetna network.

If you have Aetna Direct and Original Medicare, or if you have the Aetna Medicare Advantage plan, you’ll pay $0 when the provider is eligible to receive Medicare payment .

Most pharmacies have access to our claim system and can determine at the point of sale what your cost sharing is for your covered prescription drug. For a 30 day supply in a retail setting, your share of the cost will be:

Table of rates.

	Aetna Direct	Aetna Advantage
Preferred generics	$6	$2
Non-preferred generics	50% up to $600	$10
Preferred brand	30% up to $600	$40
Non-preferred brand	50% up to $600	$75
Specialty	50% up to $600	25% up to $350

^*Note: By using our mail-order pharmacy, you can save money on prescription costs.

Yes. Mail-order pharmacy is available for maintenance medications (drugs that treat chronic conditions such as diabetes, or heart disease). Your share of the cost for up to a 90-day prescription will be the equivalent of two retail copays.

Table of copays.

	Aetna Direct	Aetna Advantage
Preferred generics	$2	$4
Non-preferred generics	50% up to $200	$20
Preferred brand	30% up to $100	$80
Non-preferred brand	50% up to $200	$150

Also, you can get your 90-day prescription at a CVS Pharmacy® for the same cost as mail order.

Go to our secure member website and click on "pharmacy benefits" for details and forms.

You must live or work in our service area, which is nationwide, to enroll in our plan. Once enrolled in the plan, overseas emergency or urgently needed care is provided for covered medical services. Transportation would not be provided unless a medical transport is required. See Section 7 of the appropriate federal brochure for more information on how to submit overseas claims.

Yes. Aetna Medicare Advantage includes Healthy Home Visits and programs like SilverSneakers^®, meal delivery after a hospital stay and nonemergency transportation to the doctor.