Reach your health potential
At Aetna, we believe in the need to take care of the whole you -- body, mind and spirit. With an Aetna retiree plan, you can enjoy a total approach to health and wellness, so you can age actively.
Video Transcript
Choosing the right plan
{Voice over}Picture this...
You’re out to dinner with a friend, and you order the same exact meal. But when your bills arrive, yours is $30 more than your friend’s bill.
That’s what can happen if you’re not careful about your health benefit plan choice. You can end up paying more for the same coverage.
So, it’s time to do some research into your Federal Employees Health Benefits (FEHB) Program options.
Let’s start with the basics. In most cases, turning 65 is when you become eligible for Medicare. Medicare Parts A and B are also called Original Medicare.
When you retire, and if you keep your FEHB plan, Medicare will become your primary health plan. That means Medicare pays most of your medical expenses.
What about the rest of your expenses? That’s where your secondary plan comes in — your FEHB plan. Many federal retirees simply keep the FEHB plan they had while they were working. Now that might seem like the best option, and it’s the easy one, but let’s take a closer look...
When you’re retired and enrolled in Original Medicare, your FEHB plan becomes secondary. That means Medicare will pay your health care expenses first, and your FEHB plan may cover extra costs not covered by Medicare.
[on screen text] Original Medicare has a deductible and only covers about 80% of your Part B services.
But you’re still responsible for paying your full FEHB premium, even though Medicare is your primary coverage
Luckily, there are other options. Since 2015, Aetna has offered a nationwide plan with low premiums that’s tailored to Federal retirees with Medicare Parts A and B.
And in 2020 we began offering a Medicare Advantage Plan
With an Aetna plan, there’s a good chance you can keep your doctors, lower your out-of-pocket costs, and you’ll even receive some reimbursement to help pay your Medicare Part B premiums.
Our Aetna Medicare Advantage plan even include extras like SilverSneakers® fitness classes and home-delivered meals after a hospital stay.
Be sure to check out our other videos, which explain the differences between the Aetna Direct Plan and Aetna Medicare Advantage Plan – and see what works for you! Or connect directly with one of our specialists to explore your options.
Your guide to 65 and beyond
Whether you’re turning 65, getting ready to retire, or would like to take advantage of your opportunity to change your health plan, we’re here to help. You might have questions, or not know where to start. That’s why we’re providing you with this information — to help you make educated decisions.
Our mission is to fit into your life – the way you want, when you want. We look forward to hearing from you.
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Aetna Medicare Advantage » Aetna Direct »Video answers to your Federal retirement questions
The most popular Federal retirement questions answered by the Aetna Federal team.
Read the latest on making the most of your retiree benefits

Welcome to your blog
Hello. Welcome to the Aetna Retirement Resource Center blog. My name is Rick Tapnio. I’m a Relationship Manager with the Aetna Federal Plans team...
Read article »Top 10 Retiree FAQs
Frequently Asked Questions – answered.
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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.
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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
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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
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.
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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.
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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 .
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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.
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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.
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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.
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Yes. Aetna Medicare Advantage includes Healthy Home Visits and programs like SilverSneakers®, meal delivery after a hospital stay and nonemergency transportation to the doctor.
Aetna Medicare is an HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Aetna Medicare’s pharmacy network includes limited lower cost, preferred pharmacies in all areas. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp. 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 10-14 days. You can call the number on the back of your ID card 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. The formulary, pharmacy network, and provider network may change at any time. You will receive notice when necessary. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. 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. 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.
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).
Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to AetnaFeds.com.
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