Aetna Medicare Value Plan HMO POS Benefits and Costs

The Aetna Medicare Value Plan HMO POS is a Medicare Advantage plan that offers a range of benefits and costs. This plan is designed to provide more comprehensive coverage than Original Medicare.

Out-of-pocket costs for this plan are relatively low, with a maximum out-of-pocket limit of $6,700 per year. This limit includes deductibles, copays, and coinsurance for all covered services.

Network providers are an essential part of this plan, with a large network of primary care physicians and specialists available to members. Members can choose from several different network providers, depending on their location and preferences.

The Aetna Medicare Value Plan (HMO-POS) is a reliable option for those seeking affordable healthcare coverage. This plan is offered by Aetna Medicare.

The plan has a $0.00 health plan deductible, which means you won't have to pay out-of-pocket for medical expenses right away. The maximum out-of-pocket (MOOP) cost for in-network services is $4,950.

Here's a quick breakdown of the plan's key features:

To enroll in the plan, you'll need to submit an application within 30 days of receiving your eligibility letter.

The application process is straightforward and can be completed online or by mail.

You'll need to provide proof of citizenship or eligible immigration status, as well as proof of income and family size.

The plan's open enrollment period typically runs from November 1 to December 15 each year.

During this time, you can enroll in or change your plan without needing to provide evidence of a qualifying life event.

Aetna Medicare Value (HMO-POS) offers a range of health care services and medical supplies, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Chiropractic services are covered with a copayment of $15, $20, or $20, depending on the plan.

Diabetes supplies, training, and monitoring are covered with 0% or 20% copayment, depending on the supplier.

Diagnostic tests, lab services, and radiology services are covered with $0 or $25 copayment for certain services, and $200 or $250 copayment for more complex imaging.

Here's a breakdown of the copayment costs for diagnostic services:

Home health care is covered with $0 copayment.

Doctor visits are an essential part of maintaining your health. You can see an in-network specialist for a $20 copay per visit, with no need for authorization or a referral.

If you're seeing a specialist, it's good to know that you won't have to jump through hoops to get an appointment. This copay applies to each visit, so you'll pay $20 every time you see your specialist.

Here are some details about specialist visits:

Remember, a $20 copay is a small price to pay for peace of mind and good health.

Preventive Health Education Programs are a vital part of maintaining good health. They are covered in-network with a $0 copay for all preventive services covered under Original Medicare.

You can access these programs through your healthcare provider, and they're a great way to stay on top of your health. Some examples of preventive services include screenings, vaccinations, and health counseling.

Here are some specifics about the costs associated with these programs:

Note that some plans may have different costs or restrictions, so it's always a good idea to check your specific plan details.

Mental health services are crucial for maintaining overall well-being, and understanding the costs involved can help you plan accordingly.

In-network inpatient hospital stays for psychiatric issues can be quite expensive, with a daily rate of $270 for the first 8 days. After that, you won't be charged for the remaining 82 days, but you'll still need authorization.

You'll need authorization for out-of-network inpatient hospital stays as well, but the costs aren't specified. It's worth noting that a referral isn't required for either in-network or out-of-network stays.

Outpatient group therapy visits with a psychiatrist can cost $40 with an in-network provider, and you'll still need authorization. The same goes for individual therapy visits with a psychiatrist.

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In-network outpatient group and individual therapy visits without a psychiatrist are also $40 with a copay, and authorization is still required.

Here's a breakdown of the costs for in-network mental health services:

The Aetna Medicare Value Plan HMO POS offers great dental and vision benefits that can save you money and keep you healthy. You can get preventive dental services like oral exams, cleanings, and x-rays for $0 out of pocket from in-network providers.

The plan also covers comprehensive dental services like restorative services, endodontic services, and oral and maxillofacial surgery for $0 out of pocket from in-network providers. Out-of-network, you'll pay 50% of the cost for these services.

You have a $1,250 benefit amount every year for covered preventive and comprehensive dental services, both in and out of network. This can be used for services like dental exams, cleanings, and fillings.

Here's a breakdown of the dental benefits:

For vision benefits, you can get eye exams, eyewear, and contacts for $0 out of pocket from in-network providers. You'll also get a $175 benefit amount every year for non-Medicare covered prescription eyewear.

Dental Benefits are an essential part of any health insurance plan, and ours is no exception. We cover a wide range of dental services, both in-network and out-of-network.

For in-network providers, preventive dental services such as oral exams, cleanings, and x-rays are covered at $0 cost. Comprehensive services like restorative, endodontic, and periodontic services are also covered at $0 cost, as well as oral and maxillofacial surgery and adjunctive services.

In-network, you can get a range of services without paying a dime, from routine cleanings to more complex procedures.

Here's a breakdown of the costs for out-of-network providers:

You have a $1,250 benefit amount every year, both in-network and out-of-network, for covered preventive and comprehensive dental services.

Vision benefits are a crucial part of your overall health and wellness, and we're happy to break down what's covered and what's not.

You'll get eye exams for free from in-network providers, whether you're covered by Medicare or not.

For Medicare-covered prescription eyewear, you won't have to pay a dime for your glasses, contacts, or eyeglass frames and lenses.

Non-Medicare covered prescription eyewear also comes with a $175 benefit amount (allowance) reimbursement every year, so you can upgrade your glasses or contacts without breaking the bank.

Here are the details on what's covered for non-Medicare covered prescription eyewear:

The Aetna Medicare Value (HMO-POS) plan offers a range of costs and coverage options. The monthly deductible is $590, and the out-of-pocket maximum is $3600 for in-network services.

You'll also find that the plan has an initial coverage limit of $2000, which means you'll pay a certain amount out-of-pocket before the plan kicks in. This can be a helpful way to budget for medical expenses.

Here are some key costs and coverage details at a glance:

Inpatient hospital care costs $310 per day for days 1-6, and $0 per day for days 7-90. This can be a significant cost savings for longer hospital stays.

When visiting an outpatient hospital, you'll want to know what to expect in terms of costs and coverage.

If you're seeing an in-network doctor, your copay for a visit will be between $0 and $325, and you'll need to get authorization before your visit.

In-network visits typically don't require a referral, so make sure to check with your insurance provider about any specific requirements.

If you see an out-of-network doctor for non-routine services, you'll be responsible for 20% of the bill, and there may be limits on how much you'll need to pay.

For diagnostic services and extractions, the out-of-network coinsurance is also 20%, and limits may apply.

Here's a quick breakdown of the costs for out-of-network services:

Inpatient Hospital costs can be broken down into two parts: in-network and out-of-network.

For in-network care, you'll pay $325 per day for the first six days.

After the initial six days, in-network care is covered for the next 84 days with no daily payment required.

Basic Costs are a crucial aspect of understanding your healthcare plan. The monthly deductible is a flat rate of $590.

If you need medical attention, you'll be happy to know that primary care doctor visits are covered at no cost. Specialty doctor visits, however, have a copayment of $30 for services provided in-network, but only $0 for services provided in a nursing home.

Inpatient hospital care can be expensive, but the cost is capped at $310 per day for the first six days, and then it's free for the next 84 days. Urgent care visits have a copayment of $30, while worldwide urgent coverage has a copayment of $140.

Emergency room visits have a copayment of $140, but if you're admitted to the hospital within 24 hours, your cost share may be waived. Ambulance transportation costs $295.

Here's a breakdown of the costs:

The Aetna Medicare Value (HMO-POS) plan offers prescription drug coverage with varying annual drug deductibles.

The deductible for this plan is $450 per year, excluding Tiers 1 and 2.

You can also get this plan with a deductible of $590 per year, excluding Tiers 1 and 2.

For some people, the drug deductible is $0.00, which means they don't have to pay anything out-of-pocket for prescription drugs.

The Initial Coverage Limit for this plan is $5,030.00, after which the Catastrophic Coverage Limit kicks in at $8,000.00.

The plan provides Enhanced Alternative drug benefit type and Additional Gap Coverage is available.

Here's a breakdown of how the Low-Income Subsidy (LIS) impacts the Part D premium of this plan:

The Aetna Medicare Value Plan (HMO-POS) offers a comprehensive drug coverage plan with various cost-sharing options.

The plan has a $0.00 drug deductible, which means you won't have to pay anything upfront for your prescription medications.

The initial coverage limit is $5,030.00, after which the catastrophic coverage limit of $8,000.00 kicks in.

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This plan provides enhanced alternative drug benefit type, offering additional coverage for those who need it.

You can find the plan's formulary, which lists the specific drugs covered, by following the link provided.

The plan also offers additional gap coverage, which helps bridge the gap between the initial and catastrophic coverage limits.

Here's a breakdown of the LIS (Low-Income Subsidy) impact on the Part D premium of this plan: