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Healthy Benefits Plus/aetna Medicare

Reduced Early Pension Benefit

2023 Aetna MAPD Sales Presentation

If you retire at age 55 with at least 10 years of credited service and/or vesting service with a contributing employer, you are eligible for:

The Early Retiree Dental Plus Plan, which includes a dental benefit of up to $3,000 per year, a hospital indemnity plan, which pays $200 per day, up to 10 days per hospital stay, and a vision benefit

The Early Retiree Prescription Plan, which includes prescription drug coverage, and vision and hearing benefits.

If you retire between ages 60 and 64, you will receive the same retiree health benefits that members retiring with a Normal Pension Benefit receive when you reach age 65 and are Medicare-eligible.

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 this plan is the Aetna Medicare Advantage Plan. 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.

Instructions on how to use Aetna Medicare Advantage provider search »
  • Step 1: After clicking on Find your provider, choose 2023 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 with Extended Service Area *
  • 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 with an Extended Service Area , 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.

Robust Standalone Prescription Drug Plans With Lower Copays

The Aetna standalone prescription drug plans serve 6.1 million members. In 2023, Aetna Medicare will continue to offer three individual, standalone plans. SilverScript SmartRx will be renamed SilverScript SmartSaver in 2023 and will feature an average monthly premium of $5.92, along with $10 copays for select insulins at preferred pharmacies. SilverScript Choice will be available to members with full Extra Help for a $0 monthly plan premium in all 50 states and D.C., while SilverScript Plus has the most robust prescription drug coverage of our PDPs. All three plans are available in all 50 states and D.C and feature increased formulary coverage from 2022.4

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Preventive Services And Health/wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage
Preventive services and health/wellness education programs $0 copay for all preventive services covered under Original Medicare at zero cost sharing

When reviewing Florida Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary includes your drugs.

You may be able to find plans in your part of Florida that offer similar benefits at similar or lower prices than the plan above. Call TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Find The Right Medicare Plan For You

Aetna Health Insurance Plans Virginia / Employer Group Health Insurance ...

Medicare can be confusing. Medicare Parts A and B only cover so much. We can provide some information to your questions like:

  • When am I eligible for Medicare?
  • How and when do I sign up?
  • How is it different from Original Medicare?
  • Which plan has the best coverage for me?
  • Are my doctors, hospitals and prescriptions covered?
  • Are there any plans with low or no monthly plan premiums?

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What Items Are Covered With My Grocery Plus Benefit

We are pleased to offer a wide range of items to help with healthy eating: fresh fruits and vegetables, canned fruits and vegetables, frozen produce and meals, fresh salad kits, dairy products, meats, seafood, beans and legumes, pantry staples , healthy grains , nutritional shakes and bars, soups, and water/vitamin water.

Expanded Medicare Advantage Plans To Meet Diverse Needs

More than 3.2 million Medicare beneficiaries are currently enrolled in an Aetna Medicare Advantage plan, which often includes valuable benefits, such as prescription drug coverage, dental, vision, hearing and fitness. To keep plans affordable, Aetna continues to offer many $0 premium plan options. Aetna estimates 84% of the Medicare-eligible beneficiaries in the U.S. will have access to a $0 monthly premium Aetna MA plan.1

For 2023, Aetna is offering Medicare Advantage Prescription Drug plans in 46 states plus Washington, D.C. Aetna added 141 new counties across the country, providing 1 million more Medicare beneficiaries access to an Aetna plan. In total, Aetna will offer MAPD plans in 2,014 counties in 2023, accessible by 55 million Medicare beneficiaries.2

For those who qualify for both Medicare and Medicaid benefits, Aetna expanded its Dual Eligible Special Needs Plan offerings across 30 states, including new markets in South Carolina, South Dakota and Utah, and new PPO plan options in Georgia and South Dakota. All plans offer prescription drugs at no out-of-pocket cost and additional benefits for members who qualify for Low-Income Subsidy . Coverage varies by plan and may include healthy foods, utilities, over-the-counter items, additional transportation, companionship and fall prevention benefits.

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Not Helpful At All Fed Up

You can not use the card in Walmart stores at all, you must do a phone order or a mail order. Tried to order by phone first using the catalog sent with card after activating the card , operator could not find catalog number from the computer data base, gave up. Tried a second time by phone, catalog number were not in data base or out of stock, gave up. Tried mail order, order 6 items , received one item, now the app shows a balance $5.14, but no details about the order. So I do not know if there more items coming or not. Received a letter from Walmart, system overwhelmed .Something is wrong with all the 5 star ratings.This app is no use , it only shows balances, not items order or shipped. The app may show a balance, but there may be back ordered item that have not been shipped. April 2020, nothing has improved, Walmart still can not handle the business. Placed a mail order April 1st, I know we are in trying times, but I do not know if they received the order, the app is of no use, it will only show a balance, the app will never gave a brake down of items to be shipped or back order.Update: April 13, 2020, Received a conformation email from Walmart showing all item ordered and the shipping dates, order coming in 4 separate packages over a period of 2 weeks. One item I ordered not showing up at all.

This Search Uses The Five

Aetna Supplemental Health Plans

Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?

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Applied Behavior Analysis Medical Necessity Guide

The Applied Behavior Analysis Medical Necessity Guide helps determine appropriate levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.

Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member’s benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.

The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered for a particular member. The member’s benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.

Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change.

Three Ways To Shop With Your Healthy Foods Card: *

  • In-store Shop with your Healthy Foods Card at participating stores near you. You can also use the store finder online: HealthyBenefitsPlus.com/CarePlusHFC .
  • Online – Order online at Walmart.com to have approved pantry items, like canned goods, rice and pasta delivered to your home. You now have the ability to order shelf-stable foods through Walmart.com. Shelf-stable foods include:
  • Grains and pasta
  • Snacks, cookies, and chips

Please use the Walmart.com online shopping guide included with the Healthy Food Card to help you buy approved items.

  • DeliverLean – Order ready-to-heat, prepared meals from DeliverLean and have them delivered to your home. There are no shipping charges through DeliverLean. To learn more about meal choices or to order, call or go online: 1-954-246-0240 Monday – Friday, 8 am – 6 pm CST DeliverLeanCare.com/healthyfoodscard .

*Your benefit only covers approved items up to the amount on your card. You can use another form of payment to cover any remaining balance or items not approved.

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When Will The Grocery Plus Benefit Be Available

Qualifying members in GA, NJ, and SC will receive a $20 allowance to use only on groceries between August 1st and September 30, 2021.

Qualifying members in AZ, GA, MS, NJ, PA, SC, TN, and TX will receive a Grocery Plus benefit beginning on October 1st, 2021. If you qualify, you will have the choice to use your Q4 quarterly allowance to purchase groceries and/or over-the-counter items with your Healthy Benefits Plus card. If you do not qualify for the Grocery Plus benefit, you may still use your allowance for OTC items.

Where Can I Use My Card

United Healthcare Health Products Card

We are pleased to share that you have a variety of locations at which to use your Healthy Benefits Plus card:

  • In NJ, you can use your card at ACME, CVS, Duane Reade, Stop & Shop, Walgreens, and Walmart locations. You cannot use your card at CVS locations located within Target stores.
  • In GA and SC, you can use your card at CVS, Food Lion, Kroger, Walgreens, and Walmart locations. You cannot use your card at CVS locations that are located within Target stores.

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How To Get Started

  • Activate your card online or by phone. Call 1-833-832-7306 . Youll need to enter your card number, birthdate , and zip code. To activate online, go to ActivateS3.com and enter your card number, birthdate , and zip code. You must activate your card before using it the first time.
  • Shop in-store or online for approved foods and beverages. Use the online shopping guide included to help you shop for approved pantry items at Walmart.com and have them delivered.
  • Pay at checkout, use your Healthy Foods Card FIRST to pay for all approved items. Have the cashier scan the barcode on the back of your card before any other form of payment.
  • Everywhere Access With The Premier Dual Network

    Participants can redeem their benefits, rewards and services on either the S3® or Visa® network based on your benefit plan design. Our platform provides support for your benefits program however you need it.

    The S3 network can restrict spending to individual product UPCs or store departments at nearly 35,000 retail locations and online. Ninety-five percent of US residents live within 5 miles of an S3 network location. The Visa network provides anywhere access at over 11 million stores, with purchase restrictions by merchant or merchant category.

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    Careplus Healthy Foods Card Program

    The Healthy Foods Card program, which is becoming the program in 2023, is only available to Dual Eligible Beneficiaries that are enrolled in a D-SNP plan. What is a Dual eligible beneficiary? A person that qualifies for both Medicare and Medicaid benefits.

    As part of your CareNeeds Plus plan, you get a Healthy Foods Card with a monthly allowance to buy approved healthy foods and beverages. You can only use your card at participating retail stores or to buy a variety of pantry items online at Walmart.com. Funds will be added to your card on the first of each month. Be sure to use your allowance each month. Unused funds do not carry over to the following month or plan year. This benefit ends on December 31 or upon disenrollment from the plan.

    Competitive Medicare Supplement And Ancillary Plan Options

    Aetna’s Advantage Plan Benefits

    To complete our portfolio of products, Aetna also offers Medicare Supplement plans. With more than 1.3 million members, our competitively priced Individual Medicare Supplement plans utilize a simplified underwriting process. We also offer popular dental, vision and hearing products in 37 states. Our ancillary plan options cover 45 states and can provide members with life insurance coverage, benefits paid directly to them after being diagnosed with cancer, or for hospital stays, and home or skilled nursing facility recovery care.

    Visit AetnaMedicare.com to learn more about the 2023 Aetna Medicare plans. Or call 1-844-588-0041 , 7 days a week, 8 AM to 8 PM. The Medicare Annual Enrollment Period runs from October 15 through December 7, 2022. A licensed agent may answer your call.

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    Will The Grocery Plus Benefit Carry Over To My 2023 Plan

    No, this benefit will end on December 31, 2022. However, starting January 1, 2023, the Clover LiveHealthy Rewards program will begin, allowing members to earn reward dollars that may be used toward things such as groceries and more.* To learn about LiveHealthy Rewards, contact Clover Health Member Services or visit our LiveHealthy Rewards page.

    *Excludes alcohol, tobacco, and firearms. Other limitations may apply. Please contact Clover Health for details.

    Do I Qualify For The Grocery Benefit

    To qualify for the Grocery Plus benefit, you must be in a plan that is offering the benefit and have at least one of the following health conditions:

    • Autoimmune disorders
    • Chronic alcohol and other drug dependence
    • Certain chronic and disabling mental health conditions
    • Certain neurologic disorders
    • Chronic arthritis
    • Chronic heart failure
    • End-stage renal disease requiring dialysis

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    One Platform Multiple Benefits

    Make it easier to attract and retain members with the customized programs available on the Healthy Benefits+ platform. Whether you are providing OTC and food benefits to health plan members, or providing grocery discounts to your employees, S3 technology allows for custom combinations of benefits, rewards and services on a single platform. Health plans can combine member ID information into a benefit card with real-time access to health insurance, supplemental benefits and rewards.

    Check Your Wellness Credit Balance: Aetna

    Medicare Premium Payment Options

    Vanderbilt’s award winning Go for the Gold program provides a wellness credit of up to $240 per year to faculty and staff paying for Vanderbilt Health Plan benefits.

    If you participate in Go for the Gold, and you are enrolled in the health plan, you can check the balance of your wellness credit on the Aetna website.

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    Benefits Summary When You Select Aetna Medicare Advantage

    Key benefits

    If Medicare Parts A & B are not your primary coverage , you will be responsible for the deductible and coinsurance. For coverage details on the Aetna Advantage plan without Medicare, please visit our plan brochure. Please see the Medicare Advantage plan benefits guide for coverage details on the Aetna Medicare Advantage Plan.

    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 Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies . 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. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.

    For information about our plans available through the Federal Employees Dental and Vision Insurance Program , please visit our Dental PPO Plan site or our Aetna Vision Preferred site.

    Watch The Welcome Video To Learn About Your Plan

    Welcome to the Aetna® Dual Eligible Special Needs Plan, or D-SNP!

    Our No. 1 goal: making it easy to get the care you need. And we start right away with a welcome call from a member of our team. Theyll confirm your plan and help answer your questions.

    You will receive a welcome kit in the mail. Inside youll find your Quickstart Guide. It includes important benefit information and tips to help you get the most from your plan.

    You will also receive your Aetna® member ID card by mail. It will include your primary care provider and the Member Services number. Keep it safe and always bring it to pharmacies and doctor visits.

    Once your plan begins, you can take advantage of the medical and prescription drug coverage, plus coverage for dental, vision and hearing.

    All Aetna® D-SNP plans also come with a quarterly over-the-counter allowance. This allowance can be used to buy approved wellness items, such as pain relievers, cold and flu medicines, first aid items and more.

    Check your welcome kit for your OTC catalog. It shows a wide selection of approved health and wellness products you can order using your quarterly OTC allowance.

    Most plans come with a transportation benefit and a healthy foods allowance. The transportation benefit includes rides to and from approved locations like the doctors office, pharmacy and senior centers.

    Have a health question after hours? No problem. You can call the 24/7 Nurse Line for answers anytime, including nights and weekends.

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