What is an Aetna PPO plan?
PPO: The plan with the most freedom A Preferred Provider Organization (PPO) has pricier premiums than an HMO or POS. But this plan allows you to see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network doctors are low.
What type of Medicare is Aetna?
Aetna Medicare is a HMO, PPO plan with a Medicare contract.
Is Aetna Medicare nationwide?
Aetna offers Medicare Advantage plans in 49 states. Medicare Advantage plans are not currently sold in Alaska. Although there is wide availability throughout the country, specific types of plans and coverage options may only be offered in certain areas.
Does Aetna Medicare follow CMS guidelines?
Aetna Medicare Dual Core (HMO SNP) plans All MA plans are required to offer Medicare Parts A and B medical benefits and to follow CMS' national and local coverage decisions.
Does Aetna Medicare PPO require prior authorization?
For some services, your PCP is required to obtain prior authorization from Aetna Medicare. You'll need to get a referral from your PCP for covered, non‐emergency specialty or hospital care, except in an emergency and for certain direct‐access service. There are exceptions for certain direct access services.
Is Aetna Medicare the same as Medicare?
Both terms refer to the same thing. Instead of Original Medicare from the federal government, you can choose a Medicare Advantage plan (Part C) offered by a private insurance company.
Does Aetna Medicare PPO require referrals?
How do Medicare Advantage PPO plans work? Preferred provider organization (PPO) plans let you choose any provider who accepts Medicare. You don't need a referral from a primary care physician for specialist or hospital visits. However, using providers in your plan's network may cost less.
Is Aetna good for Medicare?
Aetna has a strong selection of high-quality Medicare Advantage plans. Overall, their plans have an average Medicare Star Rating of 4.1 out of 5. The insurer offers mostly HMO plans (including Special Needs Plans) and a few PPOs.
What states is Aetna Medicare in?
Aetna Medicare Advantage plans are available in most statesAlabamaHawaiiSouth DakotaConnecticutKansasVirginiaDelawareKentuckyWashingtonWashington, D.C.LouisianaWest VirginiaFloridaMaineWisconsin5 more rows
Does Aetna Medicare cover CT scans?
Policy. Aetna considers magnetic resonance imaging (MRI) and computed tomography (CT) of the spine medically necessary when any of the following criteria is met: Clinical evidence of spinal stenosis; or.
Is Aetna Medicare Part D?
Medicare prescription drug coverage (Part D) is offered through private insurance companies, like Aetna and SilverScript.
Does Aetna Medicare pay for consultation codes?
Aetna will no longer pay office consultation codes 99241, 99242, 99243, 99244 and 99245, starting with dates of service March 1 and beyond.
Is Aetna Medicare Part D?
Medicare prescription drug coverage (Part D) is offered through private insurance companies, like Aetna and SilverScript.
What is the difference between Part C and Part D Medicare?
Medicare Part C is an alternative to original Medicare. It must offer the same basic benefits as original Medicare, but some plans also offer additional benefits, such as vision and dental care. Medicare Part D, on the other hand, is a plan that people can enroll in to receive prescription drug coverage.
What is Medicare Plan A?
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. coverage if you or your spouse paid Medicare taxes for a certain amount of time while working. This is sometimes called "premium-free Part A." Most people get premium-free Part A.
What is Medicare Part A and B?
Part A (Hospital Insurance): Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. Part B (Medical Insurance): Helps cover: Services from doctors and other health care providers. Outpatient care.
Health Care Services and Medical Supplies
Aetna Medicare Freedom Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
Prescription Drug Costs and Coverage
The Aetna Medicare Freedom Plan (PPO) plan offers the following prescription drug coverage, with an annual drug deductible of $150 (excludes Tiers 1, 2 and 3) per year.