Sunday, November 27, 2022

Aetna 2023 Medicare plans put a refund in members’ pockets

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That includes reductions in prescription drug prices and money-saving Medicare Benefit advantages and extras that make a distinction

WOONSOCKET, R.I., Oct. 1, 2022 — Aetna®, a CVS Well being® firm (NYSE: CVS), introduced its 2023 Medicare choices, that includes extra reasonably priced medical and prescription drug protection and expanded money-saving advantages that help members’ complete well being and well-being. We’ll provide new Medicare Benefit plan choices, together with Twin Eligible Particular Wants Plans in new markets, a brand new Institutional Particular Wants Plan and expanded Aetna Medicare Eagle® plans designed with Veterans in thoughts.

“Along with the well being challenges that usually include getting older, we acknowledge the heavy monetary pressure on older adults and folks with disabilities, who usually reside on mounted incomes,” mentioned Christopher Ciano, president of Aetna Medicare. “To assist decrease their well being care prices, we expanded our Aetna Medicare Options portfolio of merchandise to incorporate improved prescription drug protection that can save members cash, extra important advantages that make a significant distinction in members’ lives and plans that match their distinctive wants and finances. As a part of the CVS Well being household, Aetna needs our 10.6 million Medicare members nationwide to really feel protected and supported via each second of their private well being journeys.”

Expanded Medicare Benefit plans to fulfill numerous wants

Greater than 3.2 million Medicare beneficiaries are at the moment enrolled in an Aetna Medicare Benefit (MA) plan, which frequently consists of useful advantages, equivalent to prescription drug protection, dental, imaginative and prescient, listening to and health. To maintain plans reasonably priced, Aetna continues to supply many $0 premium plan choices. Aetna estimates 84% of the Medicare-eligible beneficiaries within the U.S. can have entry to a $0 month-to-month premium Aetna MA plan.CMS Enrollment knowledge, August 2022.

For 2023, Aetna is providing Medicare Benefit Prescription Drug (MAPD) plans in 46 states plus Washington, D.C. Aetna added 141 new counties throughout the nation, offering 1 million extra Medicare beneficiaries entry to an Aetna plan. In complete, Aetna will provide MAPD plans in 2,014 counties in 2023, accessible by 55 million Medicare beneficiaries.This quantity consists of Aetna’s Joint Enterprise in Minnesota (with Allina Well being).

For many who qualify for each Medicare and Medicaid advantages, Aetna expanded its Twin Eligible Particular Wants Plan (D-SNP) choices throughout 30 states, together with new markets in South Carolina, South Dakota and Utah, and new PPO plan choices in Georgia and South Dakota. All plans provide prescribed drugs at no out-of-pocket price and extra advantages for members who qualify for Low-Revenue Subsidy (LIS). Protection varies by plan and should embody wholesome meals, utilities, over-the-counter gadgets, further transportation, companionship and fall prevention advantages.

New for 2023, Aetna will introduce the Aetna Medicare Longevity Plan, an Institutional Particular Wants Plan (I-SNP), in Pennsylvania. This plan is particularly designed for individuals residing in nursing properties. It consists of prescription drug protection and gives enhanced entry to onsite care within the facility. Members obtain additional advantages tailor-made to enhance their high quality of life by caring for his or her distinctive medical, social and emotional wants.

Aetna additionally expanded its Aetna Medicare Eagle MA plans to 42 states and 1,383 counties — reaching greater than 6.1 million Veterans over age 65. These plans are designed with Veterans in thoughtsThese plans don’t embody prescription drug protection. They’re out there to all Medicare-eligible people and could possibly be a very good match for beneficiaries who have already got prescription drug protection a minimum of nearly as good as Medicare Half D. to enhance their VA well being care protection and guarantee entry to necessary advantages for this inhabitants. All 2023 Aetna Medicare Eagle plans will characteristic a $0 month-to-month plan premium, $0 major care copay (together with walk-in clinics), dental, imaginative and prescient, listening to, over-the-counter allowance, SilverSneakers® health program and $0 lab copay. 

Strong standalone prescription drug plans with decrease copays

The Aetna standalone prescription drug plans (PDP) serve 6.1 million members. In 2023, Aetna Medicare will proceed to supply three particular person, standalone plans. SilverScript SmartRx (PDP) will likely be renamed SilverScript SmartSaver (PDP) in 2023 and can characteristic a mean month-to-month premium of $5.92, together with $10 copays for choose insulins at most well-liked pharmacies. SilverScript Alternative (PDP) will likely be out there to members with full Further Assist for a $0 month-to-month plan premium in all 50 states and D.C., whereas SilverScript Plus (PDP) has essentially the most strong prescription drug protection of our PDPs. All three plans can be found in all 50 states and D.C and have elevated formulary protection from 2022.Supply: CMS 2023 PDP Panorama Supply Recordsdata out there at

Massive reductions in prescription drug prices throughout the MAPD portfolio

Aetna made main modifications to our formularies (drug lists) for 2023 to take away many price and entry obstacles and assist our members be extra adherent with their drugs. Prescription drug profit modifications will end in important price financial savings for our 2023 Particular person MAPD members. Highlights embody:

  • $0 deductibles: 100% of MAPD members will take pleasure in a $0 deductible on all Tier 1 medicine, with 74% of plans providing a $0 deductible on all tiered medicine (Tiers 1 – 5).

  • $0 copays at most well-liked community pharmacies: Over 97% of our MAPD plans will provide $0 copay on Tier 1 medicine, and 50% of our MAPD plans will provide $0 copay on Tier 1 and Tier 2 medicine, for 30-, 60- or 100-day provide.

  • Strong drug protection: New for 2023, our most generally used formulary will transfer almost 300 medicine from higher-cost drug tiers to decrease tiers. This implies direct cost-share financial savings for our members, giving them entry to many extra medicine for a $0 or low copay. Plans utilizing our different formularies can rely on related financial savings. For instance, a member who had a drug (like Ezetimibe/generic Zetia used to deal with excessive ldl cholesterol) down-tiered from Tier 3 in 2022 to Tier 2 in 2023 on a plan with a $0 Tier 2 copay in 2023 and a $47 Tier 3 copay in 2022 would save $564 subsequent yr.

  • Pharmacy community: 99.9% of our MAPD plans provide prescription drug protection with entry to just about 66,000 community pharmacies, with 24,000 most well-liked choices providing further financial savings.

  • 100-day provide at no additional price: All MAPD plans will provide 100-day provide,Not all drugs are dispensable in 100-day provide because of unbreakable package deal sizing (e.g., inhalers), or on account of being a managed substance. for medicine on Tiers 1-4 at each retail and mail-order pharmacies with no improve in copay/coinsurance. Members who select to make use of our most well-liked mail-order pharmacy to fill their 100-day provide prescriptions can rely on handy, no-cost commonplace delivery. Prolonged-day provides will save members cash and assist them keep on their drug remedy program.

  • Tier 1/Tier 2 Protection Hole: 99.3% of our MAPD plans present strong Tier 1 and Tier 2 hole protection on the similar cost-share as within the preliminary protection section, permitting predictable copays via the donut gap and decreasing the potential for members reaching the catastrophic section.

  • $0 copays and $0 deductibles on Twin Eligible Particular Wants Plans: All D-SNPs will share one set of widespread options — strong drug protection, $0 deductibles and $0 prescription drug copays. Members merely have to qualify for D-SNP enrollment to obtain this profit.

  • Insulin: Members gained’t pay greater than $35 for a one-month provide of every insulin product lined by our plan.

  • Vaccines: Many lined Half D vaccines will likely be out there at $0 copay for Medicare beneficiaries.

Cash-saving MA advantages and extras that make a distinction

“We all know our members wish to really feel assured that their Medicare plans provide the protection they want, when and the place they need it — and at a value they will afford,” mentioned Ciano. “So, for 2023 we expanded some fashionable advantages and added new ones to empower members to get necessary preventive care, keep wholesome and hold doing the issues they take pleasure in most.” Particular person MA plan options that can make care extra reasonably priced, handy and accessible in 2023 embody:

  • Aetna Medicare Further Advantages Card (new):  Choose plans will embody a brand new, preloaded debit card with a quarterly allowance that can be utilized in the direction of the acquisition of over-the-counter (OTC) gadgets and/or a mix of help providersSome providers could also be restricted to these with qualifying situations. equivalent to: wholesome meals; utilities (together with water, electrical energy, fuel, cellphone and web service); and transportation. The cardboard might be swiped at 1000’s of taking part retailers for OTC and wholesome meals.

  • Aetna Medicare Fee Card: Aetna is increasing this debit card to extra plans and states and making it extra handy. Qualifying members will obtain a quarterly allowance to make use of in the direction of both out-of-pocket bills for in-network care; authorized OTC wellness gadgets; or each. Members whose profit consists of an allowance for OTC gadgets can purchase a big selection of things at any CVS Pharmacy® retail locationExcludes CVS Pharmacy in Goal areas. or place orders on-line via OTC Well being Options, a CVS Well being firm.

  • Reminiscence Health (new): Choose Aetna Medicare plan members will get entry to mind video games, workout routines and an enormous library of knowledge on actions that promote mind well being. Reminiscence Health might be accessed via BrainHQ on computer systems, smartphones and tablets.

  • Recent Meals Containers (new): Qualifying members of choose Particular person Aetna MA plans can obtain a produce field containing recent fruit and veggies delivered to their properties both biweekly, month-to-month or quarterly.

  • Dental, imaginative and prescient and listening to: Aetna believes advantages like dental, imaginative and prescient and listening to care are necessities and never merely extras. Aetna will proceed to supply most MA members entry to routine dental, imaginative and prescient and listening to protection.Degree and sort of protection fluctuate by plan.

    • Improved dental: In 2023, 95% of our MA plans will embody a complete dental profit. Aetna will develop the Complete Alternative dental profit launched in 2022 to further Particular person MA HMO-POS and PPO plans. This profit gives protection of preventive and complete dental providers as much as a profit most and permits the member to decide on any licensed dentist, in or out of community. Members might get monetary savings when visiting a dentist inside our community. As one of many nation’s largest MA dental networks, Aetna is continuous to develop the Aetna Dental® PPO community throughout the nation to fulfill our members’ want to search out reasonably priced dental care. We’re additionally enhancing the member expertise by eradicating dental deductibles from another dental profit plans.

    • Imaginative and prescient: In 2023, 96% of our MA plans will embody an eyewear profit.

    • Listening to: In 2023, 93% of our MA plans will embody a listening to help profit.

  • Telehealth: All Aetna MA plans will proceed to cowl telehealth visits for major care, pressing care and specialty care offered by a health care provider, together with psychological well being providers. In 2023, further telehealth providers will likely be out there together with bodily, occupational, and speech remedy, substance abuse and opioid remedy, kidney illness training and diabetes self-management coaching providers. Relying on location, members will be capable to schedule telehealth visits 24/7 through MinuteClinic®, Teladoc® or one other community supplier providing this service.

  • Meals: In 2023, 85% of MA plans will embody home-delivered meals after an inpatient keep.

  • OTC: Aetna is making its OTC profit supplied via OTC Well being Options, a CVS Well being firm, out there to extra members and growing the OTC allowance quantity on many MA plans. With the OTC profit, members can select sure well being care merchandise by cellphone, catalog or on-line for residence supply. They will additionally be capable to current their ID playing cards to obtain gadgets immediately from 3,800 choose CVS Pharmacy or Navarro Low cost Pharmacy® areas throughout 39 states. Choose Aetna plans will provide an OTC package mailed on to the member’s residence. These kits comprise curated OTC gadgets that assist help our members’ well being.

  • $0 cost-shares on choose advantages: To make sure necessary providers are reasonably priced, Aetna continues to develop providers out there at no additional price to the member. Most MA plans can have $0 copay for major care visits and plenty of plans will provide labs for free of charge to the member.

  • Steady or decreased member out-of-pocket prices limits: All Aetna MA plans embody most out-of-pocket price safety for lined plan providers. Aetna will hold member in-network most out-of-pocket prices limits the identical or lower them in 82% of its Particular person MA plans for 2023.

  • Fall prevention: Aetna continues to develop its fall prevention profit via CVS Pharmacy to further states and plans. In choose MA plans, eligible members will obtain an annual allowance for sure clinically applicable security gadgets that assist decrease the danger of damage from falls within the residence.

  • Hospice: Aetna understands some members may have additional help at essential factors of their lives. So, we’re increasing the variety of plans that provide our Compassionate Care Transitions program. On choose MA plans in Ohio and Pennsylvania, Aetna will likely be chargeable for members’ full medical protection and hospice providers. Members enrolled on this program can have entry to supplemental advantages to help their end-of-life journey. These advantages embody additional transportation, further meals, in-home help and entry to a private emergency response system.See Proof of Protection for particulars.

As well as, Aetna will proceed to supply the next supplemental advantages and applications as a part of its MA plans:

  • Wholesome Rewards Program: This system helps members enhance their well being and well-being with personalised reward actions. All Particular person MA members will be capable to earn $150 or extra yearly, relying on plan, to make use of at an expanded set of retailers, equivalent to native grocery and nationwide restaurant chains, by finishing sure wholesome actions.

  • SilverSneakers® health memberships can be found to all Particular person MA members at no further price.Exception: SilverSneakers will not be out there with the Aetna Medicare Longevity Plan (I-SNP). By way of SilverSneakers, members have entry to over 15,000 health areas. SilverSneakers FLEX® additionally offers members entry to train applications exterior of conventional gyms, equivalent to recreation facilities, malls and parks. People may hook up with a help community and digital assets via SilverSneakers LIVE™, SilverSneakers On-Demand™ and our cell app, SilverSneakers GO™. New in 2023, members can entry psychological enrichment and well-being courses via GetSetUp.

  • All MA plans will provide an annual wholesome residence go to at no additional price that features a complete well being danger evaluation and non-invasive bodily examination from the consolation of the member’s residence. The clinician may also consider the house setting to establish social help wants and dangers that might end in early detection of well being issues. Comply with up with the member’s physician can result in remedy and a greater high quality of life.

  • The Aetna Sources For Dwelling® program helps tackle loneliness and different social wants by connecting members with necessary group assets, equivalent to transportation, housing, meals applications, caregiver help and utility help, based mostly on particular person member wants. This system serves as an early level of intervention for the various points that have an effect on our members’ bodily and psychological well being.

Aggressive Medicare Complement and ancillary plan choices

To finish our portfolio of merchandise, Aetna additionally provides Medicare Complement plans. With greater than 1.3 million members, our competitively priced Particular person Medicare Complement plans make the most of a simplified underwriting course of. We additionally provide fashionable dental, imaginative and prescient and listening to merchandise in 37 states. Our ancillary plan choices cowl 45 states and might present members with life insurance coverage protection, advantages paid on to them after being identified with most cancers, or for hospital stays, and residential or expert nursing facility restoration care.

Go to to study extra concerning the 2023 Aetna Medicare plans. Or name 1-844-588-0041 (TTY: 711), 7 days every week, 8 AM to eight PM. The Medicare Annual Enrollment Interval runs from October 15 via December 7, 2022. A licensed agent might reply your name.

About CVS Well being

CVS Well being® is the main well being options firm, delivering care like nobody else can. We attain extra individuals and enhance the well being of communities throughout America via our native presence, digital channels and over 300,000 devoted colleagues – together with greater than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and each time individuals want us, we assist them with their well being – whether or not that’s managing continual ailments, staying compliant with their drugs or accessing reasonably priced well being and wellness providers in essentially the most handy methods. We assist individuals navigate the well being care system – and their private well being care – by enhancing entry, decreasing prices and being a trusted accomplice for each significant second of well being. And we do all of it with coronary heart, each day. Comply with @CVSHealth on social media.

About Aetna

Aetna, a CVS Well being enterprise, serves an estimated 34 million individuals with data and assets to assist them make higher knowledgeable choices about their well being care. Aetna provides a broad vary of conventional, voluntary and consumer-directed medical health insurance merchandise and associated providers, together with medical, pharmacy, dental and behavioral well being plans, and medical administration capabilities, Medicaid well being care administration providers, employees’ compensation administrative providers and well being data know-how services. Aetna’s prospects embody employer teams, people, school college students, part-time and hourly employees, well being plans, well being care suppliers, governmental items, government-sponsored plans, labor teams and expatriates. For extra data, go to

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our DSNPs even have contracts with State Medicaid applications. Enrollment in our plans is dependent upon contract renewal. Plan options and availability might fluctuate by service space. The formulary, supplier and/or pharmacy community might change at any time. You’ll obtain discover when needed. Aetna Medicare’s pharmacy community consists of restricted decrease price, most well-liked pharmacies in Suburban Arizona, Suburban Illinois, City Kansas, Rural Michigan, Suburban Michigan, City Michigan, City Missouri, Suburban Utah, Suburban West Virginia and Suburban Wyoming. The decrease prices marketed in our plan supplies for these pharmacies will not be out there on the pharmacy you employ. For up-to-date details about our community pharmacies, together with whether or not there are any lower-cost most well-liked pharmacies in your space, members please name the quantity in your ID card, non-members please name 1-833-278-3928 (TTY: 711) or seek the advice of the on-line pharmacy listing. Different pharmacies and suppliers can be found in our community. Out-of-network/non-contracted suppliers are beneath no obligation to deal with plan members, besides in emergency conditions. Please name our customer support quantity or see your Proof of Protection for extra data, together with the cost-sharing that applies to out-of-network providers. Members who get “Further Assist” are usually not required to fill prescriptions at most well-liked community pharmacies to be able to get Low Revenue Subsidy (LIS) copays. Collaborating physicians, hospitals and different well being care suppliers are unbiased contractors and are neither brokers nor staff of Aetna. The supply of any specific supplier can’t be assured, and supplier community composition is topic to alter. Medicare guidelines don’t permit earned rewards for use for Medicare-covered items or providers, together with medical or prescription drug out-of-pocket prices. Earned rewards will not be used to pay for medical copays, prescription prices, or some other Medicare lined good or providers. Earned rewards may additionally not be used on alcohol, tobacco or firearms or be transformed to money. This materials is for informational functions solely and isn’t medical recommendation. Well being data applications present common well being data and are usually not an alternative choice to prognosis or remedy by a doctor or different well being care skilled. Contact a well being care skilled with any questions or considerations about particular well being care wants. Suppliers are unbiased contractors and are usually not brokers of Aetna. Supplier participation might change with out discover. Aetna will not be a supplier of well being care providers and, subsequently, can’t assure any outcomes or outcomes. The supply of any specific supplier can’t be assured and is topic to alter. Info is believed to be correct as of the manufacturing date; nonetheless, it’s topic to alter. For extra details about Aetna plans, confer with our web site. The advantages talked about are part of particular supplemental program for the chronically ailing. Not all members qualify.

SilverScript is a Prescription Drug Plan with a Medicare contract marketed via Aetna Medicare. Enrollment in SilverScript is dependent upon contract renewal. 

Aetna, CVS Pharmacy and MinuteClinic, LLC (which both operates or gives sure administration help providers to MinuteClinic-branded walk-in clinics) are a part of the CVS Well being household of firms.

Sources For Dwelling  is the model identify used for services supplied via the Aetna group of subsidiary firms.

SilverSneakers is a registered trademark of Tivity Well being, Inc. ©2022 Tivity Well being, Inc. All rights reserved. GetSetUp is a third-party service supplier and isn’t owned or operated by Tivity Well being, Inc. (“Tivity”) or its associates. Customers will need to have web service to entry GetSetUp service. Web service prices are the duty of the person. Fees might apply for entry to sure GetSetUp courses or performance.

©2022 Aetna Inc.


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