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 /PRNewswire/ — 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 assist members’ entire well being and well-being. We’ll supply 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 typically dwell on mounted incomes,” stated 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 price range. As a part of the CVS Well being household, Aetna needs our 10.6 million Medicare members nationwide to really feel protected and supported by each second of their private well being journeys.”

Expanded Medicare Benefit plans to fulfill various wants

Greater than 3.2 million Medicare beneficiaries are presently enrolled in an Aetna Medicare Benefit (MA) plan, which regularly contains useful advantages, akin 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. could have entry to a $0 month-to-month premium Aetna MA plan.1

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 supply MAPD plans in 2,014 counties in 2023, accessible by 55 million Medicare beneficiaries.2

For individuals 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 supply pharmaceuticals at no out-of-pocket price and extra advantages for members who qualify for Low-Revenue Subsidy (LIS). Protection varies by plan and should embrace 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 dwelling in nursing properties. It contains 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 thoughts3 to enrich their VA well being care protection and guarantee entry to vital advantages for this inhabitants. All 2023 Aetna Medicare Eagle plans will function 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. 

Sturdy 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) can be renamed SilverScript SmartSaver (PDP) in 2023 and can function a mean month-to-month premium of $5.92, together with $10 copays for choose insulins at most well-liked pharmacies. SilverScript Alternative (PDP) can be obtainable to members with full Additional Assist for a $0 month-to-month plan premium in all 50 states and D.C., whereas SilverScript Plus (PDP) has probably the most sturdy 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 2022.4

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 medicines. Prescription drug profit modifications will end in vital price financial savings for our 2023 Particular person MAPD members. Highlights embrace:

  • $0 deductibles: 100% of MAPD members will get pleasure from a $0 deductible on all Tier 1 medication, with 74% of plans providing a $0 deductible on all tiered medication (Tiers 1 – 5).
  • $0 copays at most well-liked community pharmacies: Over 97% of our MAPD plans will supply $0 copay on Tier 1 medication, and 50% of our MAPD plans will supply $0 copay on Tier 1 and Tier 2 medication, for 30-, 60- or 100-day provide.
  • Sturdy drug protection: New for 2023, our most generally used formulary will transfer practically 300 medication from higher-cost drug tiers to decrease tiers. This implies direct cost-share financial savings for our members, giving them entry to many extra medication for a $0 or low copay. Plans utilizing our different formularies can depend on comparable 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 12 months.
  • Pharmacy community: 99.9% of our MAPD plans supply prescription drug protection with entry to almost 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 supply 100-day provide5 for medication 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 depend on handy, no-cost customary transport. 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 sturdy Tier 1 and Tier 2 hole protection on the identical cost-share as within the preliminary protection part, permitting predictable copays by the donut gap and lowering the opportunity of members reaching the catastrophic part.
  • $0 copays and $0 deductibles on Twin Eligible Particular Wants Plans: All D-SNPs will share one set of frequent options — sturdy drug protection, $0 deductibles and $0 prescription drug copays. Members merely have to qualify for D-SNP enrollment to obtain this profit.
  • Insulin: Members will not pay greater than $35 for a one-month provide of every insulin product coated by our plan.
  • Vaccines: Many coated Half D vaccines can be obtainable 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 supply the protection they want, when and the place they need it — and at a worth they’ll afford,” stated Ciano. “So, for 2023 we expanded some common advantages and added new ones to empower members to get vital preventive care, keep wholesome and maintain doing the issues they get pleasure from most.” Particular person MA plan options that can make care extra reasonably priced, handy and accessible in 2023 embrace:

  • Aetna Medicare Additional Advantages Card (new): Choose plans will embrace a brand new, preloaded debit card with a quarterly allowance that can be utilized in direction of the acquisition of over-the-counter (OTC) gadgets and/or a mix of assist providers6 akin to: wholesome meals; utilities (together with water, electrical energy, fuel, telephone and web service); and transportation. The cardboard might be swiped at hundreds of taking part retailers for OTC and wholesome meals.
  • Aetna Medicare Cost 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 direction of both out-of-pocket bills for in-network care; accredited OTC wellness gadgets; or each. Members whose profit contains an allowance for OTC gadgets should buy a wide array of things at any CVS Pharmacy® retail location7 or place orders on-line by 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 by 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 vegatables and fruits 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.8
    • Improved dental: In 2023, 95% of our MA plans will embrace a complete dental profit. Aetna will increase 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 lower your expenses when visiting a dentist inside our community. As one of many nation’s largest MA dental networks, Aetna is constant to increase 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 embrace an eyewear profit.
    • Listening to: In 2023, 93% of our MA plans will embrace a listening to support profit.
  • Telehealth: All Aetna MA plans will proceed to cowl telehealth visits for major care, pressing care and specialty care offered by a physician, together with psychological well being providers. In 2023, further telehealth providers can be obtainable together with bodily, occupational, and speech remedy, substance abuse and opioid remedy, kidney illness schooling and diabetes self-management coaching providers. Relying on location, members will have the ability to schedule telehealth visits 24/7 by way of MinuteClinic®, Teladoc® or one other community supplier providing this service.
  • Meals: In 2023, 85% of MA plans will embrace home-delivered meals after an inpatient keep.
  • OTC: Aetna is making its OTC profit supplied by OTC Well being Options, a CVS Well being firm, obtainable to extra members and rising the OTC allowance quantity on many MA plans. With the OTC profit, members can select sure well being care merchandise by telephone, catalog or on-line for dwelling supply. They will additionally have the ability to current their ID playing cards to obtain gadgets straight from 3,800 choose CVS Pharmacy or Navarro Low cost Pharmacy® areas throughout 39 states. Choose Aetna plans will supply an OTC package mailed on to the member’s dwelling. These kits comprise curated OTC gadgets that assist assist our members’ well being.
  • $0 cost-shares on choose advantages: To make sure vital providers are reasonably priced, Aetna continues to increase providers obtainable at no additional price to the member. Most MA plans could have $0 copay for major care visits and plenty of plans will supply labs without charge to the member.
  • Steady or diminished member out-of-pocket prices limits: All Aetna MA plans embrace most out-of-pocket price safety for coated plan providers. Aetna will maintain 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 increase its fall prevention profit by 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 dwelling.
  • Hospice: Aetna understands some members might have additional assist at important factors of their lives. So, we’re increasing the variety of plans that supply our Compassionate Care Transitions program. On choose MA plans in Ohio and Pennsylvania, Aetna can be liable for members’ full medical protection and hospice providers. Members enrolled on this program could have entry to supplemental advantages to assist their end-of-life journey. These advantages embrace additional transportation, further meals, in-home assist and entry to a private emergency response system.9

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 have the ability to earn $150 or extra yearly, relying on plan, to make use of at an expanded set of retailers, akin 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.10 By means of SilverSneakers, members have entry to over 15,000 health areas. SilverSneakers FLEX® additionally provides members entry to train applications outdoors of conventional gyms, akin to recreation facilities, malls and parks. People can even connect with a assist community and digital sources by SilverSneakers LIVE™, SilverSneakers On-Demand™ and our cell app, SilverSneakers GO™. New in 2023, members can entry psychological enrichment and well-being lessons by GetSetUp.
  • All MA plans will supply an annual wholesome dwelling 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 dwelling. The clinician can even consider the house atmosphere to determine social assist 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 Residing® program helps handle loneliness and different social wants by connecting members with vital neighborhood sources, akin to transportation, housing, meals applications, caregiver assist and utility help, based mostly on particular person member wants. This system serves as an early level of intervention for the numerous 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 presents 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 supply common dental, imaginative and prescient and listening to merchandise in 37 states. Our ancillary plan choices cowl 45 states and can present members with life insurance coverage protection, advantages paid on to them after being recognized 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 per week, 8 AM to eight PM. The Medicare Annual Enrollment Interval runs from October 15 by December 7, 2022. A licensed agent might reply your name.

1CMS Enrollment knowledge, August 2022.
2This quantity contains Aetna’s Joint Enterprise in Minnesota (with Allina Well being).
3These plans don’t embrace prescription drug protection. They’re obtainable to all Medicare-eligible people and could possibly be match for beneficiaries who have already got prescription drug protection at the very least nearly as good as Medicare Half D.
4Supply: CMS 2023 PDP Panorama Supply Information obtainable at
5Not all medicines are dispensable in 100-day provide resulting from unbreakable bundle sizing (e.g., inhalers), or on account of being a managed substance.
6Some providers could also be restricted to these with qualifying circumstances.
7Excludes CVS Pharmacy in Goal areas.
8Degree and sort of protection differ by plan.
9See Proof of Protection for particulars.
10Exception: SilverSneakers will not be obtainable with the Aetna Medicare Longevity Plan (I-SNP).

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 by 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 every time individuals want us, we assist them with their well being – whether or not that is managing continual ailments, staying compliant with their medicines or accessing reasonably priced well being and wellness providers in probably the most handy methods. We assist individuals navigate the well being care system – and their private well being care – by enhancing entry, reducing prices and being a trusted associate 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 info and sources to assist them make higher knowledgeable choices about their well being care. Aetna presents a broad vary of conventional, voluntary and consumer-directed medical 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 info expertise services and products. Aetna’s clients embrace 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 info, 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 will depend on contract renewal. Plan options and availability might differ by service space. The formulary, supplier and/or pharmacy community might change at any time. You’ll obtain discover when crucial. Aetna Medicare’s pharmacy community contains 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 obtainable 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 underneath 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 info, together with the cost-sharing that applies to out-of-network providers. Members who get “Additional Assist” aren’t required to fill prescriptions at most well-liked community pharmacies with a view to get Low Revenue Subsidy (LIS) copays. Taking part physicians, hospitals and different well being care suppliers are unbiased contractors and are neither brokers nor workers of Aetna. The supply of any explicit supplier can’t be assured, and supplier community composition is topic to alter. Medicare guidelines do not 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 every other Medicare coated good or providers. Earned rewards can also 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 info applications present basic well being info and aren’t an alternative to analysis 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 aren’t 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 explicit supplier can’t be assured and is topic to alter. Data is believed to be correct as of the manufacturing date; nonetheless, it’s topic to alter. For extra details about Aetna plans, discuss with our web site. The advantages talked about are part of particular supplemental program for the chronically unwell. Not all members qualify.

SilverScript is a Prescription Drug Plan with a Medicare contract marketed by Aetna Medicare. Enrollment in SilverScript will depend on contract renewal. 

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

Sources For Residing is the model identify used for services and products supplied by the Aetna group of subsidiary corporations.

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 should have web service to entry GetSetUp service. Web service expenses are the accountability of the person. Prices might apply for entry to sure GetSetUp lessons or performance.

©2022 Aetna Inc.


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