Post on 11-Jan-2016
Welcome to Medicare Prescription Drug CoverageDiscussion Topics
What is Medicare?
What is the Medicare Prescription Drug Plan benefit?
Can I also get Medical coverage?
How do I enroll?
S5810_7D_80805 (03/2009)
The Aetna AnswerSM
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What is Medicare?
A federal health insurance program Available to those age 65 and older:
who are entitled to monthly Social Security benefits widows or widowers who are entitled to monthly Social Security benefits
Available to those under age 65: who have been entitled to Social Security disability benefits for at least 24
months with ALS (Amyotrophic Lateral Sclerosis), known as Lou Gehrig’s disease, the
first month they are entitled to Social Security benefits who are entitled to Social Security benefits and need maintenance kidney
dialysis or a kidney transplant
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Part A – is primarily for hospitalization. Part B – pays doctor bills as well as outpatient costs, including preventive services. Part C – is also known as the Medicare Advantage program. Medicare Advantage
plans are offered by private insurance companies that have a contract with the federal government.
Part D – is the Medicare prescription drug benefit, which provides coverage for prescription drugs. This benefit is only available through private insurance companies.
Which “Parts” of Medicare are you interested in?
What is the Medicare Prescription Drug Plan benefit?
Understand the benefit
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95% Medicare / Plan Contribution
5% Enrollee
Co-insurance
100% Enrollee Payment at Aetna Discounted Rate
Coverage Gap
75% Plan Contribution25% Enrollee Co-insurance
$295 Enrollee Deductible$0
$2,700
$6,153.75
$295
Total Drug
Expenditures
All Medicare prescription drug plans must be at least as good as or better than the federal base benefit.
2009 Federal Medicare Prescription Drug Base Benefit
$0
$896.25
$4,350+
$295
EnrolleeOut-of-Pocket Expenditures
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Aetna Medicare prescription drug plans are open formulary, meaning they cover all Medicare Part D drugs*
All plans have $0 deductibles for preferred generic prescription drugs The variety of prescription drug features in our plans may include:
No deductible ▪ Aetna Rx Home Delivery®*
Specialty Pharmacy ▪ Coverage gap protection*
The Aetna Medicare Rx PlusSM Plan is currently available through Costco in these states: AK, AZ, CA, CO, FL, HI, ID, IL, MI, NM, NV, NY, OH, OR, UT, VA, WAAetna Medicare Rx
EssentialsSM Plan Aetna Medicare Rx PlusSM
PlanAetna Medicare Rx PremierSM
Plan Alternative to Medicare
base drug benefit
$0 generic tier deductible
Predictable cost-sharing with $0 or low generic prescription drug copay
Discounted generic and brand prescription drugs within the coverage gap
All Part D prescription drugs covered by Medicare are available*
$0 deductible
Predictable cost-sharing with $0 preferred generic copay
$10 preferred generic copay in the gap; other Part D prescription drugs discounted in the coverage gap
All Part D prescription drugs covered by Medicare are available*
Generic Benzodiazepines and Barbiturates
$0 deductible
Predictable cost-sharing with $0 preferred generic drug copay
$10 preferred generic, $25 non-preferred generic copay in the coverage gap
Discounted brand prescription drugs in the coverage gap
All Part D prescription drugs covered by Medicare are available*
Generic Benzodiazepines and Barbiturates
* Subject to precertification, step therapy, and quantity limits.
Aetna Medicare Prescription Drug Plans (PDP)
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You can find the Aetna drug plan that best meets your needs at www.aetnamedicare.com Compare plan options Check for nearby pharmacies that accept Aetna negotiated discounts for
prescription drugs Over 59,000 pharmacies throughout the United States Aetna Specialty Pharmacy provides access to highly specialized drugs and clinical
advice from pharmacists Aetna Home Delivery® mails prescription drugs to your door at a savings
Pay a 2-month copay for a 3-month supply of covered prescription drugs Pharmacists available at toll-free line for clinical advice
Detailed prescription drug list (also called a formulary): Find our printable formulary guide at www.aetnamedicare.com Request a printed version
Access to discounts on services and value-added benefits
Aetna Medicare Prescription Drug Plans (PDP)
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Aetna ExtrasSM at no extra cost: Vision discounts. Up to 40% off the retail prices of eyeglass
frames, savings on all types of lenses and up to 15% off Lasik procedures. Aetna Weight ManagementSM Program. Discounts on weight-loss programs
and products from Jenny Craig®, one of the largest weight management firms worldwide.
Aetna Natural Products and ServicesSM Program. Discounts on over-the-counter vitamins, herbal and nutritional supplements and natural products and reduced rates from chiropractors, acupuncturists, massage therapists and nutritional consultants.
Online tools such as: Aetna NavigatorTM helps you understand how your coverage is working for
you. Aetna InteliHealth® provides helpful wellness and healthy lifestyle
information.
Aetna ExtrasSM
Can I also get medical coverage?
The Aetna AnswerSM
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You may find our Medicare Advantage plans cost less than Medicare supplements
Aetna also offers Medicare Advantage plans that combine medical and prescription drug coverage in one, easy-to-use plan (MA-PD)
You may find our Medicare Advantage medical plans with prescription drug benefits (MA-PD) are cost effective, compared to paying for separate Medicare supplement and prescription drug plans
All of our Medicare Advantage plans are administered by one company, with one number to call
Medicare Advantage Plans (MA)
MedicarePrescription
Drug Plans(PDP)
Aetna Medicare Advantage Plans (MA)
Medicare Advantage Prescriptio
n Drug Plans (MA-
PD)
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The Aetna AnswerSM is an integrated Medicare Advantage plan with prescription drug coverage. With this plan you will receive medical and prescription drug coverage, plus more benefits than you typically get with the Original Medicare Plan alone.
* Prescription drug coverage available only to H, I, or J Medicare supplement policy holders who enrolled prior to December 31, 2005.
The Aetna AnswerSM
2009 Medical & Prescription Drug Coverage Choices
What do you want in a health plan?
Original Medicare
Med Supp*
PDP MA MA-PD
Medical Coverage X X X X
Extra Medical Coverage X X X
Prescription Drug Coverage*
X X
Optional Dental Coverage X X
Aetna ExtrasSM X X X
Total Integrated Solution X
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Leading Customer Service
Over 150 Years of
Experience
Simple Plan
Designs
Low or No Monthly
Plan Premium
Prescription Drug
Coverage
Aetna ExtrasSM
Predictable Copayment
s
Get all the coverage you need from Aetna Medicare.
Why Aetna Medicare?
How do I enroll?
Enrollment Process
Enrolling is as simple as 1 – 2 – 3.
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Complete the enrollment form.
Step 1 Step 2
Mail your completed form to Aetna.
Step 3
Enrolling is as simple as 1–2–3. Once you know that you are eligible for the plan, follow the steps below. You can also enroll online at www.aetnamedicare.com.
Hand in your application, or…
Review your enrollment kit and
select a plan.
Enrollment 1 –2 – 3
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*You may qualify for a Special Election Period (SEP) – ask your Aetna Representative.
Initial Enrollment Period (IEP) – the 7-month period surrounding your Medicare eligibility, including the three months prior to your 65th birthday, the month of your 65th birthday, and the 3 months after your 65th birthday.
Annual Election Period (AEP) – Nov. 15 through Dec. 31
Enroll in the plan of your choice for a Jan. 1 effective date
Important dates to remember
Annual Election Period
12/31
AEP ends*
11/15
AEP begins
November 2008 December 2008
Do you have any questions?
Welcome to Aetna
Thank you, we look forward to serving you. For additional information, you can also contact Medicare at 1-800-MEDICARE or Medicare.gov.
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Benefits coverage is provided through Aetna Life Insurance Company, a Medicare Prescription Drug Plan Sponsor with a Medicare contract and benefits, limitations, service areas and premiums are subject to change on January 1 of each year. This material is for informational purposes only. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. Pharmacy clinical programs such as pre-certification, step therapy, and quantity limits may apply to your prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Aetna does not provide care or guarantee access to health services. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Discount programs provide access to discounted prices and are not insured benefits. You must be entitled to Medicare Part A and continue to pay your Part B premium and Part A, if applicable, if not otherwise paid for under Medicaid or by another third-party. You must reside in the Aetna Medicare Prescription Drug Plan service area.
© 2008 Aetna Inc. 18.25.304.1 (10/08)