Aetna Medicare Premier (HMO-POS)

Medicare Plan Details (2023 Plan)


Monthly Premium

 

by Aetna Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.0
out of 5 stars

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Plan Type

Medicare Advantage (Part C) with Prescription Drug (Part D)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D

 

$0
$0
$0
$0
$5,200 In-network
No
Yes
Yes
Yes

Doctor Services

In-network: $0 copay
Out-of-network: No Data
In-network: $40 copay per visit
Out-of-network: No Data

Tests, labs, & imaging

In-network: 0-20% coinsurance
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
In-network: $0-200 copay
Out-of-network: No Data
In-network: $10-100 copay
Out-of-network: No Data
$110 copay per visit (always covered)
$0-45 copay per visit (always covered)

Hospital Services

In-network: $300 per day for days 1 through 7
$0 per day for days 8 through 90
Out-of-network: Not Applicable
In-network: $0-275 copay per visit
Out-of-network: No Data

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$196 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

In-network: $0 copay
Out-of-network: No Data

Ambulance

In-network: $260 copay
Out-of-network: No Data

Therapy services

In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data

Mental health services

In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data
In-network: $40 copay
Out-of-network: No Data

Opioid treatment services

Covered

Other services

In-network: 20% coinsurance per item
Out-of-network: No Data
In-network: 20% coinsurance per item
Out-of-network: No Data
In-network: 0-20% coinsurance per item
Out-of-network: No Data

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phase1Catastrophic coverage phase
Preferred Generic$15.00 copay$15.00 copay


Generic drugs :
$4.15 copay or 5% (whichever costs more)

Brand-name drugs :
$10.35 copay or 5% (whichever costs more)

Generic$20.00 copay$20.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug$100.00 copay
Specialty Tier33%
1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.

Part B Drugs

In-network: 20% coinsurance
Out-of-network: No Data
In-network: 20% coinsurance
Out-of-network: No Data

Hearing

In-network: $40 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data

Preventive Dental

In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance

Comprehensive dental

In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance

Vision

In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 4
 3
 4
 4
 2
 5
 3.5
 5
 2
 4
 3

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