Aetna 2023 Medicare plans put a reimbursement in members’ pockets

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 inexpensive 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 sometimes include getting older, we acknowledge the heavy monetary pressure on older adults and other people 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 desires 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 satisfy numerous wants

Greater than 3.2 million Medicare beneficiaries are presently enrolled in an Aetna Medicare Benefit (MA) plan, which frequently contains helpful advantages, corresponding to prescription drug protection, dental, imaginative and prescient, listening to and health. To maintain plans inexpensive, 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.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 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 supply pharmaceuticals at no out-of-pocket price and extra advantages for members who qualify for Low-Earnings 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 further 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 enhance their VA well being care protection and guarantee entry to necessary 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. 

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) shall be renamed SilverScript SmartSaver (PDP) in 2023 and can function a median month-to-month premium of $5.92, together with $10 copays for choose insulins at most popular pharmacies. SilverScript Alternative (PDP) shall be out there 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 essentially 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 lead to vital price financial savings for our 2023 Particular person MAPD members. Highlights embrace:

• $0 deductibles: 100% of MAPD members will take pleasure in 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 popular 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.
• Strong 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 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 12 months.
• Pharmacy community: 99.9% of our MAPD plans supply prescription drug protection with entry to just about 66,000 community pharmacies, with 24,000 most popular choices providing further financial savings.
• 100-day provide at no further 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 popular 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 similar cost-share as within the preliminary protection part, permitting predictable copays by the donut gap and decreasing the potential for 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 shall be out there at $0 copay for Medicare beneficiaries.

Cash-saving MA advantages and extras that make a distinction

“We all know our members need 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 will afford,” mentioned Ciano. “So, for 2023 we expanded some well-liked 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 inexpensive, 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 the direction of the acquisition of over-the-counter (OTC) gadgets and/or a mixture of assist providers⁶ corresponding to: wholesome meals; utilities (together with water, electrical energy, fuel, telephone and web service); and transportation. The cardboard may be swiped at hundreds of collaborating 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 contains an allowance for OTC gadgets can purchase 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 may be accessed by BrainHQ on computer systems, smartphones and tablets.
• Contemporary Meals Bins (new): Qualifying members of choose Particular person Aetna MA plans can obtain a produce field containing recent vegetables and fruit 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 develop the Whole 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 could lower your expenses 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 satisfy our members’ want to seek out inexpensive 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 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 shall 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 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 provided by OTC Well being Options, a CVS Well being firm, out there 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 residence supply. They will additionally be capable to current their ID playing cards to obtain gadgets instantly from 3,800 choose CVS Pharmacy or Navarro Low cost Pharmacy® places throughout 39 states. Choose Aetna plans will supply an OTC equipment mailed on to the member’s residence. These kits include curated OTC gadgets that assist assist our members’ well being.
• $0 cost-shares on choose advantages: To make sure necessary providers are inexpensive, Aetna continues to develop providers out there at no further price to the member. Most MA plans can have $0 copay for major care visits and plenty of plans will supply labs for gratis to the member.
• Secure or decreased member out-of-pocket prices limits: All Aetna MA plans embrace most out-of-pocket price safety for coated 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 by CVS Pharmacy to further states and plans. In choose MA plans, eligible members will obtain an annual allowance for sure clinically acceptable security gadgets that assist decrease the danger of damage from falls within the residence.
• Hospice: Aetna understands some members might have further assist at important 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 shall be liable for members’ full medical protection and hospice providers. Members enrolled on this program can have entry to supplemental advantages to assist their end-of-life journey. These advantages embrace further 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 customized 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, corresponding 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 way of SilverSneakers, members have entry to over 15,000 health places. SilverSneakers FLEX® additionally offers members entry to train applications outdoors of conventional gyms, corresponding to recreation facilities, malls and parks. People also can connect with a assist community and digital assets by SilverSneakers LIVE™, SilverSneakers On-Demand™ and our cellular 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 residence go to at no further price that features a complete well being threat evaluation and non-invasive bodily examination from the consolation of the member’s residence. The clinician may even consider the house atmosphere to establish social assist wants and dangers that might lead to early detection of well being issues. Observe up with the member’s physician can result in remedy and a greater high quality of life.
• The Aetna Sources For Dwelling® program helps deal with loneliness and different social wants by connecting members with necessary group assets, corresponding 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 gives 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 well-liked 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 identified with most cancers, or for hospital stays, and residential or expert nursing facility restoration care.

Go to AetnaMedicare.com to study extra in regards to 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 could 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 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 each time individuals want us, we assist them with their well being – whether or not that is managing persistent ailments, staying compliant with their medicines or accessing inexpensive 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, reducing prices and being a trusted companion for each significant second of well being. And we do all of it with coronary heart, each day. Observe @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 gives 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, staff’ compensation administrative providers and well being data know-how services and products. Aetna’s clients embrace employer teams, people, faculty college students, part-time and hourly staff, well being plans, well being care suppliers, governmental models, government-sponsored plans, labor teams and expatriates. For extra data, go to www.aetna.com.

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 could fluctuate by service space. The formulary, supplier and/or pharmacy community could change at any time. You’ll obtain discover when obligatory. Aetna Medicare’s pharmacy community contains restricted decrease price, most popular 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 might not be out there on the pharmacy you utilize. For up-to-date details about our community pharmacies, together with whether or not there are any lower-cost most popular 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 data, 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 popular community pharmacies in an effort to get Low Earnings Subsidy (LIS) copays. Collaborating 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 might not be used to pay for medical copays, prescription prices, or every other Medicare coated good or providers. Earned rewards might 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 data applications present normal well being data 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 could change with out discover. Aetna just isn’t a supplier of well being care providers and, due to this fact, 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, seek advice from 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 Dwelling is the model title used for services and products provided 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 consumer. Expenses could apply for entry to sure GetSetUp lessons or performance.

©2022 Aetna Inc.

Y0001_32296_2023_M

Media contacts
Ethan Slavin
860-273-6095
[email protected]

Rosemarie Miller
610-399-1957
[email protected]

Investor contact
Larry McGrath
800-201-0938
[email protected]

SOURCE CVS Well being