Aetna 2022 Medicare plans feature more benefits, lower member costs and greater affordability

84 percent of Medicare beneficiaries can choose a $0 premium Aetna Medicare Advantage plan¹

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Oct 01, 2021, 07:00 ET

HARTFORD, Conn., Oct. 1, 2021 /PRNewswire/ -- Aetna^®, a CVS Health^® company (NYSE: CVS), announced its 2022 Medicare offerings, featuring expanded benefits focused on a holistic approach to health and new Medicare Advantage plan options, including Dual Eligible Special Needs Plans and Aetna Medicare Eagle^® plans designed especially for Veterans in additional states.

A pioneer in the Medicare industry, Aetna has served Medicare beneficiaries since 1966, when it paid the nation's first Medicare claim. Aetna now serves nearly 9.8 million Medicare members nationwide, as of June 30, 2021.

"The pandemic continues to disrupt so many aspects of our lives, including our health and well-being," said Christopher Ciano, president of Aetna Medicare. "While we're still focused on protecting our members from COVID-19, we also want to help improve their overall physical and mental health. That's why we expanded our Aetna Medicare Solutions portfolio of products to include more benefits designed to make care more affordable, accessible and convenient. As part of the CVS Health family, Aetna helps provide access to the coverage and care you need from trusted health care professionals, when and where you need it, for maximum peace of mind."

Medicare Advantage plans

More than 2.9 million Medicare beneficiaries are currently enrolled in an Aetna Medicare Advantage (MA) plan, which can include extra benefits, such as prescription drug coverage, vision, dental, hearing and fitness.

To make plans more affordable, Aetna expanded its $0 premium plan options. Aetna estimates 84 percent of the Medicare-eligible beneficiaries in the U.S. will now have access to a $0 monthly premium Aetna Medicare Advantage plan.¹

For 2022, Aetna is offering Medicare Advantage Prescription Drug (MAPD) plans in 46 states plus Washington, D.C. Aetna added 83 new counties across the country, providing an additional 1 million more Medicare beneficiaries access to an Aetna plan. In total, Aetna will offer MAPD plans in 1,875 counties in 2022, accessible by 53.2 million Medicare beneficiaries.²

For those who qualify for both Medicare and Medicaid benefits, Aetna expanded its Dual Eligible Special Needs Plan (D-SNP) offerings across 27 states, including new markets in Arkansas, Colorado, Delaware and Indiana. Most plans offer prescription drugs at no out-of-pocket cost and additional benefits for members that qualify for Low-Income Subsidy (LIS). Coverage varies by plan and may include healthy foods or utilities benefits cards, as well as companionship or fall prevention benefits.

Aetna also expanded its Aetna Medicare Eagle MA plans to 41 states and 1,151 counties — reaching more than 5.8 million Veterans over age 65. These plans are designed with Veterans in mind to complement their VA health care coverage and ensure access to important benefits for this population. All 2022 Aetna Medicare Eagle plans will feature a $0 monthly plan premium, $0 primary care copay (including walk-in clinics), dental, vision, hearing, over-the-counter allowance, SilverSneakers^® fitness program and $0 lab copay.

Medicare prescription drug plans

The Aetna standalone prescription drug plans (PDP) serve 5.7 million members. In 2022, Aetna Medicare will offer the same three individual standalone PDPs as in 2021. SilverScript SmartRx (PDP), featuring an average monthly premium of $7.08, will again be the lowest premium plan available from Aetna. SilverScript Choice (PDP) will be under the Centers for Medicare & Medicaid Services (CMS) benchmark pricing in 49 states and D.C., while SilverScript Plus (PDP) has the most robust prescription drug coverage. All three plans are available in all 50 states and D.C and feature lower Tier 1 and Tier 2 copays at preferred retail pharmacies.³

Medicare Supplement plans

With more than 1.2 million members, our competitively priced individual Medicare Supplement plans utilize a simplified underwriting process. We also offer popular dental, vision and hearing products in 37 states. Our ancillary plan options cover 45 states and can provide members with life insurance coverage, benefits paid directly to them after being diagnosed with cancer, or for hospital stays, and home or skilled nursing facility recovery care.

Offering innovative new programs and benefits

Aetna provides individual MA members access to convenient and affordable care through various benefits and programs that are new this year:

Extra support for low-income members: Most D-SNP plans offer prescription drugs at no out-of-pocket cost and additional benefits for members that qualify for LIS. Coverage varies by plan and may include healthy foods or utilities benefit cards, as well as companionship or fall prevention benefits.
Hospice: Aetna understands that members who require hospice services may need special care and support. As part of expanded coverage on select MA plans in Ohio and Pennsylvania, Aetna will be responsible for members' full medical coverage and hospice services. Members enrolled in the Aetna Compassionate Care Program utilizing select health care providers will have access to supplemental benefits to support their end-of-life journey. Members will receive continued transitional concurrent care, like treatment for diagnosis of terminal illness and related conditions, extra transportation, additional meals, in-home support and access to a personal emergency response system (PERS).
Aetna Medicare Payment Card: Aetna is partnering with PayFlex^® to offer a new debit card containing funds to use towards copayments for in-network primary and specialist care, and other medical and diagnostic services. Qualifying members will receive $100 per quarter with a $400 per year maximum. This benefit will be included on select Individual MA plans in Pennsylvania and Minnesota.
Therapeutic massage: As an expansion of our alternative medicine benefits, select MA plans in the Northwest region will cover up to 24 therapeutic massage visits per year.

Addressing social determinants of health with new and expanded MA benefits

Aetna Medicare Advantage plans take a total approach to health that goes beyond clinical care. With this approach in mind, Aetna expanded benefits to include:

Telehealth: All Aetna 2022 MA plans will cover telehealth visits for primary care, urgent care, and specialty care provided by a doctor, including mental health services. Depending on location, members will be able to schedule telehealth visits 24/7 via MinuteClinic Video Visit™, Teladoc^®, or another network provider offering this service.
Healthy Foods Benefit card: To help address food insecurity, availability of the Healthy Foods benefit card will expand to 77 MA plans across 28 states. Qualified members will receive an allowance to use towards the purchase of nutritious food items from over 30,000 approved retailers nationwide.
Utility card: Select DNSP plans in 2022 will offer a new utilities card. This debit card will provide a monthly allowance for use towards utility expenses such as water, electricity, sewage and gas.
Companionship: Aetna is expanding its companionship benefit to address social isolation to select MA plans in eight states. In partnership with Papa Inc., adult companions are connected with qualified members to assist with house chores and technology for up to 10 hours a month at no extra cost. Remote companionship can be delivered through telephone or secure video.
Fall Prevention: Aetna is expanding its fall prevention benefit through CVS Pharmacy to additional states and plans. In select MA plans, eligible members will receive an annual allowance for certain clinically appropriate safety items that help lower the risk of injury from falls in the home.

Making care more affordable, accessible and convenient

$0 member cost-shares on select benefits: To ensure important services are affordable, three out of four Aetna Individual MA plans now offer no member cost-sharing for primary care visits or labs. Additionally, all Aetna MA plans offer $0 copay for A1c, urine protein and COVID-19 testing and $0 copay for diabetes eye exams including retinal photo.
OTC: Aetna is expanding availability of its over-the-counter (OTC) benefit through OTC Health Solutions, a CVS Health Company, and increasing the OTC allowance amount available to members on many MA plans. With the OTC benefit, members can choose certain health care products by phone, catalog or online for home delivery. They'll also be able to present their ID cards to receive items directly from 3,000 select CVS Pharmacy^® or Navarro Discount Pharmacy^® locations across 37 states. In line with CVS Health's commitment to helping people lead smoke-free lives, Aetna is pleased to provide all members with the OTC allowance benefit access to Nicotine Replacement Therapy (NRT). Eligible members will be able to select from a variety of FDA-approved smoking-cessation items such as gums, lozenges, or patches.
Lowering insulin costs: Aetna is expanding participation in the Part D Senior Savings model, offering members in some Individual MAPD Plans and all SilverScript Plus Part D plans affordable, predictable copays of no more than $35 for a 30-day supply of select insulins.
Prescription Drugs: All Aetna Individual MAPD plans will increase prescription drug day supply to a maximum of 100 days for drugs on tiers 1–4.⁴ Members can take advantage of the new larger day supply with no increase in copay/coinsurance.
Innovative dental design: Aetna Medicare is introducing a new Total Choice dental benefit available on many Individual MA HMO-POS and PPO plans. This dental benefit provides coverage of preventive and comprehensive dental services up to a benefit maximum and allows the member to choose any licensed dentist, in or out of network. Aetna is expanding the Aetna Dental^® PPO network and members may save money when visiting a dentist within our network.
Decreased member out-of-pocket costs: Aetna decreased member in-network maximum out-of-pocket costs in about one-third of its Individual MA plans for 2022.
Member rewards program: In 2022, we're expanding our rewards program to all Aetna individual Medicare Advantage members. The program helps members improve their health and well-being with personalized reward activities. Members will be able to earn $150 or more by completing activities like preventive screenings and annual physicals already covered by their benefits.

In addition, Aetna will continue to offer the following supplemental benefits or other services as part of its Medicare Advantage plans:

All MA plans will offer an annual in-home assessment at no extra cost that includes a comprehensive health risk assessment and non-invasive physical exam from the comfort of the member's home. The clinician will also assess the home environment for potential fall risks, helping the member stay safe in their home.
The Aetna Resources For Living^®program helps address loneliness and other social needs by connecting members with important community resources, such as transportation, housing, food programs, caregiver support and utility assistance, based on individual member needs. The program serves as an early point of intervention for the many issues that affect our members' physical and mental health.
SilverSneakers^® fitness memberships are available to all Aetna individual MA members at no additional cost. Through SilverSneakers, members have access to over 16,000 fitness locations. SilverSneakers FLEX^® also gives members access to exercise programs outside of traditional gyms, such as recreation centers, malls and parks. Individuals can also connect to a support network and virtual resources through SilverSneakers LIVE™, SilverSneakers On-Demand™ and our mobile app, SilverSneakers GO™.
Aetna will continue to offer most Medicare Advantage members access to routine vision, dental and hearing coverage.⁵

Visit AetnaMedicare.com to learn more about the 2022 Aetna Medicare plans. Or call 1-844-588-0041 (TTY: 711), 7 days a week, 8 AM to 8 PM. The Medicare Annual Enrollment Period runs from October 15 through December 7, 2021. A licensed agent may answer your call.

¹Data as of August 2021 CMS eligibility file.
²This number includes Aetna's Joint Venture in Minnesota (with Allina Health).
³Source: CMS 2022 PDP Landscape Source Files available at https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.
⁴Not all medications are dispensable in 100-day supply due to unbreakable package sizing (e.g., inhalers), or as a result of being a controlled substance.
⁵Level and type of coverage vary by plan.

About Aetna

Aetna, a CVS Health business, serves an estimated 34 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit www.aetna.com and explore how Aetna is helping to build a healthier world.

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Plan features and availability may vary by service area. The formulary and/or pharmacy network may change at any time. You will receive notice when necessary. Aetna Medicare's pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri and Suburban West Virginia. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp. Other pharmacies and providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat Aetna members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Members who get "Extra Help" are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.

SilverScript is a Prescription Drug Plan with a Medicare contract marketed through Aetna Medicare. Enrollment in SilverScript depends on contract renewal.

Aetna, CVS HealthHUB and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies.

Aetna Resources For Living^SMis the brand name used for products and services offered through the Aetna group of subsidiary companies (Aetna). The EAP is administered by Aetna Behavioral Health, LLC. and in California for Knox-Keene plans, Aetna Health of California, Inc. and Health and Human Resources Center, Inc.

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SOURCE CVS Health