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Staying on Top of the 2020 Medicare Changes
By Daniel Casciato

Aetna Medicare Advantage, the largest Medicare Advantage company in the commonwealth of Pennsylvania with over 200,000 members, offers its members a total, connected approach to health. Their plans often include prescription drug coverage and extra benefits and many feature an affordable plan premium.

“Medicare Advantage premiums are the lowest they've been in 14 years,” says Bob O’Connor, Vice President and Chief Medicare Officer of Aetna Medicare for the Keystone Market, which covers Pennsylvania, West Virginia, and Delaware. “They've actually been falling over time. People are paying less and they're getting more because so many of these plans now include coverage for dental, vision, hearing, and over the counter medications—things people look for.”

The plans also include several items that you may not necessarily look for to help keep you healthy such as additional care management programs and non-emergency transportation for doctor office visits.

Some people have both Medicare and Medicaid which means you are “dual eligible.” That’s where dual special needs plans (DSNP) — or “dual” plans — come in. Each of Aetna’s DSMP members has a case manager, and the case manager will see if they qualify each year.

“There are a number of enhancements that we're making in our DSNP program,” says O'Connor. “One of them is for people with chronic conditions. They'll receive a healthy foods debit card, which is $25 monthly allowance towards the purchase of healthy and nutritious foods and produce.”

Another new program is called PAPA, a social needs benefit which provides companion support.

“It helps resolve social isolation with very carefully screened college students, many who have a healthcare background,” explains O'Connor. “They provide companionship. Usually, it's meant to be in person, but it can be virtually too. And it might be simple things such as playing a game, but it could also be helping buy groceries or figuring out little things around the house. It's for up to 10 hours a month, for a person who qualifies.”

This year, Aetna also increased its dental allowance to $4,500. It covers not only the traditional cleanings, x-rays and fillings, but it also covers items like crowns, root canals, dentures, endodontics and periodontics.

“This is an expansion of a very robust dental program,” adds O’Connor. “In addition, our quarterly over-the-counter health allowance has increased to $330. Members can receive a catalog in the mail or go online, and order $330 of items per quarter—items to help them with mobility, to help them keep healthy, so many things that we all use now or are now over-the-counter instead of necessarily prescribed.”

O’Connor notes that the DSNP plans include a robust model of care, where they put together an integrated care plan for each member, in conjunction with the patients' doctors.

“Our case manager works closely with their different health care providers,” he says. “We partner with the person to reduce barriers and help solve their problems.”

Aetna has also made some really significant program improvements to its MA only plan—a plan that covers medical only, not medication.

“There are thousands of people, locally, here in Western Pennsylvania, who are either getting their medications from the VA or other program,” says O’Connor. “This is a program that wraps around medical care and has inexpensive medical copays. It also has a lot of terrific supplemental benefits, like a $3,000 dental plan, transportation, where we'll take people to the VA. This is a plan that is very strong and attractive. Anybody who needs a medical only plan, needs to take another look, because we made some really strong improvements to that plan.”

If you’re interested in an Aetna Medicare Advantage plan or any other plan, O’Connor recommends to call first.

“We can find out how they want to learn more and/or enroll,” he says. “We're also doing many virtual seminars this year. People can go and take part in a virtual seminar, where they can see the person presenting who will go over the different products and plans. Give us a call, and we'll find a good virtual seminar for somebody to do.”

They are scheduling one-on-one visits for people who are comfortable with that option.

“Of course, we are socially distanced and wear the proper protective equipment,” he says. “Frankly, that varies, and people have different levels of comfort. We can meet with people either in person, by video, or by phone. We have local company employees and agents who are trained on these products, and this is their full-time job—to know all about these products. So, there's an opportunity to work with a local person who's an expert.”

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If you’d like more information visit www.aetnamedicare.com.

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Their SNPs also have contracts with State Medicaid programs. Enrollment in their plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. 

©2019 Aetna Inc.

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