Medicare is a vital program provided by the U.S. government, offering health insurance coverage through Part A (hospital insurance) and Part B (medical insurance).
While Original Medicare has long been a staple for millions, many individuals are now opting for Medicare Advantage Plans.
These plans, offered by private companies approved by Medicare, expand coverage to include Part C and sometimes Part D (prescription drugs).
One prominent provider of Medicare Advantage Plans is Aetna Healthcare, one of the largest health insurance companies in the United States. Aetna offers various plans tailored to meet different health needs.
Below, we’ll explore the Medicare Advantage plans offered by Aetna in Maine, highlighting their features, benefits, and costs.
1. Aetna Gold Plus H5619-001 (HMO)
- Monthly Premium: $0
- Annual Deductible: None
- Out-of-Pocket Maximum: $6,700
This plan offers comprehensive benefits at no monthly premium. You’ll pay:
- $0 copay for primary care visits
- $50 copay for specialist visits
Prescription Drug Coverage:
- $400 deductible, applicable to preferred brand, non-preferred, and specialty drugs
- 25% coinsurance for generic and brand-name drugs
Additional Benefits:
- Vision, dental, hearing, and over-the-counter benefits
- Fitness programs, including SilverSneakers
- $0 copay for skilled nursing facilities (first 20 days)
- Transportation services included
2. Aetna Gold Plus H5619-066 (HMO)
- Monthly Premium: $0
- Annual Deductible: $500
- Out-of-Pocket Maximum: $6,700
This plan is ideal for those seeking broader coverage, offering:
- $0 copay for primary care visits
- $50 copay for specialists
Prescription Drug Coverage:
- $355 deductible
- 25% coinsurance for generic and brand-name drugs
Additional Benefits:
- Cardiac and pulmonary rehabilitation
- Physical, occupational, and speech therapy
- 40 meals provided over 20 days
- Chiropractic care and transportation services
3. Aetna Choice H5216-059 (PPO)
- Monthly Premium: $0
- Annual Deductible: None
- Out-of-Pocket Maximum: $4,500 (in-network), $10,000 (out-of-network)
This plan offers greater flexibility, allowing access to out-of-network providers. You’ll pay:
- $0 copay for primary care visits
- $40 copay for specialists (in-network)
Prescription Drug Coverage:
- Not included; must enroll separately in a Part D plan
Additional Benefits:
- Emergency room services: $90 copay
- Vision, dental, hearing, and fitness benefits
- $0 copay for preventive and home health care
4. Aetna Choice H5216-175 (PPO)
- Monthly Premium: $0
- Annual Deductible: None
- Out-of-Pocket Maximum: $5,900
This plan includes:
- $0 copay for primary care visits
- $35 copay for specialists
Prescription Drug Coverage:
- $250 deductible for non-preferred drugs and specialty tiers
- 5% coinsurance for generic and brand-name drugs
Additional Benefits:
- $0 copay for transportation (up to 24 trips annually)
- Cardiac and pulmonary rehabilitation services
5. Aetna Choice H5216-177 (PPO)
- Monthly Premium: $38
- Annual Deductible: None
- Out-of-Pocket Maximum: $4,900
With a low monthly premium, this plan provides:
- $0 copay for primary care visits
- $30 copay for specialists
Prescription Drug Coverage:
- No deductible
- 5% coinsurance for generic and brand-name drugs
Additional Benefits:
- $90 copay for emergency services
- $0 copay for skilled nursing facilities (first 20 days)
- Comprehensive preventive and home health care
6. Aetna Gold Plus SNP-DE H5619-003 (HMO D-SNP)
- Monthly Premium: $0
This Special Needs Plan (SNP) caters specifically to individuals with chronic conditions such as heart failure or end-stage renal disease. Enrollment is limited to those meeting eligibility criteria.
Key Features:
- $0 copay for both primary and specialty doctor visits
- Comprehensive prescription drug coverage (in-network pharmacies only)
- Dental, vision, hearing, fitness, and over-the-counter benefits
- $0 copay for transportation services
Why Consider Aetna Medicare Advantage Plans?
Aetna’s Medicare Advantage Plans in Maine cater to diverse health needs with varying levels of coverage and affordability. Key benefits include:
- Comprehensive Coverage: Beyond hospital and medical insurance, many plans include prescription drugs, dental, vision, and wellness programs.
- Affordable Options: With $0 premium plans available, Aetna provides cost-effective solutions for Medicare beneficiaries.
- Additional Services: Plans often include transportation, meal delivery, and fitness programs like SilverSneakers.
Choosing the right Medicare Advantage Plan is essential for managing your healthcare needs effectively.
Aetna’s diverse options in Maine offer something for everyone, from basic coverage to specialized care for chronic conditions. Evaluate your health requirements and budget to select the plan that’s right for you.
Medicare Advantage Plans like those from Aetna can simplify your healthcare, providing peace of mind and comprehensive coverage all in one package.
