THE CHOICE IS YOURS
Plan details for Aetna Medicare Eagle Plan (PPO), a 2021 Medicare Advantage Plan. Together, Banner and Aetna are taking a new approach to the way health care is offered. Learn more about this innovative partnership, and how these two industry leaders aim to provide more efficient and effective patient care at a more affordable cost.
Aetna offers easy to understand health benefit plans. Even if you like the plan you’re in, it’s a good idea to review your selections every year.
All health plans give you access to quality doctors and hospitals, free 24-hour nurse hotline and a secure website to keep all of your personal health records in one place.
Two Aetna Medicare Advantage PPO plans:
Aetna PPO Extended Service Area (ESA)
- Aetna Medicare Advantage PPO ESA 10
- Aetna Medicare Advantage PPO ESA 15
Did you like your Freedom Plan as a pre-65 retiree? Than we have an even better plan for you now that you are Medicare eligible!
The Aetna Medicare (PPO) plan with an Extended Service Area (ESA) offers services and programs beyond Original Medicare and includes special programs only available to Aetna members. And, unlike a traditional PPO, you can use in-network or out-of-network providers, at the in-network cost sharing amount. This gives you added flexibility when it comes to your care.
Plan Details:
You can use providers who are in or out of the plan’s nationwide network. An out-of network provider must be eligible to receive Medicare payment and willing to accept the PPO ESA plan.
What's special?
- With these plans you have the same member cost-share in and out-of-network. For example, as long as you see a provider that is eligible to receive Medicare payment, your Primary Care Physician cost-share under the Medicare Advantage PPO ESA 10 plan will be $10 if you go in or out-of-network. It’s that simple.
- Our Care Management program is designed to help you manage health conditions such as hypertension.
- Freedom to use providers in and out of network as long as they are eligible for Medicare payment and agree to accept your PPO plan.
- Selecting a primary care physician (PCP) is not required, but we do encourage you to select one. A PCP is often the doctor who has a complete picture of your health.
- Access to the National Medical Excellence Program®, a select network of respected doctors and facilities designed to help those with a complex illness or injury receive the most appropriate care.
- Preventive benefits beyond Original Medicare at no additional cost.
What you should know
- You must be enrolled in Medicare Part A and/or B and continue to pay your Part B premium and Part A premium, if applicable.
- Guaranteed acceptance as long as you meet eligibility requirements.
- You must live in the plan service area offered by your former employer.
- You’ll enjoy limits to your out-of-pocket plan costs.
- If you use a provider that does not participate in the plan’s network, the provider must be licensed, eligible to receive Medicare payment and willing to accept the plan.
- For complete information, please refer to the plan documents in the links below.
Summary of Benefits and Coverage
Click here for the Summary of Benefits and Coverage page on the Division of Pension and Benefits website.
Two Aetna Medicare Advantage HMO plans:
Health Maintenance Organization (HMO)
- Aetna Medicare Advantage HMO 10
- Aetna Medicare Advantage HMO 1525
If you liked your Aetna HMO plan as a pre-65 retiree, we can’t wait for you to try our Aetna Medicare HMO plans!
The Aetna Medicare Plan (HMO) Open Access includes coverage for Medicare Parts A and B benefits, and it goes beyond those benefits to offer you additional benefits not covered under Original Medicare. Our HMO offers you an affordable way to help you manage your health care costs.
Plan Details:
You typically pay a flat fee, or copay, for most covered expenses. You are not required to select a Primary Care Physician (PCP) form the plan’s network.* With the Aetna Medicare Plan (HMO) Open Access, you may access care from participating providers without a PCP referral. If you seek care from a provider who does not accept the Aetna Medicare Plan, services will not be covered, except in an emergency or urgent care situation, or for out-of-area kidney dialysis. For some services, you may pay a percentage of the expense (coinsurance).
What's special?
- Our Care Management program is designed to help you manage health conditions such as hypertension.
- You have access to the large Aetna Medicare HMO network of doctors, hospitals and other health care providers.
- Access to the National Medical Excellence Program®, a select network of respected doctors and facilities designed to help those with a complex illness or injury receive the most appropriate care.
- You have medical coverage whenever you travel to another Aetna Medicare Plan service area with Aetna’s U.S. Travel Advantage Program; however, you must enroll by calling Aetna Medicare before you travel.
- Preventive benefits beyond Original Medicare at no additional cost.
What you should know
- You must be enrolled in Medicare Part A and/or B and continue to pay your Part B premium and Part A premium, if applicable.
- Guaranteed acceptance as long as you meet eligibility requirements.
- You must live in the plan service area offered by your former employer.
- You’ll enjoy limits to your out-of-pocket plan costs.
- If you use a provider that does not participate in the plan’s network, the provider must be licensed, eligible to receive Medicare payment and willing to accept the plan.
- For complete information, please refer to the plan documents in the links below.
*Members residing in Illinois and California will be required to declare a Primary Care Physician when electing your plan.
Summary of Benefits and Coverage
Click here for the Summary of Benefits and Coverage page on the Division of Pension and Benefits website.
Health Home Visit
At your invitation, a licensed and board-certified nurse practitioner or physician will come to your home to give you a health assessment with our Healthy Home Visit, at no extra cost to you. At your request, they will also check your home for potential issues that may increase your chances of falling.
What does the Healthy Home Visit involve?
You can use this yearly visit to:
- Ask health care questions
- Review your medicines
- Update your medical history
- Discuss issues you may have getting the health resources you need
- Discuss concerns you may have to ensure that you can move around safely in your home
You can schedule a free Healthy Home Visit today. Just call 1-855-205-0431
Resources for Living
Happiness and peace of mind play an important role in living your best life.
The Aetna Medicare Advantage Resources For Living program may help you achieve that. With just one call, a life consultant can help you find services and support in your area. And the phone call doesn’t cost you anything. You’d pay the cost of any services you decide to use.
- Help at Home - for example cleaning, lawn service, maintenance and repairs
- Help for your caregiver
Find out how to start using these services at 1-866-370-4842 (TTY: 711), Monday – Friday, 8 a.m. to 6 p.m. (all time zones)
Medicare Claim form
Fill out this form if you are asking for a medical reimbursement that you paid a doctor, healthcare professional, or service provider who did not bill us directly.
Make copies of all of your receipts and itemized bills from your provider. Be sure to include your Aetna member ID number on each receipt and bill. All materials submitted will be retained by us and cannot be returned to you.
Summary of Benefits and Coverage
Click here for the Summary of Benefits and Coverage page on the Division of Pension and Benefits website.
Call 1-866-234-3129 and talk to someone from Member Services who knows all the details about the available Aetna plans.
New Hires have 60 days to choose benefits.
Sign up at www.benefeds.com or call 1-877-888-3337.
- $300 to spend on frames with our High Option and $150 for Standard Option
- Large, nationwide network including online ordering options
- Lower premiums for 2021
2021 Biweekly rates
| Aetna Vision | Self Only | Self + 1 | Self & Family |
|---|---|---|---|
| Standard | $3.09 | $6.18 | $9.27 |
| High | $5.61 | $11.20 | $16.81 |
2021 Monthly rates
| Aetna Vision | Self Only | Self + 1 | Self & Family |
|---|---|---|---|
| Standard | $6.70 | $13.39 | $20.09 |
| High | $12.16 | $24.27 | $36.42 |
Benefit and cost comparisons (see the difference)
| You Pay*** | ||
|---|---|---|
| Key benefit features in the Aetna network | Standard option | High option |
| Routine eye exam | $0 | $0 |
| Frames BONUS: You'll also get an additional 20% off any balance over the frame allowance. Frame choices aren't limited to frame towers or collections. | You get $150 allowance once every calendar year | You get $300 allowance once every calendar year |
| Standard Plastic Lenses — single, bifocal, trifocal, lenticular once every calendar year in lieu of contacts | $10 | $0 |
| Standard progressive lenses | $75 | $0 |
| Most premium progressive lenses | $95 – $120 | $40 - $65 |
| Standard Polycarbonate lenses; scratch coating | $0 | $0 |
| UV treatment; tint | $15 copay for each | $0 |
| Most Anti-Reflective Coatings | $45-$68 | $20-$43 |
| Contacts BONUS: Receive an additional 15% off any balance over the allowance on conventional contact lenses once every calendar year in lieu of eyeglass lenses | You get $150 | You get $150 |
| Standard Contact Lens Fit and Follow-U | $40 fixed discount** | $40 fixed discount** |
| Premium Contact Lens Fit and Follow-Up | 90% of retail price | 90% of retail price |
Other Aetna plan advantages
- No deductible to meet - the plan starts paying right away
- No limit on your choice of frames
- No limit on what brand of contact lenses network providers can prescribe - you get maximum benefits no matter which brand you choose
- Aetna Vision Preferred mobile app – download for free! And easily find a provider, view your ID card, get benefit information and answers to frequently asked questions
- Members-only special offers are available on aetnavision.com!
- Award winning customer service 7 days per week
- Welcome kit mailed to your home with 2 ID cards
- You can use your flexible spending account (FSA) or health savings account (HSA) toward your out–of-pocket expenses
- International travel solution – we’re ready to help if a vision emergency sneaks up on you when traveling abroad
Go practically anywhere for eye care
With Aetna Vision Preferred, you can see any provider you want, in the Aetna network or out. But remember, network providers will cost you less.
Choice, convenience, flexibility
We know you live busy lives, that’s why our network includes providers with convenient evening and weekend hours. You can receive care from any of our 110,000 providers including top retailers like:
You can also apply your benefits online at any of the below retailers:
Why pick Aetna Vision Preferred?
Video Transcript
Aetna Vision Preferred Plan
Text on screen: Rick Tapnio. Retired Air Force. Current Aetna Employee. Aetna Vision Preferred Member.
Rick Tapnio: (00:03) What I love about the Aetna Preferred Vision Plan is choice, savings and convenience. That really narrows down the three most important things for myself and my family simply because we just, we didn't have that before on the plan that we had.
Text on screen: Vision plans can help keep an eye on your health.
Text on screen: John Lahr. Optometrist.
John Lahr: (00:20) Statistics show that close to four times as many people receive a comprehensive eye exam annually as compared to a physical. If they can't see that will drive them in to an optometrist or ophthalmologist to get their eye exam, maybe through a vision plan. We really look at the person in total as we're really trying to assess what's going on, not only with their eyes but what relates from their body into the eyes. Sometimes we can see it in the eye or maybe we're just looking for something that they gave us a hint on medication that we should be assessing, whether it be high blood pressure, high cholesterol, or even diabetes, both type one and type two.
Text on screen: Plans that fit your needs.
Text on screen: Sarah Marbach. Senior Business Consultant. Aetna.
Sarah Marbach: (01:01) One of the things that people most often ask is, 'Which plan is going to be the best for me?' And there's no really easy answer to that question. So, that's really where it comes in, trying to focus in on what do you personally and your family need from a plan? When it comes to vision insurance, do you wear glasses? Do you wear contacts? Are you just going for your annual exam? What kind of extra features are you looking for in your plan? What's your budget like? All those types of things are going to be important factors when you're looking at different options. What's really great about Aetna's plans is that there's a plan for every type of need out there.
Text on screen: Savings
Rick Tapnio: (01:41) Without the cost savings from the Aetna Preferred Vision Plan, I would have paid hundreds more for these frames.
Text on screen: Convenience.
Rick Tapnio: (01:50) Being part of the Aetna vision plan truly allows myself to plan around my busy schedule, around my busy family schedule. I have children that are in school and when we have to make appointments for their eyecare, it usually was during work hours and it was really challenging to do that. But now I know that I can pick up the phone and make an appointment after 5:00 PM or 6:00 PM or on the weekends and make sure that my family's taken care of.
Text on screen: Choices
Sarah Marbach: (02:20) Our provider network is pretty large. We have over a hundred thousand providers nationwide, so you've got a really wide choice when it comes to what eye doctor you want to go see. We're constantly working to make sure that our benefits are top of the line for our customers.
Rick Tapnio: (02:34) I would absolutely recommend the Aetna Preferred Vision Plan to a friend or family, simply because it was the best choice for myself and my family. Minix laptops & desktops driver download. We looked around, you should too, and at the end of the day, you'll know it's the right one for you as well.
Text on Screen: AetnaFedsLive.com. Connect live to find out which plan works for you.
Disclaimer: The testimonials, statements and opinions expressed on this website are individual experiences, reflecting real life experiences of those who have used an Aetna product and/or service. All such accounts were voluntarily provided without compensation. The testimonials, statements and opinions are not necessarily representative of all of those who will use an Aetna product and/or service.
Enroll today at benefeds.com or call 877-888-3337.
*Internal database as of August 2020.
**The amount shown is the negotiated discounted price you will pay the provider. Discounts may not be available in all states at all in-network providers. To see a list of providers who do honor discounts, go to directly to www.aetnavision.com , select Find a Provider, and if you see 'May not accept all additional plan discounts' you should contact the provider to confirm.
***Please refer to the plan brochure in Section 4, Your Cost for Covered Services, for the nationwide reimbursement schedule and Section 6, International Services and Supplies, for the international reimbursement schedule.
Aetna Ppo Prescription Copay
Aetna Ppo Copay Amounts
Vision insurance plans are underwritten by Aetna Life Insurance Company (Aetna). Certain claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care, LLC ('EyeMed').
Aetna Medicare Ppo Benefit Summary
This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the plan’s applicable federal brochure(s). All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure. This material is for information purposes only. Providers participating in the Aetna Vision Network are contracted through EyeMed Vision Care, LLC (EyeMed). EyeMed and Aetna are independent contractors and not employees or agents of each other. Participating vision providers are credentialed by and subject to the credentialing requirements of EyeMed. Aetna does not provide medical/vision care or treatment and is not responsible for outcomes. Aetna does not guarantee access to vision care services or access to specific vision care providers, and provider network composition is subject to change without notice. Not all vision services are covered. Discount offers provide access to discounted services and are NOT insured benefits. Lens coverage can be used once every benefit period to purchase either one pair of eyeglass lenses throughout benefit period. Exam coverage and frame coverage can be used once every benefit period. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to aetnafeds.com/vision.