Aetna 2024 Medicare plans offer more choices, flexibility and simplicity

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Oct 01, 2023, 08:00 ET

Plans feature expanded money-saving benefits that matter most to members

WOONSOCKET, R.I., Oct. 1, 2023 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), announces our 2024 Medicare products ― the largest Medicare offering in our history¹ ― featuring more choices, flexible benefit allowances, a strong provider network and further simplified medical and prescription drug plans that support members' overall health and well-being. We included dental, vision and hearing benefits on every Medicare Advantage (MA) plan, reduced prescription drug costs across our Medicare Advantage Prescription Drug (MAPD) plan portfolio and enriched our Extra Benefits Card and over-the-counter (OTC) benefits on many plans. We'll also offer new MA plan options and expanded money-saving benefits for individuals who qualify for a Dual Eligible Special Needs Plan (D-SNP) or Extra Help.

"Our experience shows Medicare consumers want more than just a one-size-fits-all approach to health care," said Terri Swanson, president of Aetna Medicare. "They want personalized plans that fit their unique needs and budgets, and flexible benefits that matter most to them. And Aetna kept this top of mind when developing plans for 2024. Our brokers and service teams are energized by our 2024 Medicare product portfolio and stand ready to guide consumers across the country to choose a plan that's right for them."

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 11 million Medicare members nationwide, including 3.4 million currently enrolled in an Aetna MA plan.

New and expanded individual MA plans to support diverse needs

We made significant investments in our 2024 plan benefits that will offer members more choices, added value and greater flexibility to help with everyday expenses and empower them to achieve their personal health goals. Plan highlights include:

Expanded footprint: For 2024, Aetna will offer MAPD plans in 46 states plus Washington, D.C. We added 255 new counties across the country, providing 2.2 million more Medicare-eligible beneficiaries access to an Aetna plan. In total, Aetna will offer MAPD plans in 2,269 counties in 2024, accessible by 58 million Medicare-eligible beneficiaries.²
$0 premium plan options: Aetna estimates 84% of the Medicare-eligible beneficiaries in the U.S. will have access to a $0 monthly premium Aetna MA plan.³
Expanded D-SNP products: For those who qualify for both Medicare and Medicaid benefits, we'll expand our D-SNP offerings to 433 new counties across 31 states, including a new market in Maryland and new preferred provider organization (PPO) plan options in Alabama, Arkansas, Louisiana, Mississippi, Pennsylvania and Utah. All D-SNPs offer $0 Part D drugs, dental, vision, hearing and an Extra Benefits Card with a new Extra Supports Wallet.⁴ It features an enhanced allowance for members to spend on things they need the most, like healthy foods, utilities, rent/mortgage, OTC items, gas, transportation, personal care items and pet care supplies.⁵On select D-SNPs, members can earn an additional $30 per month in their Extra Supports Wallet by selecting a high value primary care provider (PCP).
Expanded options for people who get Extra Help: Aetna offers Value Plus^SM MA plans⁶ that provide additional value for individuals who qualify for Extra Help — also known as Part D Low-Income Subsidy (LIS). These plans feature low premiums, dental, vision, hearing, SilverSneakers® fitness benefit, OTC allowance and $0 copays for in-network primary care visits and labs. Through our new Aetna Assist program, those with Extra Help may qualify for $0 plan premiums and additional benefits like $0 Part D drugs and an Extra Benefits Card. Aetna Assist packages vary by plan. The Inflation Reduction Act expanded eligibility for the Extra Help program, qualifying more Medicare beneficiaries for the program in 2024.⁷ Aetna stands ready to help these individuals take advantage of those benefits.
Expanded Aetna Medicare Eagle® MA-only plans: We'll expand these MA-only plans to 43 states (adding Arkansas) and 1,591 counties — reaching more than 6.3 million veterans over age 65 in 2024. These plans offer additional benefits for veterans or individuals who already have prescription drug coverage.⁸ All 2024 Aetna Medicare Eagle plans will feature a $0 monthly plan premium, $0 primary care copay (including walk-in clinics), dental, vision, hearing, OTC allowance and a SilverSneakers fitness benefit. These plans also offer $0 copays for labs, colonoscopies and routine eye and hearing exams. Most MA-only plans include a Part B premium reduction benefit.
New Aetna Medicare SmartFit plans: These are designed for prescription drug plan customers considering switching to a Medicare Advantage plan. These $0 monthly premium plans include dental, vision and hearing. There is also a variety of no-cost benefits like $0 in-network primary care visits and labs and $0 Tier 1 generics at preferred pharmacies and through mail order. Additionally, these plans help consumers stay healthy with a SilverSneakers fitness membership and a fitness reimbursement benefit of $600-$1,200 annually for activities like pickleball, golf and more.
Expanded Institutional Special Needs Plan (I-SNP) products: In continued collaboration with Longevity Health, Aetna will offer new I-SNPs in Ohio and New York and expand our footprint in Pennsylvania. These plans are specifically designed for people living in nursing homes. They include prescription drug coverage and provide enhanced access to on-site care in the facility. Members receive additional benefits tailored to help improve their quality of life by caring for their unique medical, social and emotional needs.

More choices and greater flexibility, with benefits that matter most to members

Medicare can be confusing. So we simplified our plans and invested in those benefits that are most important to our members. To make staying healthy easier, we looked closely at benefit details and made meaningful improvements, like replacing frozen foods with freshly prepared meals. Highlights include:

Strengthened core benefits: Every county where Aetna will offer plans will have options that include a $0 monthly premium, $0 primary care copay, $0 copays for Tier 1 drugs, OTC allowance, dental, vision and hearing.
Improved dental, vision and hearing benefits: Every 2024 Aetna MA plan will include dental,⁹ vision and hearing benefits, ensuring all members can maintain their dental health and access corrective eyewear and hearing aids.
- Dental: In 2024, all of our plans include a dental benefit.⁹ Most plans include annual allowances for things like dentures, crowns and more. Allowances vary by plan. For 2024, we streamlined our dental designs to promote simplicity, strengthen coverage, reduce member cost sharing and improve member experience.
- Vision: In 2024, all plans have a $0 routine eye exam benefit and an eyewear benefit. Eyewear allowances vary by plan.
- Hearing: In 2024, all plans have a $0 routine hearing exam benefit and a hearing aid benefit.
Aetna Medicare Extra Benefits Card: All D-SNPs will include a preloaded debit card with a new Extra Supports Wallet⁴ featuring an allowance and more ways to spend it. The flexible allowance can be used to buy healthy foods, OTC items,¹⁰ gas, transportation, personal care items and pet care supplies.⁵ It can also be used to help pay for utilities (including water, electricity, gas, phone and internet service) and assist with rent or mortgage payments. The card can be swiped at an expanded network of participating retailers for OTC items and healthy foods. Value Plus plans with the Extra Benefits Card provide an allowance to those who receive Extra Help. In certain markets, members can earn an additional allowance by selecting a high value PCP.
Aetna Medicare Payment Card: We'll expand this payment card offering to more plans and states and make it more convenient. Qualifying members will receive a quarterly allowance to use toward either out-of-pocket expenses for in-network care, select OTC wellness items or both. Members whose benefit includes an allowance for OTC items can buy a wide selection of items at any CVS Pharmacy® retail location¹¹ or place orders online through OTC Health Solutions, a CVS Health company.
Expanded fitness benefits: We made enhancements to our fitness benefits to help our members stay physically and mentally active, so they can keep enjoying their favorite activities as they age:
- SilverSneakers and Apple Fitness+™: We'll continue to offer a SilverSneakers fitness memberships to all individual MA members at no additional cost.¹² Through SilverSneakers, members have access to over 15,000 fitness locations, as well as exercise programs outside of traditional gyms, such as recreation centers, malls and parks. Individuals can also connect to virtual resources, including mental enrichment and well-being classes. Apple Fitness+ is also included in the SilverSneakers membership at no additional cost. Fitness+ is an award-winning fitness and wellness service with workouts and meditations designed to be welcoming to all and help people live a healthier day. Fitness+ offers 12 different workout types, from high-intensity interval training (HIIT) to meditation, so there's something for everyone.
- Fitness reimbursement: New for 2024, an enhanced and expanded fitness reimbursement gives members new ways to stay on top of their personal fitness and wellness goals. Members can use their fitness reimbursement allowance on the activities they enjoy most, including pickleball, golf, bowling, swimming and entrance fees for national and state parks. And to make staying healthy even easier, we also added fitness supplies, athletic shoes and more. In 2024 more plans will include this benefit.
Fresh meals: New for 2024, the meal benefit will now provide freshly prepared (not frozen) precooked meals delivered to members' homes upon discharge from an inpatient hospital stay or skilled nursing facility.
$0 cost-shares on select benefits: To ensure important services are affordable, we continue to expand services available at no additional cost to the member. In 2024, we have plans that offer $0 copay for primary care visits and labs. New for 2024, all plans will provide $0 copay for preventive and diagnostic colonoscopies at in-network providers.
Stable or reduced member out-of-pocket costs limits: All Aetna MA plans include maximum out-of-pocket cost protection for covered plan services. We'll keep member in-network maximum out-of-pocket costs limits the same or decrease them in 75% of our individual MA plans for 2024.

Continued reductions in prescription drug costs across the MAPD portfolio

We continued to make changes to our formularies (drug lists) for 2024 to reduce cost and obstacles to accessing medications. These changes also help our members be more adherent with their medications. Highlights include:

$0 deductibles: 100% of MAPD members will enjoy a $0 deductible on all Tier 1 and Tier 2 drugs. We also have plans with a $0 deductible on all tiered drugs (Tiers 1–5).
$0 copays at preferred network pharmacies: All of our MAPD plans will offer $0 copays on Tier 1 drugs. We also have plans with $0 copays on Tier 1 and Tier 2 drugs, for 30-, 60- or 100-day supplies.
Pharmacy network: We have MAPD plans that offer prescription drug coverage with access to nearly 66,000 network pharmacies, with 24,000 preferred options offering additional savings.
100-day supply at no extra cost: All MAPD plans will offer up to a 100-day supply¹³for drugs on Tiers 1–4 at both retail and mail-order pharmacies. Members who choose to use our preferred mail-order pharmacy to fill their prescriptions can count on convenient, no-cost standard shipping. Extended-day supplies may save members money and help them stay on their medication treatment program.
Tier 1/Tier 2 coverage gap: We have MAPD plans that provide robust Tier 1 and Tier 2 gap coverage at the same cost-share as in the initial coverage phase, allowing predictable copays through the donut hole and reducing the possibility of members reaching the catastrophic phase.
$0 copays and $0 deductibles on D-SNPs: All D-SNPs will share one set of common features — robust drug coverage, $0 deductibles and $0 prescription drug copays. Members simply need to qualify for D-SNP enrollment to receive this benefit.
Insulin: Members won't pay more than $35 for a one-month supply of each insulin product covered by our plan.
Vaccines: Many covered Part D vaccines will be available at $0 copay for Medicare beneficiaries.

Innovative programs and money-saving benefits through CVS Health

As a CVS Health company, Aetna offers a unique set of assets that enables us to bring care closer to home. We'll provide individual MA members access to convenient and affordable benefits and programs in their communities, including:

Nationally contracted retail health clinics, including MinuteClinic®: Members in PPO and health maintenance organization (HMO) plans that do not require a PCP can visit either one of the nationally contracted retail health clinics, including MinuteClinic locations, and pay the same copay as a regular visit to a PCP.¹⁴ With over 1,000 locations across 36 states and Washington, D.C., and virtual on-demand care available, MinuteClinic offers convenient access for sick care, prevention and wellness services, and management for chronic conditions. For patients over 65, MinuteClinic delivers age-friendly care via the 4Ms framework: what matters, medication, mentation and mobility. Located in select CVS Pharmacy® and Target stores, MinuteClinic locations are open seven days a week.
OTC benefit: We'll make our OTC benefit offered through OTC Health Solutions, a CVS Health company, available to more members and will increase the OTC allowance amount on MA plans. Members can choose certain health care products and order by phone or online for home delivery. New for 2024, they can also use their benefit in-store at all standalone CVS Pharmacy or Navarro Discount Pharmacy® retail locations across 48 states, up from 39 states in 2023. Catalogs are available in all stores and covered items are easy to identify throughout the store. Members only need to present their member ID card to use their OTC allowance. Select Aetna plans will offer an OTC kit mailed directly to the member's home. These kits contain curated OTC items that help support our members' health.
Healthy Home Visits through Signify Health: All MA plans will offer an annual healthy home visit at no extra cost. It includes a comprehensive health risk assessment and non-invasive physical exam from the comfort of the member's home. The clinician will also evaluate the home environment to identify social support needs and risks that could result in early detection of health problems. These home visits are provided through Signify Health, a CVS Health company.
Oak Street Health primary care network: The acquisition of Oak Street Health this year enables us to offer more coordinated and connected care ― especially in underserved communities. Oak Street Health's innovative care model provides comprehensive primary care with a focus on prevention and wellness. Aetna MA members will have access to all Oak Street Health primary care clinic locations across the country as part of the extensive Aetna provider network.
Fall prevention: We continue to expand our fall prevention benefit through CVS Pharmacy to additional states and plans. For 2024, all D-SNPs (except the NY FIDE plan) will include a fall prevention benefit. In select MA plans, eligible members will receive an annual allowance for certain home and bathroom safety items that may help lower the risk of injury from falls in the home.
Pharmacist panels: We'll connect members who are CVS Pharmacy customers with their local CVS pharmacist. They can deliver personalized advice to drive medication adherence, offer alternatives for high-risk medications, recommend screenings and administer immunizations. Pharmacists can also connect members with recommended health plan resources and support their enrollment into care management programs.
CVS Health Resources For Living® (RFL): This 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. RFL serves as an early point of intervention for the many issues that affect our members' physical and mental health.

Robust standalone prescription drug plans

The Aetna standalone prescription drug plans (PDPs) serve 6.1 million members. In 2024, Aetna Medicare will continue to offer three individual, standalone plans. SilverScript® SmartSaver (PDP) will feature an average monthly premium of $11.19, along with $0 copays for Tier 1 generics at preferred pharmacies and a reduced deductible from 2023. SilverScript Choice (PDP) will be available to members with full Extra Help for a $0 monthly plan premium in 21 states and D.C., while SilverScript Plus (PDP) has the most robust prescription drug coverage of our PDPs including $0 Tier 1 and $0 Tier 2 generics at preferred pharmacies. All three plans are available in all 50 states and D.C.¹⁵

Competitive Medicare Supplement and ancillary plan options

To complete our portfolio of products, Aetna also offers Medicare Supplement plans. With more than 1.4 million members, our competitively priced individual Medicare Supplement plans use a simplified underwriting process. We also offer popular dental, vision and hearing products in 40 states. Our ancillary plan options cover 45 states and often offer members personalized, add-on protection to their individual Medicare plans. This includes plans that provide life insurance coverage, dental, vision and hearing coverage, benefits paid directly to them after being diagnosed with cancer, or for hospital stays, and home or skilled nursing facility recovery care.

Visit AetnaMedicare.com to learn more about our 2024 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, 2023. A licensed agent may answer your call.

¹ Aetna filed 747 individual MA plans with CMS for 2024. This represents the largest number of plans in our history.
²This number includes the Aetna Joint Venture in Minnesota (with Allina Health).
³Centers for Medicare & Medicaid Services (CMS) Enrollment data, August 2023.
⁴Extra Supports Wallet not included with IN and CA plans.
⁵Pet care supplies not included with NJ plans.
⁶Known as Value plan for Allina Health │ Aetna Medicare.
⁷U.S. Department of Health and Human Services. Fact sheet: Biden-Harris administration announces new tools to lower prescription drug costs for low-income seniors and people with disabilities. June 12, 2023. Accessed September 18, 2023.
⁸These plans do not include prescription drug coverage. They are available to all Medicare-eligible individuals and could be a good fit for beneficiaries who already have prescription drug coverage at least as good as Medicare Part D.
⁹Excluding NY I-SNP.
¹⁰OTC items are only included in the Extra Supports Wallet for D-SNPs and limited plans.
¹¹Excludes CVS Pharmacy in Target locations.
¹²Exception: SilverSneakers is not available with the Aetna Medicare Longevity Plan (I-SNP).
¹³Not 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.
¹⁴Members have a choice of providers and can elect to go to their PCP or a nationally contracted clinic of their choice.
¹⁵CMS: https://www.cms.gov/medicare/coverage/prescription-drug-coverage.

About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that's managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.

About Aetna
Aetna, a CVS Health business, serves an estimated 36 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 Aetna.com.

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our DSNPs 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 /or pharmacy network may change at any time. You will receive notice when necessary. The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Rural California, Urban Kansas, Rural Michigan, Suburban Michigan, Urban Michigan, Urban Missouri, Rural North Dakota, Suburban Utah, Suburban West Virginia and Suburban Wyoming. 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 1-833-278-3928 (TTY: 711) or consult the online pharmacy directory. Other pharmacies and providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat plan 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. Participating 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. Eligibility for the Model Benefit or Reward and Incentive (RI) Programs under the Value-Based Insurance Design (VBID) Model is not assured and will be determined by Aetna after enrollment, based on relevant criteria (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program). If your plan's Extra Benefits Card includes roll-over, any unused amount will rollover into the next month/quarter. The monthly/quarterly amount can be rolled over through the end of the plan year but will not carry over into the next plan year. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 10 days. You can call 1–866–235–5660 (TTY: 711), 24 hours a day, 7 days a week, if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery.

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

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

Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies.

Apple Fitness+ is a trademark of Apple Inc.

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SOURCE CVS Health