Aetna Medicare Advantage – CMS Sanctions Lifted
Aetna Medicare Advantage Plans an option once again as CMS lifts sanctions
In April 2010 the Centers for Medicare and Medicaid Services (CMS) imposed sanctions on Aetna that required them to cease marketing of Aetna Medicare Advantage Plans and their Part D Plans.
These sanctions were imposed mostly due to how they were administering their Medicare Part D Plans. This was a huge blow not only to Aetna but to potential members who may have been interested in their plans.
The CMS sanctions have been lifted and beginning June 13 2011 Medicare beneficiaries who qualify are able to enroll in an Aetna Medicare Advantage Plan or a stand-alone Part D Plan with a July 1, 2011 effective date. Enrollments will require a Special Enrollment Period initially as the Annual Enrollment Period does not begin until October.
Medicare Advantage enrollment and Part D enrollment for plans with a 2012 effective date begins October 15, 2011 and ends December 7, 2011. This enrollment period time frame is a change from years past.
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Aetna Medicare Advantage not available to everyone
Aetna Advantage Plans are primarily focused on major metropolitan areas. This unfortunately seems to be a trend with Medicare Advantage Plans as it’s easier to develop networks in more populated areas. In addition, regulations that became effective January 2011 regarding the ability for insurance carriers to offer Private fee-for-service plans drove them to focus less on rural areas.
Aetna Medicare Advantage Plans are available in 19 States (though on a County-by-County basis). States where plans are offered include: (AZ, CA, CO, CT, DE, FL, GA, IL, MD, ME, NJ, NV, NY, OH, OK, PA, TN, TX, VA). Nearly 37% of Medicare beneficiaries will be able to choose an Advantage Plan from Aetna.
Aetna’s network for HMO and PPO plans includes:
- 1,500 hospitals
- Almost 205,000 primary doctors and specialists
- approximately 60,000 pharmacies
- 92,000 other health care providers
Aetna plans are also strong when it comes to the extra value-added benefits. Plans include:
- Annual hearing and vision exams
- Free gym/health club membership
- RX home delivery benefit
- Discount on weight loss programs
Keep an eye on Aetna Medicare for 2012
With the huge set back Aetna suffered with the loss of an entire Annual Enrollment Period expect that their 2012 Advantage Plans will be designed to make up lost ground. In addition they may have learned a valuable lesson from their past digressions and go above and beyond to serve their members.
These factors alone may make it worth your while to compare 2012 Aetna Medicare Advantage plans and Part D Plans to other options you may have available.
Remember the Annual Enrollment Period starts earlier this year and you would be wise to start early in your comparison process. Whether you shop online or meet with an agent take some time to see if Aetna’s Medicare Plans are right for you.
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