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Aetna Medicare Advantage – CMS Sanctions Lifted


Aetna Medicare Advantage Plans an option once again as CMS lifts sanctionsBusiness People Poised to Run a Race

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.

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. CMS lifted these sanctions in 2011.

Aetna continues to be a strong player in the Medicare Advantage market. The recently announced Medicare Advantage contract for the Texas teacher system is one example of their growth.

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

Follow These Tips to Find Affordable Medicare Plans


Keep an eye on Aetna Medicare

Aetna 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 Aetna Medicare Advantage plans and Part D Plans to other options you may have available.

Many companies have be sanctioned by CMS and as long as transgressions have been remedied there is no reason not to give that companies Medicare plans a look in the future.

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