Aetna offers Medicare Advantage plans, but the available options and benefits depend on your county and coverage year. The Aetna name alone does not identify your network, premium or copayments. Compare the exact plan identifier and documents before enrolling.
Understand the plan type
| Type | What to verify |
|---|---|
| HMO | Routine in-network care, any referral requirement and applicable emergency, urgent-care or out-of-area dialysis protections. |
| HMO-POS | Which specific services the point-of-service option permits outside the network and at what cost. |
| PPO | In-network costs versus permitted out-of-network care; the outside provider must agree to treat you. |
| Special Needs Plan | Whether you meet the specific eligibility criteria and which providers participate. |
A PPO designation does not guarantee every clinician will accept the plan or that all care costs the same outside the network.
Compare your likely annual costs
Record the plan premium, any deductible, primary-care and specialist charges, hospital costs and the medical out-of-pocket limit. You generally continue to owe the Part B premium. A plan premium of $0 does not eliminate service costs.
Check any additional dental, vision, hearing or other benefit individually. Availability, network and limits can differ from the medical benefit. Do not choose on an advertised extra alone.
Use the current documents
Aetna’s coverage and benefits page provides the route to plan information. Review the Summary of Benefits, full Evidence of Coverage and, for an existing member, Annual Notice of Change. Match the plan ID and year.
- Verify each regular doctor and hospital with both the plan and the office.
- Ask about authorization and referrals for anticipated care.
- Check the appropriate enrollment period and effective date.
- Keep the enrollment confirmation and current ID card.
Medicare Advantage requires Parts A and B and residence in the service area. This guide does not assign a universal rating to Aetna or establish that every Aetna product is available through our agency.
Related coverage questions
- How to Find and Verify a Medicare Provider
- How to Verify Your Medicare Coverage and Plan Enrollment
- Medicare HMO and PPO: Networks, Referrals and Costs