Aetna Benefits Mastercard Prepaid Card

Aetna Benefits Mastercard Prepaid Card: Medicare Plans

Aetna Benefits Mastercard Prepaid Card allows the members’ access to medicare. They can quickly pay the copayment account by just swiping their card. Aetna offers a broad range of benefits, including dental, Aetna vision, and hearing coverage, as well as several plans with additional (and valuable) perks.

Keep reading for more details!

Espuebla’s Summary

  • Extra Advantages The majority of customers have access to standard vision, dental, and hearing coverage through Aetna Medicare Advantage.
  • New Total Choice dental benefit from Aetna Medicare is now offered on a number of individual MA HMO-POS and PPO plans.
  • Rewards Program for Members: Beginning in 2022, Aetna will offer the rewards program to all of its individual Medicare Advantage members.
  • All individual MA Aetna members have access to SilverSneakers® fitness memberships at no extra cost.

About Aetna, Member Of The CVS Health Family

An estimated 37.3 million consumers receive information and tools from Aetna Inc., one of the top national providers of diverse health and wellness benefits, according to the American Medical Association, to help them make better decisions about their health care.

It offers medical, pharmaceutical, dental, behavioral health, group life, disability plans, and health information technology services in addition to medical management skills and Medicaid health care management services.

Customers include labor unions, employer organizations, individuals, students, part-time employees, and hourly workers as well as health insurance plans and service providers from the government and the private sector.

The Aetna group of companies, which includes Aetna Life Insurance Company and its affiliates, uses this brand name for products and services it offers. Both health benefits and health insurance have exclusions and restrictions.

The insurer was established in Hartford, Connecticut, in 1853, and in 2018, it merged with CVS Health Corp. The company’s main office is in Hartford. Aetna offers health, dental, and pharmacy insurance plans.

It provides Medicare Prescription Drug Plans, Medicare Supplement Insurance, and Medicare Advantage Plans (MAp) to both individuals and groups.

As of October 2022, it will cover 10.6 million Medicare recipients in the US, including more than 3.2 million who are enrolled in Aetna MA plans and 6.1 million who have stand-alone prescription drug coverage.

Function Of The Aetna Benefits Mastercard Prepaid Card

The card will be topped out with $100 every three months as of January 1. When visiting a general practitioner (PCP), a specialty clinic, and clinics that offer specific other services, members can utilize it to cover in-network copays.

If your branch supports Mastercard® pre-paid, the member can use it like a debit card to make their own payments (with or without a PIN). In this approach, the member may pay the entire cost.

The member may also decide to pay a portion of the total and use a different payment method for the remaining balance if your branch accepts the usage of multiple payment methods.

What Happens If A Member Forgets Their Card Or It Doesn’t Have Enough Money On It?

The member must make a different co-payment first, then ask for a manual refund. Alternatively, if the member is aware of their balance, your branch may allow them to make a split payment, in which case they can pay a portion of the balance with their cards and the remaining balance using another method.

Function Of The Aetna Benefits Mastercard Prepaid Card

What If It Is Rejected Or Doesn’t Work?

  • Ensure that the cardholder only contributes personally by using the benefits of the card.
  • The credit card is not active. The member can phone the number on his activation sticker to activate his card. 1-877-261-9951 is the number (TTY: 711).
  • The expenses might not be regarded as eligible under the plan. An explanation of coverage (EOC) document should be reviewed by the member.
  • A qualified subscription cannot include the member. The following Keystone Market Plans meet the plans: H3959-001, H3959-002, H3959-010, H3959-011, H3959-037, H3959-041, H3959-047, H3959-051, H3959-053, H5521-261, and H5522- 018.

Pros And Cons Of The Aetna Medicare Advantage Service

One million more Medicare patients will have access to an Aetna plan in 2022 thanks to Aetna’s addition of 83 new counties nationwide. There are benefits and drawbacks to Aetna’s Medicare Advantage service.

Pros

  • Several Benefits: Many plans provide Aetna customers with access to benefits cards that cover dentistry, vision, and hearing in addition to over-the-counter reimbursement, meal delivery services, and home health visits.
  • Solid 0$ Premium Offering: Aetna predicts that 84 percent of U.S. qualified beneficiaries will have access to a free monthly Aetna MA membership by 2023.
  • Widespread accessibility: Aetna provides standalone drug plans in all 50 states, as well as MA plans in 46 states and Washington, DC.
  • Savings on Medications: Nearly all Tier 1 drugs covered by Aetna MA prescription insurance have a $0 copay and no deductible. Nearly 300 medications are now available at lower cost levels in Aetna’s most popular formulary.

Cons

  • Star ratings average The Medicare Advantage coverage offered by Aetna for 2023 has an average weighted rating of 3.67 stars from the Centers for Medicare & Medicaid Services (CMS).
  • Moderate Member Love: According to JD Power, Aetna® Medicare Advantage got 796 out of 1,000 points, which is below the sector average of 809.

Available Medicare Advantage Plans

The structure, price, and advantage of the various varieties that Aetna offers differ. A majority of plans include dental, vision, and hearing coverage in addition to fitness benefits through SilverSneakers.

Aetna typically offers standalone Medicare Advantage plans, MAPDs, and MA plans without prescription drug coverage. This veteran-specific plan has been expanded by the firm, Aetna By 2023, 42 states will be included in the Medicare Eagle plan.

The program is intended to complement the medical care that veterans receive through the VA. In order to supplement their VA health care coverage and ensure that this population has access to crucial benefits, the plans were created with Veterans.

In 2023, Aetna will also roll out the Longevity Plan in Pennsylvania. This Institutional Special Needs Plan was created with members who reside in nursing homes in mind. By province, subscription availability could differ. The following sorts of subscriptions may exist as well:

HMO

You are typically required to use a particular network of physicians and hospitals if you are a member of a health maintenance organization, or HMO.

If you want to see a specialist, your primary care provider may need to refer you, and the benefits of going outside of the network are typically modest.

Subscriptions for HMO-POS

You have a little more flexibility with HMO point-of-service plans than with standard HMO. While you have a primary care physician and could still require a referral, you have more freedom to see healthcare providers outside of your insurance network, albeit you’ll pay more for out-of-network care.

PPO

You have the most freedom with a PPO, or preferred provider organization, as you can visit any provider who accepts your insurance.

You might not need to select a primary care physician, and you don’t need a prescription to see a specialist. Although it could cost more than visiting a doctor in your network, you can get care outside of it.

D-SNPs

A Dual-Eligible Special Needs Plan, or D-SNP, may be available to you if you have both Medicare and Medicaid and reside in one of the 30 states.

These plans include hospital, doctor, and drug coverage along with extra benefits including a care coordinator to assist you in managing medical visits, a social worker to help you connect with local and state programs, and an advocate to assist you in obtaining your state benefits.

Medicare Prescription Drug Plans 

5.7 million Medicare members are served by Aetna’s standalone prescription pharmaceuticals (PDP). Aetna Medicare will continue to offer three distinct freestanding PDPs in 2022 as it did in 2021.

The lowest premium Aetna plan offered by Aetna will once again be SilverScript SmartRx (PDP), with an average monthly premium of $7.08. While SilverScript Healthy Benefits Plus has the most comprehensive medication coverage, SilverScript Choice (PDP) is priced below the CMS baseline in 49 states and DC.

All three plans have lower Tier 1 and Tier 2 copays at recommended pharmacies and are accessible in all 50 states and DC. 

Medicare Supplement Plans

The reduced individual Medicare Supplement plan has a streamlined underwriting procedure and has more than 1.2 million members. Additionally, they provide well-liked dentistry, vision, and hearing products in 37 states.

The 45-state supplemental plan options can offer consumers coverage for life, benefits paid to them promptly after a cancer diagnosis or for hospital stays, and recovery care at home or in a skilled nursing facility.

Medicare Supplement Plans

Extra Advantages

The majority of customers have access to standard vision, dental, and hearing coverage through Aetna Medicare Advantage. Which many are absent from other MAp. Here are some noteworthy items:

Fitness: A lot of plans come with SilverSneakers, which gives you access to community centers and gyms that are in the fitness, as well as savings on healthy living and a fitness app.

Home health visits: For increased convenience, certain beneficiaries may ask for telecare or an in-person home health visit.

Concierge Services for Local Resources: Aetna’s Resources for Living program can assist clients in getting the aid they require, whether it be in the form of home assistance, caregiving resources, or assistance in locating local activities.

Over-the-counter: Some plans have an OTC benefit that enables you to purchase specific items, such vitamins and cold medications, at participating stores (or online) without paying any additional fees.

Meals at home: Some plans provide you with healthy meals to speed up your recovery after being hospitalized.

Telehealth: For primary care, emergency care, specialist care, and mental health, virtual visits are available in all 2023 plans. Physical, occupational, and speech therapy as well as drug rehab, information on renal illness, and diabetic self-management training are all offered via telehealth.

Space-Limited Extras

Aetna MA further provides several benefit packages, some of which are only offered on a few plans in particular areas. These programs include the following:

Benefit for Companionship: In select D-SNP plans, Aetna matches users with a companion who can assist them with errands or keep them company for up to 10 hours each month.

  • Extra Card: Some individuals have access to a prepaid debit card that can be used to pay for over-the-counter goods, wholesome foods, utilities, or transportation.
  • Memory Training: Some people have access to a collection of mental workouts and games, as well as information on the health of their brains.
  • Fresh Food Boxes: Some customers are qualified to get a box of fresh fruits and vegetables on a biweekly or monthly basis.
  • Fall Prevention: Some users are entitled to an annual stipend that they can spend on safety equipment that helps lower the risk of injuries from falls.

Offering Innovative New Programs And Benefits

By offering a number of benefits and services that are brand-new for this year, Aetna provides individual member benefit plans with access to easy and inexpensive care.

Additional support for low-income individuals

For members who qualify for LIS, the majority of D-SNP offer prescription medications at no out-of-pocket expense as well as additional benefits. Depending on the plan, coverage may also include healthy food or utilities, as well as companionship or fall prevention benefits.

Hospice

Aetna is aware that customers who require hospice care could need extra care and support. Aetna will be in charge of the members’ full medical coverage and hospice as part of the all-inclusive coverage of particular MAp in Ohio and Pennsylvania.

Access to additional benefits to help their end of life is available to people who are members of the Aetna Compassionate Care program and who use specific healthcare providers.

They will get continuing temporary concurrent care, including access to a Personal Emergency Response System, additional transportation, additional meals, treatment for a terminal illness and associated conditions, and home assistance (PERS).

Aetna Medicare Debit

With the help of PayFlex®, Aetna is now able to provide a new debit card that covers out-of-pocket expenses for in-network general and specialty care as well as additional medical and diagnostic services.

Users that qualify get $100 every three months, up to $400 annually. In Minnesota and Pennsylvania, this benefit is bundled with a few individual MAp plans.

Therapeutic Massage

In addition to the benefits of alternative medicine, certain MAp in the Northwest region will pay for up to 24 therapeutic massage sessions annually.

Medical Clinical Policy

You are pre-covered for certain dental services with MAp that includes a dental network benefit, but you might need to visit a dentist in your network of providers.

Any certified dental provider may be seen under some Preferred Provider Organizations (PPO), Preferred Provider Organizations (HMO-POS), and HMO-POS (Health Maintenance Organization) plans, but you will likely save money if you go to a provider in the network. When logged in as a member, you can access the provider list to find a network provider.

Most insurance plans provide full coverage for preventive services including cleanings, oral exams, and X-rays. If you continue to use the network, you won’t have to pay anything out of pocket.

Depending on the plan, there may be a difference in coverage for comprehensive services like crowns, extractions, and fillings, and you might be responsible for some of the cost. For further details, please see your subscription.

When organizing your dental care, keep in mind that there may be restrictions on the number of preventative care appointments you can schedule annually as well as coverage for additional services.

The majority of plans also have a maximum benefit, which establishes a cap on the amount that may be used to pay for dental care. The maximum benefit is between $150 and $6,000, approximately.

Dental Clinical Policy

This dental clinical policy includes a wide range of dental care topics, such as preventative care, fundamental procedures, and significant treatments. Routine oral exams and cleanings are part of preventive care. Root canals, extractions, and fillings are examples of basic operations.

Bridges, implants, and dentures are examples of major operations that require more substantial work. Because it outlines which procedures are covered by Aetna’s dental insurance, this policy is crucial for both patients and dentists.

Medicare Advantage Providers

The list below contains more details about some of the biggest providers. In most states, these insurers offer coverage. Your county and ZIP code will decide which plans are accessible to you.

The other Medicare providers are listed below for your convenience: AARP, Anthem, Blue Cross Blue Shield, Cigna, Humana, Kaiser Permanente, UnitedHealthcare, and Wellcare.

Using New and Expanded MA Benefit to Address Social Health Determinants

Beyond just providing clinical care, the MAp adopts a holistic approach to health. In light of this strategy, Aetna has increased the list of benefits to include:

Telehealth: All Aetna 2022 MAp plans support telehealth consultations for primary care, emergency care, and specialized care delivered by a doctor, including mental health services. People can book around-the-clock telehealth appointments through MinuteClinic Video Visit TM, Teladoc ®, or another network provider that provides this service, depending on where they are.

Healthy Foods Card: To combat food insecurity, 77 MA plans in 28 states will now accept the Healthy Foods Card. Users who meet certain criteria are given money they can use to buy wholesome foods from more than 30,000 authorized stores countrywide.

Utility card: Useful card In 2022, a new utility card is available with some DNSP subscriptions. With the help of this debit card, you can pay for the monthly health care expenses associated with using utilities like gas, water, electricity, and sewage.

Companionship: To combat social isolation, Aetna is extending its companionship benefit to some MAp in eight states. Adult companions engage with approved users through Papa Inc. to assist with housework and technology for up to 10 hours per month at no additional cost. Secure video or telephone calls can be used for remote guidance.

Fall Prevention: Aetna is extending the reach of its CVS Pharmacy fall prevention benefit to additional plans and states. For specific clinically relevant safety items that assist lower the risk of injury from falls in the home, eligible users of a particular MAp receive annual reimbursement.

Using New and Expanded MA Benefit to Address Social Health Determinants

Making Healthcare More Affordable, Accessible And Easier

Cost-sharing of 0 dollars for some benefits: Three of the four Aetna Individual MAp plans now offer primary care and lab visit visits at no cost-sharing to ensure that essential services are accessible and affordable. Additionally, all Aetna MAp provide free A1c, COVID-19, and urine protein tests, as well as free eye exams for diabetics that include retinal photos.

OTC: Aetna is boosting the amount of its over-the-counter (OTC) benefit that is offered to consumers of many MAp through OTC Health Solutions, a CVS Health Company. By phone, catalog, or online, beneficiaries of the OTC benefit may select specific healthcare products for home delivery.

3,000 specific CVS Pharmacy® or Navarro Discount Pharmacy® sites throughout 37 states are also available for direct delivery of items when an ID card is shown. Aetna is happy to offer all members the OTC benefit to give access to nicotine replacement treatment, in keeping with CVS Health’s commitment to assisting people in leading smoke-free lives (NRT).

Users who qualify may select from a range of FDA-approved smoking cessation products, including gum, lozenges, or patches.

Reduced Insulin Costs: Aetna is extending its involvement in the Part D Senior Savings model to provide individuals with some individual MAPD plans and all SilverScript Plus Part D plans with inexpensive, dependable co-payments of no more than $35 for a 30-month daily supply of specific insulins.

Aetna Medicare promotes SilverScript, a Prescription Drug Plan that has been approved by Medicare and is covered by a Medicare contract.

Prescription Pharmaceuticals: The daily supply of prescription drugs for all of Aetna’s individual MAPD plans will be increased to a maximum of 100 days for medications at levels 1-4. Without raising copays or coinsurance, people can benefit from the new daily supply advantage.

New Total Choice dental benefit from Aetna Medicare is now offered on a number of individual MA HMO-POS and PPO plans. Innovative Dental Design.

With this dental reimbursement, the member may select a qualified dentist from either inside or outside the network, and preventative and complete dental services are covered up to the maximum reimbursement coverage.

Cut Cash Expenses: For 2022, Aetna has reduced the maximum cash costs for network members in around one-third of each of its different MAps.

Rewards Program for Members: Beginning in 2022, Aetna will offer the rewards program to all of its individual Medicare Advantage members. With the aid of customized reward activities, the program aids in their improvement of health and wellbeing.

They can make $150 or more by finishing tasks like preventive examinations and yearly physicals that are already covered by their benefits.

Additionally, Aetna will keep providing the subsequent benefits or additional services as part of its Medicare Advantage plans:

Every year, All MAp members can have a no-charge in-home evaluation that includes a thorough evaluation of their health risks and a painless physical examination in the convenience of their own homes. In order for the member to remain at home safely, the doctor will also evaluate the home environment for any fall hazards.

By connecting users to important local resources, including housing, food programs, transportation, caregiver assistance, and utilities, according to their needs, the Aetna Resources For Living ® program helps address loneliness and other social issues.

For the numerous problems that have an impact on physical and mental health, the program acts as an early intervention point.

All individual MA Aetna members have access to SilverSneakers® fitness memberships at no extra cost. People have access to more than 16,000 fitness centers with SilverSneakers.

Additionally, SilverSneakers FLEX® allows them access to exercise programs in locations other than conventional gyms, like recreation centers, shopping malls, and parks.

Through SilverSneakers LIVETM, SilverSneakers On-DemandTM, and the mobile application SilverSneakers GO, people can also access to a support network and virtual resources.

The majority of Medicare Advantage members will still have access to routine face, dental, and hearing coverage thanks to Aetna.

Visit to find out more about Aetna Medicare’s 2022 plans, go to AetnaMedicare.com. You can also phone 1-844-588-0041 (TTY: 711) 7 days a week from 8 a.m. to 8 p.m.

October 15 through December 7, 2021, is the annual Medicare enrollment period. Calls are answered by authorized personnel.

Frequently Asked Questions

PayFlex Systems USA, a top benefits administrator, was acquired by Aetna in 2011. In order to give health care customers access to safe, simple card services, Aetna is now making use of the partnership that already exists between MasterCard and PayFlex.

The all-purpose Visa Prepaid card is a prepaid card that you can use to withdraw cash, pay bills, or make purchases anywhere Visa Debit cards are accepted, both offline and online.

Benefits covered under Medicaid

Aetna Better Health of Florida has a big network of physicians in the counties they cover. You can find a doctor close to you using the Provider Search Tool. Being a Medicaid member of Aetna Better Health of Florida has several other significant benefits, such as: Language translation services.

Thanks for reading this article till the end. Hope you find this informative and useful. If you need more help, do not hesitate to contact us on espuebla.com.

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