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What is the Aetna Medicare OpenSM Plan?

The Aetna Medicare Open Plan is a Medicare Advantage Private Fee-For-Service (PFFS) Plan. As an Open Plan member, you won't have a special network to use and you may be able to continue using your same health care providers if they are eligible for Medicare. As long as they accept the Aetna Medicare Open Plan terms and conditions, you'll just pay a copayment or coinsurance for your care. If your health care providers do not participate in the Original Medicare Program, they may bill you up to 15% over the Medicare allowable limit. This is called balance billing.

To enroll in the Aetna Medicare Open Plan, click here.

Other plan features include:

Easy-to-use coverage

  • No special networks or providers needed.
  • Visit any doctor or hospital that is eligible to receive payment from Medicare, agrees to treat you, and accepts the Aetna Medicare Open Plan terms and conditions.
  • Show your Aetna member ID card before receiving care.
  • Pay a copayment or coinsurance for the care you receive.

Contact your doctor or check the government's Medicare website to find health care providers that accept Medicare.

Coverage for prescription drugs
Some Aetna Medicare Advantage Plans (including the Aetna Medicare Open Plan) may include our Medicare prescription drug coverage.

  • Coverage for all Medicare Part D prescription drugs.
  • Over 56,000 retail pharmacies to choose from nationwide.
 Find a Pharmacy

Preventive care services covered in full.

  • Routine eye and vision exams, flu and pneumonia shots, annual mammograms or ob/gyn services, and more are all covered under the plan.

Travel coverage

  • Urgent and emergency care are covered 24 hours a day, 7 days a week, anywhere in the world.
  • Use a health care provider that accepts the Original Medicare Plan and the Aetna Medicare Open Plan terms and conditions.
  • Pay the same copays or coinsurance you pay at home.

Aetna ExtrasSM

  • Available at no extra cost to you.
  • Includes discounts for a variety of products and services like vision care, hearing exams, chiropractic care, vitamins, alternative therapies and more.
  • Allowances for eyewear and hearing aids available in select service areas.

Have questions about the Aetna Medicare Open Plan? Find answers to common questions in our FAQs.Indicates Adobe Reader File Format



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Questions? Call us at 1-800-529-5586 (TTY/TDD 1-800-628-3323)
Monday - Friday, 8 a.m. - 6 p.m.

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M0001_S5810_7A_71050
Updated 2/2008


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You must be entitled to Medicare Part A and continue to pay your Part B premium and Part A, if applicable. You can receive covered services from any licensed doctor or hospital that is eligible to receive payment from Medicare, agrees to treat you and accepts the Aetna Medicare Open Plan private fee-for-service terms and conditions of payment. This product does not require a contracted network and providers are not required to accept Medicare Private Fee-for-Service plans.
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