Available in selected network service areas where large populations of Medicare beneficiaries reside and Aetna has strong provider networks.
Plan Sponsor qualification requires a minimum of 2 eligible Medicare beneficiaries
Our integrated Medicare Advantage-Prescription Drug (MA-PD) plans - the Aetna Golden Medicare Plan® (HMO) and the Aetna Golden Choice™ Plan (PPO) - offer a complete health and drug coverage solution.
MA-PD integration also simplifies enrollment, billing, administration and communications, since it's all coordinated by one source.
- Fully insured plan helps to reduce your risk.
- MA-PD plans deliver Medicare health benefits more efficiently through a single process that includes Parts A, B and D.
- Aetna's strong patient management and disease management capabilities have the ability to result in a more stable trend than unmanaged programs.
- You can begin obtaining savings immediately, as a result of reduced premium rate payments made possible by government subsidies.
- Further savings may result by reducing costs associated with FASB/GASB liability.
Navigational Highlights
Aetna Golden Medicare Plan® (Group HMO)
Aetna Golden Choice™ Plan (Group PPO)
Network Service Areas - Aetna Medicare Advantage Plans (Group HMO and PPO)
Following is a list of states and counties (and specific cities, if applicable) where the Aetna Golden Medicare Plan® (Group HMO) and the Aetna Golden Choice™ Plan (Group PPO) are available:
Arizona(HMO and PPO) - Maricopa - Pinal*
California(HMO Only) - Fresno* - Kern* - Los Angeles - Orange - Riverside* - San Bernardino*
Delaware(PPO Only)- Kent - New Castle - Sussex
Florida(HMO and PPO) - Brevard - Broward - Charlotte - Duval - Hillsborough - Indian River* - Lake - Lee - Martin - Miami-Dade - Nassau - Orange - Osceola - Palm Beach - Pinellas - Saint Johns - Seminole - Volusia
Georgia(HMO and PPO) - Cherokee - Cobb - DeKalb - Forsyth - Fulton
Illinois(HMO and PPO) - Cook
Maryland(HMO/PPO status as follows) - Allegany (PPO only) - Anne Arundel (HMO/PPO) - Baltimore (HMO/PPO) - Baltimore City (HMO/PPO) - Calvert (HMO/PPO) - Caroline (PPO only) - Carroll (HMO/PPO) - Cecil (HMO/PPO) - Charles (HMO/PPO) - Dorchester (PPO only) - Frederick (HMO/PPO) - Garrett (PPO only) - Harford (HMO/PPO) - Howard (HMO/PPO) - Kent (HMO/PPO) - Montgomery (HMO/PPO) - Prince Georges (HMO/PPO) - Queen Annes (HMO/PPO) - Saint Marys (HMO/PPO) - Somerset (PPO only) - Talbot (HMO/PPO) - Washington (HMO/PPO) - Wicomico (HMO/PPO) - Worcester (PPO only)
New Jersey(HMO and PPO) - Atlantic - Bergen - Burlington - Camden - Cape May - Cumberland - Essex - Gloucester - Hudson - Hunterdon - Mercer - Middlesex - Monmouth - Morris - Ocean - Passaic - Salem - Somerset - Sussex - Union - Warren
New York(HMO and PPO) - Bronx - Cayuga - Dutchess - Kings - Nassau - New York - Onandaga - Orange - Oswego - Putnam - Queens - Richmond - Rockland - Suffolk - Sullivan - Ulster - Westchester
Ohio(HMO and PPO) - Cuyahoga - Franklin - Hamilton - Lucas - Summit
Pennsylvania(HMO and PPO) - Adams - Allegheny - Armstrong - Beaver - Berks - Blair - Bradford - Bucks - Butler - Cambria - Carbon - Chester - Clarion - Clinton - Columbia - Cumberland - Dauphin - Delaware - Erie - Fayette - Franklin - Fulton - Greene - Jefferson - Lackawanna - Lancaster - Lawrence - Lebanon - Lehigh - Luzerne - Lycoming - Mercer - Monroe - Montgomery - Northampton - Northumberland - Perry - Philadelphia - Pike - Schuylkill - Snyder - Somerset - Sullivan - Susquehanna - Washington - Wayne - Westmoreland - Wyoming - York
Texas(HMO and PPO) - Bexar - Brazoria - Collin - Comal - Dallas - Denton - Fort Bend - Harris - Jefferson - Kendall - Montgomery - Orange - Rockwall - Tarrant
Virginia(HMO and PPO) - Fairfax - Fairfax City - Falls Church City - Alexandria City
Washington, DC(HMO and PPO) - District of Columbia
*Partial Counties
Check this website regularly to find out when our Medicare Advantage plans are available in additional areas.
Aetna Golden Medicare Plan MA-PD (HMO) - Member Eligibility
As with the Original Medicare Plan, the Aetna Golden Medicare Plan requires enrollees to meet certain federal requirements to be eligible. Medicare beneficiaries:
- Must be entitled to Medicare Part A and enrolled in Medicare Part B.
- Must reside in an Aetna Golden Medicare Plan service area.
NOTE: If an enrollee has end-stage renal disease, certain federal enrollment restrictions may apply. Contact Aetna for details.
Aetna Golden Medicare Plan MA-PD (HMO) - Features
- Members access care through Primary Care Doctors.
- Medicare prescription drug coverage is included.
- Some direct access benefits.
- $0 copay for preventive services.
- No annual lifetime dollar maximums.
- Access to benefits when traveling to plan-approved service areas through the U.S. Travel Advantage® program.
- Access to Aetna ExtrasSM, which provide discounts on vision products, fitness club memberships and more.
Voluntary access option
If you choose not to make contributions towards Aetna MA-PD plans, you can choose to offer our MA-PD plans on a voluntary direct-bill basis. This enables you to offer quality group coverage with no employer contribution required. These plans can be entirely funded by your retirees.
Aetna Golden Medicare Plan MA-PD (HMO) - Contact Us
To learn more about the Aetna Golden Medicare Plan, please contact your Aetna Account Executive, or Contact Us via e-mail, or call:
1-800-307-4830
The Aetna companies that offer, underwrite or administer benefits coverage are Aetna Health Inc., Aetna Health of California Inc., and/or Aetna Health of Illinois Inc.
Members must use network providers except in an emergency or for urgent care or renal dialysis services received out of the service area.
Coverage is provided through a Medicare Advantage organization with a Medicare contract and benefits, limitations, service areas and premiums are subject to change on January 1 of each year.
This material is for informational purposes only. It contains only a partial, general description of plan benefits or programs and does not constitute a contract. Plans contain exclusions and limitations.
Aetna ExtrasSM: Value-added services are discount programs offered in addition to your plan benefits. Program providers are solely responsible for the products and services provided.
Aetna Golden Choice Plan MA-PD (PPO) - Member Eligibility
As with the Original Medicare Plan, the Aetna Golden Choice Plan requires enrollees to meet certain federal requirements to be eligible. Medicare beneficiaries:
- Must be entitled to Medicare Part A and enrolled in Medicare Part B.
- Must reside in an Aetna Golden Choice Plan service area.
NOTE: If an enrollee has end-stage renal disease, certain federal enrollment restrictions may apply. Contact Aetna for details.
Aetna Golden Choice Plan MA-PD (PPO) - Features
- Flexibility to visit doctors and hospitals both in and out of the Aetna network for covered services, without a referral.
- Medicare prescription drug coverage is included.
- Coordination of care through a network primary care doctor for a fixed PCP copay, if the member so chooses.
- Direct access to network specialists at the fixed specialist copay.
- Access to non-network providers with payment of a low deductible and coinsurance.
- No annual or lifetime dollar maximums for in-network services.
- Access to Aetna ExtrasSM, which provide discounts on vision products, fitness club memberships and more.
Voluntary access option
If you choose not to make contributions towards Aetna MA-PD plans, you can choose to offer our MA-PD plans on a voluntary direct-bill basis. This enables you to offer quality group coverage with no employer contribution required. These plans can be entirely funded by your retirees.
Aetna Golden Choice Plan MA-PD (PPO) - Contact Us
To learn more about the Aetna Golden Choice Plan, please contact your Aetna Account Executive, or Contact Us via e-mail, or call:
1-800-307-4830
The Aetna companies that offer, underwrite or administer benefits coverage include Aetna Life Insurance Company.
Higher costs apply for out-of-network services. Certain services require precertification or prior approval of coverage. Providers must be licensed and eligible to receive payment under the federal Medicare program.
Coverage is provided through a Medicare Advantage organization with a Medicare contract and benefits, limitations, service areas and premiums are subject to change on January 1 of each year.
This material is for informational purposes only. It contains only a partial, general description of plan benefits or programs and does not constitute a contract. Plans contain exclusions and limitations.
Aetna ExtrasSM: Value-added services are discount programs offered in addition to your plan benefits. Program providers are solely responsible for the products and services provided.
7A-40709.2
