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 for your customers.
MA-PD integration also simplifies enrollment, billing, administration and communications, since it's all coordinated by one source.
- Fully insured plan helps to reduce plan sponsor's 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.
- Your customer 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 group sales are authorized for the Aetna Golden Medicare Plan® (Group HMO) and the Aetna Golden Choice™ Plan (Group PPO):
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
For a list of zip codes available for Aetna Medicare Advantage Plan group sales in partial counties, contact your Aetna representative or access our Contact Us page.
Check this website regularly to find out when producer sales are available in additional areas.
Aetna Golden Medicare Plan MA-PD (HMO) - 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 Medicare Plan service area.
NOTE: If an enrollee has end-stage renal disease, certain federal enrollment restrictions may apply. Contact Aetna for details.
Applying is simple!
It's as easy as 1, 2, 3 for employer group Medicare beneficiaries to apply for the Aetna Golden Medicare Plan (HMO):
- Review the Kit documents.
- Complete the application.
- Mail the application.
Electronic Funds Transfer (EFT)
After enrolling, if the Medicare beneficiary wishes to have the monthly premium automatically deducted from a checking or credit card account, he/she can complete an Electronic Funds Transfer form and mail it to Aetna.
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 your customer chooses not to make contributions towards Aetna MA-PD plans, your customer can choose to offer our MA-PD plans on a voluntary direct-bill basis. This enables your customer to offer quality group coverage with no employer contribution required. These plans can be entirely funded by the plan sponsor's retirees.
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Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. The Aetna companies that offer, underwrite or administer benefits coverage are Aetna Health Inc., Aetna Health of California Inc., and Aetna Health of Illinois Inc.
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.
Aetna Extras: Value-added services are discount programs offered in addition to your plan benefits. Program providers are solely responsible for the products and services provided. Because these products and services are not offered or guaranteed under our contract with the Medicare program, they are not subject to the Medicare appeals process. They may be subject to Aetna's grievance process.
This material is for informational purposes only and is neither an offer of coverage nor medical advice. It contains only a partial, general description of plan benefits or programs and does not constitute a contract.
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Aetna Golden Choice Plan MA-PD (PPO) - 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.
Applying is simple!
It's as easy as 1, 2, 3 for employer group Medicare beneficiaries to apply for the Aetna Golden Choice Plan (PPO):
- Review the Kit documents.
- Complete the application.
- Mail the application.
Electronic Funds Transfer (EFT)
After enrolling, if the Medicare beneficiary wishes to have the monthly premium automatically deducted from a checking or credit card account, he/she can complete an Electronic Funds Transfer form and mail it to Aetna.
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 your customer chooses not to make contributions towards Aetna MA-PD plans, your customer can choose to offer our MA-PD plans on a voluntary direct-bill basis. This enables your customer to offer quality group coverage with no employer contribution required. These plans can be entirely funded by the plan sponsor's retirees.
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Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. The Aetna company that offers, underwrites or administers benefits coverage is Aetna Life Insurance Company.
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.
Aetna Extras: Value-added services are discount programs offered in addition to your plan benefits. Program providers are solely responsible for the products and services provided. Because these products and services are not offered or guaranteed under our contract with the Medicare program, they are not subject to the Medicare appeals process. They may be subject to Aetna's grievance process.
This material is for informational purposes only and is neither an offer of coverage nor medical advice. It contains only a partial, general description of plan benefits or programs and does not constitute a contract.
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