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Woman with Aetna Medicare Advantage HMO plans hiking in a forest

Understanding Medicare Advantage HMO plans

With ${company} Medicare Advantage HMO plans, you choose an in-network primary care provider (PCP). Your PCP works with you to help you get the right care at the right time so you can achieve your best health.

How do Aetna Medicare Advantage HMO plans work?

A health maintenance organization (HMO) gives you access to a network of doctors and hospitals. Your plan requires you to use these network providers. Your HMO plan may also require you to get a referral from a PCP for hospital care and specialist visits. There are limited out-of-network benefits with an HMO plan.

Comparing Aetna Medicare Advantage plans

Our Medicare Advantage HMO plans

Our Medicare Advantage HMO-POS plans

Our Medicare Advantage PPO plans

Preventative services covered

Yes

Yes

Yes

Requires you to use a network provider

Yes, unless it’s an emergency

Seeing out-of-network medical providers generally costs more.

No. But seeing out-of-network providers generally costs more.

Requires you to have a primary care provider (PCP)

Yes

Yes

Usually no PCP required

Requires referral to see a specialist

Varies by plan

Varies by plan

Varies by plan

Monthly premiums

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Medical deductible

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Limits what you pay out-of-pocket for covered medical care each year

Yes

Yes

Yes

Includes prescription drug (Rx) coverage

Varies by plan

Varies by plan

Varies by plan

Includes Rx mail-order benefit

Yes, if plan has Rx coverage

Yes, if plan has Rx coverage

Yes, if plan has Rx coverage

Dental, vision and hearing coverage

Yes (except for I-SNP)

Yes (except for I-SNP)

Yes (except for I-SNP)

ER and urgent care coverage worldwide

Yes

Yes

Yes

Fitness benefit

Yes, through SilverSneakers®

Yes, through SilverSneakers®

Yes, through SilverSneakers® except Institutional Special Needs Plans (I-SNP)

Over-the-counter (OTC) benefit

Varies by plan

Varies by plan

Varies by plan

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Yes

Yes

Yes

Comparing Aetna Medicare Advantage plans

Our Medicare Advantage HMO plans

Preventative services covered

Yes

Requires you to use a network provider

Yes, unless it’s an emergency

Requires you to have a primary care provider (PCP)

Yes

Requires referral to see a specialist

Varies by plan

Monthly premiums

Varies by plan, check your ZIP code for details

Medical deductible

Varies by plan, check your ZIP code for details

Limits what you pay out-of-pocket for covered medical care each year

Yes

Includes prescription drug (Rx) coverage

Varies by plan

Includes Rx mail-order benefit

Yes, if plan has Rx coverage

Dental, vision and hearing coverage

Yes (except for I-SNP)

ER and urgent care coverage worldwide

Yes

Fitness benefit

Yes, through SilverSneakers®

Over-the-counter (OTC) benefit

Varies by plan

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Yes

Our Medicare Advantage HMO-POS plans

Preventative services covered

Yes

Requires you to use a network provider

Seeing out-of-network medical providers generally costs more.

Requires you to have a primary care provider (PCP)

Yes

Requires referral to see a specialist

Varies by plan

Monthly premiums

Varies by plan, check your ZIP code for details

Medical deductible

Varies by plan, check your ZIP code for details

Limits what you pay out-of-pocket for covered medical care each year

Yes

Includes prescription drug (Rx) coverage

Varies by plan

Includes Rx mail-order benefit

Yes, if plan has Rx coverage

Dental, vision and hearing coverage

Yes (except for I-SNP)

ER and urgent care coverage worldwide

Yes

Fitness benefit

Yes, through SilverSneakers®

Over-the-counter (OTC) benefit

Varies by plan

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Yes

Our Medicare Advantage PPO plans

Preventative services covered

Yes

Requires you to use a network provider

No. But seeing out-of-network providers generally costs more.

Requires you to have a primary care provider (PCP)

Usually no PCP required

Requires referral to see a specialist

Varies by plan

Monthly premiums

Varies by plan, check your ZIP code for details

Medical deductible

Varies by plan, check your ZIP code for details

Limits what you pay out-of-pocket for covered medical care each year

Yes

Includes prescription drug (Rx) coverage

Varies by plan

Includes Rx mail-order benefit

Yes, if plan has Rx coverage

Dental, vision and hearing coverage

Yes (except for I-SNP)

ER and urgent care coverage worldwide

Yes

Fitness benefit

Yes, through SilverSneakers® except Institutional Special Needs Plans (I-SNP)

Over-the-counter (OTC) benefit

Varies by plan

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Yes

Medicare Advantage plans for every need

Aetna® Medicare offers you other Medicare Advantage plan options with monthly plan premiums as low as $0. We can help you find a plan that’s right for you.

Questions? We’ve got answers

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