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Woman with Aetna Medicare Advantage HMO-POS plans looking at flowers

Understanding Medicare Advantage HMO POS plans

With ${company} Medicare Advantage HMO-POS plans, you have a network of providers to use for medical care. Our HMO- POS plans require you to use a network provider for medical care. But there are options to go out of network for dental care. That gives you more choice and flexibility.

How do Aetna Medicare Advantage HMO-POS plans work?

HMO-POS plans generally offer you more choice than traditional health maintenance organization (HMO) plans. You’ll want to  choose an in-network primary care provider. Generally, HMO-POS plans require you to use an in-network provider for medical care. And, these plans provide you with flexibility to go to licensed dentists either in or out of our network for routine dental care. However, you may pay more for out-of-network care you receive.

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

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