Important Notice Regarding County Changes – Please Read Carefully

2019 Plan Guide for Northern, Central, Upstate, NY.

Attached are some of the in-network costs and benefit information for Aetna Medicare plans; however, it is not a complete list. For more information about these plans, refer to the Summary of Benefits, visit the Aetna Website at https://aetnamedicare.com.

Download Aetna 2019 Plan Guide

Aetna is the brand name used for products and services provided by one or more of the Aetna group for subsidiary companies, including Aetna Life Insurance Company, Coventry Health, and Life Insurance Company and their affiliates (Aetna).

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract.

Plan features and availability may vary by service area.  Members who get “extra help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays.

Members in Aetna HMO plans must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services.  If you obtain routine care from out-of-network providers, neither Medicare nor Aetna will be responsible for the costs.

Members in Aetna HMO POS/PPO plans can go to doctors, specialists or hospitals in-or-out-of-network.  With the exception of emergency or urgent care, it may cost more to get care from out-of-network providers. Out-of-network/non-contracted providers are under no obligation to treat Aetna members, except in emergency situations.

This information is not a complete description of benefits.  Contact the plan for more information.  See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations, and conditions of coverage. Please call the customer service number or see the Evidence Coverage for more information, including the cost-sharing that applies to out-of-network services.  

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