Plan number
Pennsylvania and West Virginia: The Aetna® Medicare Payment Card for the Keystone market
What is the Aetna Medicare Payment Card?
The Aetna Medicare Payment Card is a preloaded debit card that Aetna Medicare members received on or before January 1, 2023. The purpose of this card is to make it easier for members to pay for medical services or, for certain plans, medical services and over-the-counter (OTC) expenses. On the first day of every quarter, PayFlex® will load funds onto the card.
For plans that offer coverage for medical services only, members can use their card to pay for copays, and coinsurance for plan-covered services such as:
- Physician visits
- Physical, speech and occupational therapy visits
- Diagnostic procedures, labs, X-rays and tests
- Telehealth-related services
For plans that offer coverage for both medical and OTC expenses, members can use their card for the medical services listed above and for purchasing over-the-counter items through Over-the-Counter Health Solutions (OTCHS) via mail order or in person at any CVS Health® retail stores.
How does the Aetna Medicare Payment Card work?
If your office accepts Mastercard, the member can swipe the card with or without using a PIN to pay for their medical services up to the quarterly amount that is on the card.
If your office allows the use of more than one payment method, the member can opt to pay a portion of their bill using the card and the rest of their bill using another form of payment.
If your office does not accept Mastercard or if the member forgets their card, they can request a manual reimbursement. When a member requests reimbursement, they must provide itemized statements that include their name, the provider’s name, the date of service, a description of the service and the payment amount.
What Aetna Medicare Advantra plans include the Aetna Medicare Payment Card in 2023?
Effective January 1, 2023, there are sixteen Advantra plans that include the Aetna Medicare Payment Card. The plans are provided below. Plans marked with an asterisk provide additional coverage for over-the-counter items.
|
|
Plan name |
|---|---|
|
H1608-027 |
Aetna Medicare Advantra Gold (PPO) |
|
H1692-002 |
Aetna Medicare Advantra Silver (HMO-POS) |
|
H3931-004* |
Aetna Medicare Premier Plus (HMO-POS) |
|
H3931-064* |
Aetna Medicare Premier (HMO-POS) |
|
H3959-001 |
Aetna Medicare Advantra Gold (HMO) |
|
H3959-002 |
Aetna Medicare Advantra Gold (HMO) |
|
H3959-010 |
Aetna Medicare Advantra Silver (HMO-POS) |
|
H3959-011 |
Aetna Medicare Advantra Silver (HMO-POS) |
|
H3959-037 |
Aetna Medicare Advantra Gold (HMO-POS) |
|
H3959-041 |
Aetna Medicare Advantra Eagle (HMO) |
|
H3959-047 |
Aetna Medicare Advantra Butler Prime (HMO) |
|
H3959-049 |
Aetna Medicare Advantra Excela Prime (HMO-POS) |
|
H3959-051 |
Aetna Medicare Beaver Valley Prime (HMO) |
|
H3959-053* |
Aetna Medicare Advantra Philly Prime (HMO) |
|
H5521-261 |
Aetna Medicare Value (PPO) |
|
H5522-022 |
Aetna Medicare Silver Back (PPO) |
Plan number |
H1608-027 |
|---|---|
Plan name |
Aetna Medicare Advantra Gold (PPO) |
Plan number |
H1692-002 |
Plan name |
Aetna Medicare Advantra Silver (HMO-POS) |
Plan number |
H3931-004* |
Plan name |
Aetna Medicare Premier Plus (HMO-POS) |
Plan number |
H3931-064* |
Plan name |
Aetna Medicare Premier (HMO-POS) |
Plan number |
H3959-001 |
Plan name |
Aetna Medicare Advantra Gold (HMO) |
Plan number |
H3959-002 |
Plan name |
Aetna Medicare Advantra Gold (HMO) |
Plan number |
H3959-010 |
Plan name |
Aetna Medicare Advantra Silver (HMO-POS) |
Plan number |
H3959-011 |
Plan name |
Aetna Medicare Advantra Silver (HMO-POS) |
Plan number |
H3959-037 |
Plan name |
Aetna Medicare Advantra Gold (HMO-POS) |
Plan number |
H3959-041 |
Plan name |
Aetna Medicare Advantra Eagle (HMO) |
Plan number |
H3959-047 |
Plan name |
Aetna Medicare Advantra Butler Prime (HMO) |
Plan number |
H3959-049 |
Plan name |
Aetna Medicare Advantra Excela Prime (HMO-POS) |
Plan number |
H3959-051 |
Plan name |
Aetna Medicare Beaver Valley Prime (HMO) |
Plan number |
H3959-053* |
Plan name |
Aetna Medicare Advantra Philly Prime (HMO) |
Plan number |
H5521-261 |
Plan name |
Aetna Medicare Value (PPO) |
Plan number |
H5522-022 |
Plan name |
Aetna Medicare Silver Back (PPO) |
What would cause a card to be declined?
- The member did not activate their card. The phone number to activate their card is 1-877-261-9951 ${tty}.
- The expense might not be considered eligible under the plan.
- There is not enough money on the card to cover the expense.
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Health benefits and health insurance plans contain exclusions and limitations.