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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 |
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 |
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 |
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 |
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.
${company} Medicare Advantage HMO-POS plans
With our HMO-POS plans, you can enjoy all the benefits of receiving medical care through a network provider. Our HMO-POS plans require you to use a network provider for medical care but provide you with flexibility to go to licensed dentists in or out of network for routine dental care.
${company} Medicare Advantage PPO plans
With our preferred provider organization (PPO) plans, you can visit providers, in or out of network, who accept Medicare and ${company} plan terms. The freedom is yours.
${company} Medicare Advantage D-SNPs
Our Dual-eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan, available to people living in our service area who have both Medicare and Medicaid. We can help you find out if you qualify.
Questions? We’ve got answers
Medicare FAQs
Get answers to common Medicare questions.