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 |
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
With our HMO plans, an in-network primary care provider coordinates the care you receive to help you achieve your best health.
${company} Medicare Advantage PPO
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 who have both Medicare and Medicaid. We can help you find out if you qualify.
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