![]() Most of these plans include access to a personalized care team. Some people have a plan with copays or coinsurance. These plans offer the most comprehensive benefits for people with the highest need. The precise amount of coverage you get will depend on your Aetna plan. Aetna D-SNPsĭual Eligible Special Needs Plans (D-SNPs) are designed for people who are eligible for both Medicare and Medicaid. You’re not required to choose a PCP and don’t need referrals to see specialists. Seeing an out-of-network provider will typically cost more. Aetna PPO plansĪetna’s Preferred Provider Organization (PPO) plans let you use any doctor, in and out of network, provided that they accept Medicare and Aetna’s plan terms. Some will require specialist referrals from your PCP as well. With an Aetna HMO-POS plan, you’ll typically pay more to see an out-of-network doctor.Īetna HMO-POS plans also require you to choose a PCP. 250 copay per admission Covered in full 100 per admission 200 copay per admission Skilled Nursing Facility Care Semiprivate room and board, skilled nursing and rehabilitation services/supplies First 20 days, 100 of approved amount additional 80 days, all but : 200 per day beyond 100. Plan members may access medical treatment outside their HMO network for specific treatments or under special circumstances. HMO Point-of-Service (HMO-POS) plans are HMOs that include an out-of-network option. All plans include worldwide ER and urgent care coverage. In the case of an emergency, you’ll be able to use an out-of-network doctor, ER, or hospital. COMPARISON OF BASIC HEALTH, VALUE HEALTH, AND CHOICE HEALTH. You may need a referral from your PCP to see a specialist. Doctor office visits: 35 per visit for PCP / 60 per visit for Specialist Hospital Stay: 500 copay/day first 5 days per. 2022 SCHEDULE OF AETNA NATIONAL NETWORK BENEFITS. You’ll have access to a specified network of doctors and hospitals that includes specialists. With most of Aetna’s Health Maintenance Organization (HMO) plans, you’re required to choose an in-network primary care physician (PCP). Now we’ll take a closer look at how the four types of Aetna Medicare Advantage plans typically work.
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