Aetna Copay For Specialist

Mar 22, 2021 Medicare provides you with coverage for health-related expenses, but it doesn't cover everything. There are a number of gaps in Medicare coverage. Learn how a Medicare Supplement Insurance plan can help you fill them. $20 copay/visit, deductible doesn't apply 90% coinsurance. None Specialist visit $40 copay/visit, deductible. Doesn't apply 90% coinsurance None Preventive care /screening /immunization No charge 90% coinsurance, except no charge for flu & pneumonia vaccines You may have to pay for services that are not preventive. Ask your provider if the services. Aetna's National network allows you to seek care within the State or outside of Florida within our network of providers; No deductible; You pay a copay when you receive care from network providers – NO REFERRALS NEEDED; You pay the entire cost if you receive care from a non-network provider, except in a health emergency; Preventive Care.

• Aetna Copay Information
• Aetna Copay For Specialist Dental
• Aetna Copay For Specialist Card
• Aetna Medicare Copay For Specialist
• Aetna Copay Plans

Jump to:

Aetna Medicare Plus Plan (HMO) H4982-003 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in California. This plan includes additional Medicare prescription drug (Part-D) coverage. The Aetna Medicare Plus Plan (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $2,100 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $2,100 out of pocket. This can be a extremely nice safety net.

Aetna Medicare Plus Plan (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.

Aetna Medicare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Aetna Medicare Plus Plan (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Aetna Medicare and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Aetna Medicare except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.

Ready to Enroll?

Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST

2021 Aetna Medicare Medicare Advantage Plan Costs

Aetna Medicare Plus Plan (HMO) Part-C Premium

Aetna Medicare plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

H4982-003 Part-D Deductible and Premium

Aetna Medicare Plus Plan (HMO) has a monthly drug premium of $0 and a $0 drug deductible. This Aetna Medicare plan offers a $0 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Aetna Medicare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.

Aetna Medicare Gap Coverage

In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Aetna Medicare plan does offer additional coverage through the gap.

H4982-003 Formulary or Drug Coverage

Aetna Medicare Plus Plan (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.

2021 Aetna Medicare Plus Plan (HMO) Summary of Benefits

Additional Benefits

Comprehensive Dental

Deductible

Diagnostic Tests and Procedures

Doctor Visits

Emergency care/Urgent Care

Foot Care (podiatry services)

Ground Ambulance

Hearing

Inpatient Hospital Coverage

Medical Equipment/Supplies

Medicare Part B Drugs

Mental Health Services

MOOP

Option

Optional supplemental benefits

Outpatient Hospital Coverage

Preventive Care

Preventive Dental

Rehabilitation Services

Skilled Nursing Facility

Transportation

Vision

Wellness Programs (e.g. fitness nursing hotline)

Aetna Copay Information

Ready to Enroll?

Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST

Coverage Area for Aetna Medicare Plus Plan (HMO)

Aetna Copay For Specialist Dental

(Click county to compare all available Advantage plans)

Aetna Copay For Specialist Card

Aetna Medicare Copay For Specialist

Aetna Copay Plans

Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.