Aetna Medicare Advantage

2021 Aetna Medicare Advantage

Aetna will continue to administer the City’s Medicare plan for the 2021 plan year. 

• There is no monthly premium for retirees; the City will continue to pay your monthly plan premiums to Aetna on your behalf.
• The 2021 monthly premium for spouses of retirees is $140.38, which must be paid directly to Aetna.
• Both retirees and spouses of retirees must continue their Medicare Part A and Part B coverage in order to continue enrollment in the City’s Aetna Medicare plan. 
• To determine eligibility for participation in the City’s Medicare plan, review the presentation: Eligibility of retiree health insurance and Medicare
• For additional information about the Aetna Medicare plan, you can review the presentations: 
  • 2021 Aetna Medicare Formulary
  • 2021 Aetna Medicare Benefit Guide Booklet
  • 2021 Aetna Medicare Plan Summary Presentation 
  • 2021 Schedule of Cost Sharing
• If you are new to Medicare, visit https://www.ncdoi.gov/consumers/medicare-and-seniors-health-insurance-information-program-shiip/new-medicarefor information on when and how to enroll in Medicare or locating Senior’s Health Insurance Information Program (SHIIP) counselors. SHIIP counsels Medicare beneficiaries about Medicare, Medicare supplements, and Medicare Advantage plans throughout North Carolina. To speak with volunteers with the Forsyth County SHIIP coordinating site, call 336-748-0217.
  • Medicare Basics 2020 
  • Road to Medicare: Planning Your Drive

Healthy at Home Webcasts 

We’ve all had to make lifestyle changes over the last year — many of us are spending a lot more time at home. But there are still ways to engage and stay connected. During the Healthy at Home webcasts, you’ll hear from celebrity speakers and experts who are excited to join you on your journey to a healthier you. The Healthy at Home webcasts are available at no cost to you. All you need is a computer or tablet to attend. View the schedule of topics and speakers here.

Frequently Asked Questions

• Why do I need Medicare Part A and Part B in order to enroll in this plan? 
  • This is a Medicare/CMS requirement for ALL Medicare Advantage Carriers and the plans they offer. 
• What happens with my Original Medicare? Is this plan a supplement to my Original Medicare? 
  • You are still a Medicare member. This is not a supplement to Original Medicare. When enrolling into a Medicare Advantage plan, sometimes referred to as “Medicare Replacement”, you are notifying Medicare you wish to have your Medicare benefits administered by Aetna. The Aetna Medicare Advantage plan provides all the same benefits as Original Medicare, and more, such as SilverSneakers, Routine Vison, Hearing and Podiatry services. The Aetna Medicare Advantage plan is an approved plan by Medicare/CMS and must follow the rules and guidelines set forth by Medicare/CMS.
• Does this prescription plan have "donut hole"? Explain. 
  • No. You continue to pay the same cost share as you do during the initial coverage phase. Please refer to the copay/coinsurance amounts listed within your plan benefits for more details. 
• Can I visit any retail pharmacy for my prescriptions? Mail-order prescriptions?
  • Our pharmacy network includes national chains as well as local options for your prescription drugs. We have over 65,000 pharmacies in our network. You can find a network pharmacy by visiting aetnaretireeplans.com or calling Aetna at the number on the back of your ID card. New to Aetna? Please call Aetna at 800-307-4830. You may use CVS Caremark Mail Service Pharmacy for your mail-order prescriptions. Please review the formulary ahead of time as some medications may be limited to a local retail pharmacy. To access the formulary, please follow the steps below: 
    • Visit Aetnaretireeplans.com
    • Scroll to “Manage your prescription” section 
    • Plan type, select: “MAPD” 
    • Formulary name, select: 2021 GRP Open 2 Plus (4 Tier) Formulary – MAPD
    • Open first link for List of Covered Drugs - Formulary
• Can I visit any vision provider for routine exams? 
  • You may see any provider of your choice who is eligible to receive Medicare payments and accepts your plan. You may locate network providers at aetnaretireeplans.com, but it is not a requirement to see a network provider. 
• I’m diabetic, what is the coverage of diabetics and do I have to use a specific brand of diabetic supplies?   
  • Diabetic supplies are covered at $0 copay. This includes supplies to monitor your blood glucose from LifeScan. Please refer to your Evidence of Coverage or Schedule of Cost Share for more information. 
• Do I need to sign up every year or sign up for additional coverage while on this plan? 
  • No. Once you enroll, you will not need to do anything annually to stay in the plan. Be aware of insurers trying to convince you that you need additional coverage. If you sign up with another advantage or supplement plan, you will lose Aetna coverage. Please see this flyer for more information.

Questions? 

Call Aetna at 1-800-307-4830 with any questions.