Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) By Aetna Medicare
Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) H2293 005 0 is a 2023 Medicare Advantage Special Needs Plan plan by Aetna Medicare. This plan from Aetna Medicare works with Medicare to give you significant coverage beyond original Medicare. If you decide to sign up 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. All Medicare SNPs also provide Medicare additional Part-D drug coverage.
Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) H2293-005 is a Dual Eligible Special Needs Plan (D-SNP). A Dual Eligible SNP is for beneficiaries who are eligible for both Medicare and Medicaid. If you have Medicare and get help from Medicaid you can join any Medicare SNP you qualify for or switch plans at any time.
The Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) H2293-005 is available to residents to
Medicare eligible seniors in Georgia.
All Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage.
Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) is a Local PPO. A preferred provider organization (PPO) is a medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.
How much does Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) cost?
A monthly premium is the fee you pay to the plan in exchange for coverage. Aetna Medicare 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.
Part-D Deductible and Premium
An annual deductible is the amount you pay out-of-pocket for your prescription drugs before your plan begins to pay. Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) has a monthly drug premium of $18.60 and a $505.00 drug deductible. This Aetna Medicare plan offers a $18.60 Part-D Basic Premium that is 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 $18.60. The Part D Total Premium is the addition of supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.
Aetna Medicare Gap Coverage
In 2023 once you and your plan provider have spent $4660 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 not offer additional coverage through the gap.
Extra Help Premium Assistance
The Low Income Subsidy (LIS) Extra Helps people with Medicare pay for prescription drugs and lowers the costs of Medicare prescription drug coverage. Income limits are based on the Federal Poverty Level (FPL), which changes every year in February or March. The 2022 income limit is $1,719 ($2,309 for couples) per month. Depending on your income level you may be eligible for a full 75%, 50%, 25% premium assistance. The Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) medicare insurance offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $4.60 for 75% low-income subsidy $9.30 for 50% and $13.90 for 25%.
Full Assistance Premium:
75% Assistance Premium:
50% Assistance Premium:
25% Assistance Premium:
H2293-005 Formulary and Drug Coverage
Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) 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 Special Needs Plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
The benefit information provided is a summary of what Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Aetna Medicare helps
get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.
Prosthodontics, other oral/maxillofacial surgery, other services
In-Network Comprehensive dental
Out-of-Network Comprehensive dental
Out-of-Network Comprehensive dental
In-Network Comprehensive dental
In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
(Click county or state to compare all available Advantage plans)
The availability of Medicare Special Need Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for Aetna Medicare Dual Choice Plus Plan (PPO D-SNP) requires you to live in that plan’s service area. The service area is listed below:
Notes: Data are subject to change. All contracts for 2023 have not been finalized. For 2023, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Part D benefit.
Includes 2023 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.
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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.