2012 individual .pdf

File information


Original filename: 2012_individual.pdf

This PDF 1.4 document has been generated by Adobe InDesign CS5 (7.0.4) / Adobe PDF Library 9.9, and has been sent on pdf-archive.com on 31/05/2012 at 04:51, from IP address 72.219.x.x. The current document download page has been viewed 1014 times.
File size: 3.7 MB (189 pages).
Privacy: public file


Download original PDF file


2012_individual.pdf (PDF, 3.7 MB)


Share on social networks



Link to this file download page



Document preview


Aetna’s Brand Value

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Starting Your Path to Success:

For Agent Use Only. Not to
be shared with Medicare
beneficiaries. Aetna Inc.
Proprietary and Confidential.

2012 Aetna Individual Medicare Broker Training Presentation

Producer Support
Program

18.25.004.1 

M_OT_PR_10651

Aetna’s Brand Value

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Disclosure
 GENT USE ONLY – Aetna Medicare 2012 Individual
A
Product Offering. The intent of this document is to
provide education to agents on 2012 product and service
area information.
P roviding this information to Medicare beneficiaries prior
to October 1, 2011, is a violation of your Aetna General
Agent Agreement and/or Aetna Producer Agreement as
well as CMS Marketing Guidance and Regulations.

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

1

Information to Keep
You Current

Aetna’s Brand Value

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

What we will cover today:
A etna’s Brand Value
Fast & Responsive Service
Sales Support to Grow Your Business
Product Choices & Benefits
Information to Keep You Current

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

2

Information to Keep
You Current

Aetna’s Brand Value

Fast & Responsive Service

For Agent Use Only. Not to be shared
with Medicare beneficiaries. Aetna Inc.
Proprietary and Confidential.
Producer Support
Program

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna’s Brand Value

A e t n a’ s
B r a n d Va l u e
M edicare
Demographics

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

The Right Demographics Enhance
Your Medicare Opportunity

Leader in
Health Insurance

T he 65+ age group is projected to grow by 14.4M individuals,
a 35% increase, over the next decade (2010 – 2020).

 op Financial
T
Ratings

T he senior population will double from 40M to 80M, and represent
one out of every five U.S. citizens (20%) over the next 30 years.

History,
Reputation,
Innovation
T he Aetna Way

Population Aged 65 and Over: 2000 to 2050
(in millions)
80.0

86.7

71.5
54.6
For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

35.0

2000

40.2

2010

2020

2030

Note: The reference population for these data is the resident population.
Sources: 2000, U.S. Census Bureau, 2001, Table PCT12; 2010 to 2050, U.S. Census Bureau, 2004.

Producer Support
Program

4

2040

2050

Aetna’s Brand Value

A e t n a’ s
B r a n d Va l u e
Medicare
Demographics

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna: A Recognized Leader In
Health Insurance

L eader in
Health Insurance

More than 850 thousand
Medicare members*

 op Financial
T
Ratings
History,
Reputation,
Innovation
T he Aetna Way

18 . 2 million
medical member s
For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

13.7 million
dental member s
8 .7 million
pharmac y member s

5

*As of June 30, 2011.

Aetna’s Brand Value

A e t n a’ s
B r a n d Va l u e
Medicare
Demographics
Leader in
Health Insurance

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Aetna Has Top Financial Ratings*
*P ertains to Aetna Life Insurance Company financial strength;
updated April 29, 2011.

Top Financial
Ratings
History,
Reputation,
Innovation
T he Aetna Way

A

A1

A . M . B est

Moody ’s

A+

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Sta n da rd &
P oo r ’s
Producer Support
Program

6

AAF itc h

Information to Keep
You Current

Aetna’s Brand Value

A e t n a’ s
B r a n d Va l u e

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

History, Reputation, Innovation

Medicare
Demographics
Leader in
Health Insurance
 op Financial
T
Ratings
H istory,
Reputation,
Innovation
T he Aetna Way

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Aetna has more than 155 years of insurance expertise.
FACT: Aetna paid the industry’s first Medicare claim in 1966.

7

Information to Keep
You Current

Aetna’s Brand Value

A e t n a’ s
B r a n d Va l u e
Medicare
Demographics
Leader in
Health Insurance

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

The Aetna Way
Ou r s u c c e s s fu l t e am w o r k s t r at e g y b l e n d s
all of the following:

 op Financial
T
Ratings

Integrity

History,
Reputation,
Innovation

Service

T he Aetna Way

Excellence

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

8

Aetna’s Brand Value

A e t n a’ s
B r a n d Va l u e
Medicare
Demographics

Fast & Responsive Service

Product Choices
& Benefits

What Aetna’s Brand Value
Means for You:

Leader in
Health Insurance

We give YOU…
confidence.

 op Financial
T
Ratings
History,
Reputation,
Innovation

We give YOUR CLIENTS…
real peace of mind.

T he Aetna Way

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Sales Support to Grow
Your Business

9

Information to Keep
You Current

Aetna’s Brand Value

Fast & Responsive Service

For Agent Use Only. Not to be shared
with Medicare beneficiaries. Aetna Inc.
Proprietary and Confidential.
Producer Support
Program

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna’s Brand Value

Fa s t &
R e s p o n s iv e
S e r vi c e
Broker Support
Unit
Producer World ®

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

We emphasize personal
service for brokers with...
a dedicated response unit for Medicare producers
with one number for all administrative questions
1-888-247-1050, and
 elpful representatives located within the four
h
Aetna regions.
Our Broker Support Unit representatives
can answer your questions regarding:
C ommissions
License, appointment, certification
Enrollment status

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Product and sales resources

11

Information to Keep
You Current

Aetna’s Brand Value

Fa s t &
R e s p o n s iv e
S e r vi c e
Broker Support
Unit
Producer World ®

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

We put ALL the information
you need at your fingertips.
®
Count on Producer World –
a website dedicated to
supporting your business:
 eal-time online application status and tracking
R
to help you close sales more easily
Product details to help you sell
 4/7 online order form for customized
2
enrollment kits and sales materials
Support to help you manage your business

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Commission information to keep you up to date
 nline support for licensing, appointment,
O
and certification status

12

Information to Keep
You Current

Aetna’s Brand Value

Fa s t &
R e s p o n s iv e
S e r vi c e
Broker Support
Unit

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

What Aetna’s Broker Service
Means for You:
Easier than ever to do business with Aetna

Producer World ®

Streamlined access to important sales information
Support to manage your business better

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

13

Information to Keep
You Current

Aetna’s Brand Value

Fast & Responsive Service

For Agent Use Only. Not to be shared
with Medicare beneficiaries. Aetna Inc.
Proprietary and Confidential.
Producer Support
Program

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna’s Brand Value

Sa l e s Supp o r t
to g row yo u r
bu s i n e s s
Customized
Enrollment Kits &
Marketing Materials
Consumer Education

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Available Programs and
Materials to Help Build
Your Business:
Customized enrollment kits with personalized
broker contact information
Medicare Print-on-Demand Marketing
Materials Portal
- Expansive library of CMS-approved marketing
material, most of which may be co-branded
with your contact information
- Timely ordering and delivery of marketing materials
- Co-op dollars available for qualified brokers

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

15

Information to Keep
You Current

Aetna’s Brand Value

Sa l e s Supp o r t
to g row yo u r
bu s i n e s s

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

We also provide you with:

Customized
Enrollment Kits &
Marketing Materials

Consumer education to keep you
OUT FRONT of the market

Consumer
Education

- 2012 MA-PD Sales Presentation
- 2012 PDP Sales Presentation
- S eminar support including invitations
and reminders
DocFind® physician directory
for mobile devices
-N
 ext time prospects ask if their doctors
are in network, you’ll have the answer
in the palm of your hand.
For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Cross-sell opportunities to earn more
- Individual under-65 plans that can include
dental — valuable options for spouses who
have not yet turned 65
- S mall group plans

Producer Support
Program

16

Aetna’s Brand Value

Sa l e s Supp o r t
to g row yo u r
bu s i n e s s
Customized
Enrollment Kits &
Marketing Materials

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

What Our Sales Support
Means for You:
We will help you reach more
qualified prospects.

Consumer Education

We will help you build your brand in
your community.
We will help you have more opportunities
to close more business.

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

17

Information to Keep
You Current

Aetna’s Brand Value

Fast & Responsive Service

For Agent Use Only. Not to be shared
with Medicare beneficiaries. Aetna Inc.
Proprietary and Confidential.
Producer Support
Program

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Medicare Overview
ma n a g e d b y t h e f e d e r a l g o v e r n m e n t

Member Programs
& Discounts

Part A

Helps cover inpatient hospital, skilled nursing, home health and hospice care; does not
cover prescription drugs

National Medicare
Product Offering

Part B

Helps pay for doctor bills, as well as outpatient surgery and medical services, such as labs
and x-rays; does not cover Part D prescription drugs

National PDP
Product Offering

o ff e r e d b y p r ivat e i n s u r a n c e c o mpa n i e s w it h a n app r o v e d m e d i c a r e c o n t r a c t

Part C

Provides coverage for Parts A, B and often includes Part D — all in one plan, with extra
features and services; also known as the Medicare Advantage program

Part D

Purchased in addition to Medicare Parts A and/or B, provides coverage for Medicare Part D
prescription drugs only; also known as the Medicare prescription drug benefit

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region
Southeast Region
West Region

o ff e r e d b y p r ivat e i n s u r a n c e c o mpa n i e s ; r e g u l at e d b y s tat e s

Medicare
Supplement Plans

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

19

Purchased in addition to Medicare Parts A and B, helps pay for medical benefits not
covered by Parts A and B; does not cover Part D prescription drugs; also known as Medigap

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering
National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region
Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

2012 Individual Medicare
Election Periods
 nnual Election Period (AEP): October 15 A
December 7, 2011 (Enrollments are effective January
1, 2012, subject to approval by CMS.)
Initial Election Period (IEP): 3 months before,
month of, and 3 months after 65th birth month
 edicare Advantage Disenrollment Period
M
(MADP): January 1, 2012 - February 14, 2012
 pecial Election Period (SEP): Permitted in certain
S
situations, such as losing employer coverage or
moving to a new service area
 -Star Plan Special Election Period: Beginning
5
January 1, 2012, Medicare has established a SEP to
allow Medicare beneficiaries eligible for Medicare
Advantage (MA) plans to enroll in 5-star MA plans
at any point during the year

20

Information to Keep
You Current

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna Individual Medicare
Advantage Products
2 0 1 2 C M S R e g u l at o r y Gui d a n c e : M e d i c a r e A d va n ta g e
R e q ui r e m e n t s f o r p l a n c h a r a c t e r i s ti c s

Plan type characteristics have not changed for 2012

National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Plan Type

P r ima r y Ca r e
P HYS I C I A N

Referrals

N e t w o r k O n ly

Mid-America Region

HMO Traditional

Required

Required - Electronic

Yes

Northeast Region

HMO Open Access

Not Required

Not Required

Yes

PPO

Not Required

Not Required

No

Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

21

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering
National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Aetna Individual Medicare
Advantage Products:
Medicare Advantage
2 0 1 2 C M S R e g u l at o r y Gui d a n c e : M e d i c a r e A d va n ta g e
R e q ui r e m e n t f o r o ut - o f - p o c k e t ma x imum s

Out-of-Pocket (OOP) maximums required on all Aetna plans
Our HMO plans have an in-network OOP maximum ranging from $3,000 to $6,700

Mid-America Region


Our
PPO plans have an in-Network OOP Maximum ranging from $3,400 to $6,700
and a Combined Catastrophic OOP Maximum ranging from $5,000
to $10,000

Northeast Region
Southeast Region
West Region

 OP maximum applies to the all covered Part A and Part B services for all
O
Aetna Medicare products

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

 OP maximum does not include Part D or supplemental services, such as:
O
- Dental rider/dental optional supplemental benefit
- Eyewear reimbursements
- Hearing aid reimbursements
22

Aetna’s Brand Value

Product
Choices &
B e n e fit s

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

We Offer A Variety of Plan Options

Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering
National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

2 Standalone Part D Medicare
Prescription Drug Plans (PDP)
in all 50 states plus D.C. –
including a new co-branded
offering with CVS/pharmacy
in select service areas

Medicare Advantage (MA)
and Medicare AdvantagePrescription Drug Plans
(MA-PD) in 19 states plus D.C.

50

PDP in

Northeast Region
Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

23

As of July 2011

STATES

MA-PD in

19

STATES

Mid-America Region

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

We Have an Extensive National
Medicare Health Care Network.

Member Programs
& Discounts
National Medicare
Product Offering

215,600+
primary care doctors and specialists

National PDP
Product Offering

1,780+
hospitals (important to members who
travel or have dual residences)

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

85,650+

Southeast Region

other health care professionals

West Region

Over 65,000 pharmacies
nationally, including more than

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

7,200 CVS/pharmacy locations

24

Network as of July, 2011

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering
National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

We Offer Programs Specially
Targeted to Medicare Members.
Dedicated customer service team
 edicated disease and case management –
D
MA and MA-PD plans only
 ancer screening and reminders –
C
MA and MA-PD plans only
 4/7 access to registered nurses for
2
information related to health topics –
MA and MA-PD plans only

Southeast Region
West Region

 nline Personal Health Record tool keeps
O
health information in one place –
MA and MA-PD plans only

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

25

Information to Keep
You Current

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering

Fast & Responsive Service

Sales Support to Grow
Your Business

Easy-to-Use Tools Help Members
Make Informed Decisions!
Aetna Navigator ®, our secure member
website gives members access to:
Price-a-Drug tool

National PDP
Product Offering

C ost of Care tool

P l a n o pti o n s b y
r e g i o n a n d s tat e :

 ealth Information Guide providing
H
members the facts before a medical visit

Mid-America Region
Northeast Region
Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Product Choices
& Benefits

Aetna SmartSourceSM search engine
Personalized information and multiple
resources in a single search
Aetna InteliHealth® website
Insights from Harvard Medical School,
Columbia University College of Dental
Medicine, and other sources

26

Information to Keep
You Current

Aetna’s Brand Value

Product
Choices &
B e n e fit s

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Added Money-Saving Benefits for Members

Medicare Overview
Member Programs
& Discounts

E

National Medicare
Product Offering

Annual vision exams
(MA and MA-PD plans only)

National PDP
Product Offering

Annual hearing exams
(MA and MA-PD plans only)

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region
Southeast Region

Aetna Rx Home Delivery®
(MA-PD and PDP plans only)

West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

27

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

And…Extra-Value Discounts Help
Medicare Members Save Even More.*

Member Programs
& Discounts

New for 2012: MEM-X – Preferred rates on vocal memory aids,
reminding you at a precise date and time of whatever it is you’d like to
do, from making a phone call to taking a medication

National Medicare
Product Offering
National PDP
Product Offering

New for 2012: Aging with Grace, LLC (AWG) – Savings on yearly
membership to join a national eldercare assistance program that
provides the solution to eldercare stress by educating, coordinating
and facilitating senior care options one member at a time

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

Aetna VisionSM discount program – Discounts on
routine eye exams and select items and services, including
LASIK eye surgery

Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Aetna Hearing SM discount program** – Savings on hearing aids,
comprehensive hearing tests, and hearing-aid services from licensed
professionals, in certain areas
* Discount programs provide access to discounted prices and are NOT insurance benefits. The member is responsible for the full cost of
the discounted services. Availability varies by plan. Aetna may receive a percentage of the fee members pay to the discount vendors.
** Members need to use one of the contracted providers HCS or HearPO to access the hearing aid discount. Aetna Hearing discount
program is not available for standalone PDP members.

Producer Support
Program

28

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

And…Extra-Value Discounts Help
Medicare Members Save Even More.*

Member Programs
& Discounts

Aetna Weight ManagementSM discount program – Discounts on
eDiets ® plans and products, Jenny Craig® weight-loss programs and
Nutrisystem ® weight-loss meal plans

National Medicare
Product Offering
National PDP
Product Offering

Aetna Fitness SM discount program Preferred rates** on gym
memberships and discounts on at-home weight-loss programs,
home fitness options and one-on-one health coaching services

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

Aetna Natural Products and ServicesSM discount program –
Reduced rates on acupuncture, chiropractic care, massage therapy
and dietetic counseling through the ChooseHealthy ® program.***

Southeast Region
West Region

- Through the ChooseHealthy program, members also can get discounts
on over-the-counter vitamins, herbal and nutritional supplements and
natural products
- Through Vital Health Network, members can receive a discount on
online consultations and alternative remedies provided by medical
doctors for a variety of conditions

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

* Discount programs provide access to discounted prices and are NOT insurance benefits. The member is responsible for the full cost of the
discounted services. Availability varies by plan. Aetna may receive a percentage of the fee members pay to the discount vendors.
**  Participation is for new gym members only. Membership to a gym to which members are now, or were recently members, may not be available.
*** The ChooseHealthy program is made available through American Specialty Health Networks, Inc. (ASH Networks) and Healthyroads, Inc.,
subsidiaries of American Specialty Health Incorporated (ASH). ChooseHealthy is a federally registered trademark of ASH and used with
permission herein.

Producer Support
Program

29

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

And…Extra-Value Discounts Help
Medicare Members Save Even More.*

Member Programs
& Discounts

The Aetna BookSM discount program – Discounts on books
and other items purchased from the American Cancer Society
Bookstore, the MayoClinic.com Bookstore and, for yoga-related
titles, Pranamaya.

National Medicare
Product Offering
National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Additional Discount Programs
- Discounts on a ZAGAT.com Premium Membership to access
restaurant Ratings and Reviews, Zagat products and more
- Discounts on sonic toothbrushes and water-jet flossers from Waterpik®
- Savings on cavity-fighting products from Epic Industries

Mid-America Region
Northeast Region
Southeast Region
West Region

* Discount programs provide access to discounted prices and are NOT insurance benefits. The member is responsible for the full
cost of the discounted services. Availability varies by plan. Aetna may receive a percentage of the fee members pay to the
discount vendors.

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

30

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

“Welcome” Information
Helps Promote Loyalty.
Dedicated Aetna Medicare member website

National Medicare
Product Offering

Healthful member magazine published twice a year

National PDP
Product Offering

Annual calendar to promote healthy eating

P l a n o pti o n s b y
r e g i o n a n d s tat e :

learn to

take our quiz, p. 11

us!
Boan
r-ouT
Te ard
c

ur
for yo
ctor’s
next do
visit

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

31

REFERENCE

exclusively for aetna medicare members

play
again
collector
or hoarder?

West Region

for your

healthful
healthier, tastier picks

Southeast Region

for your

ENJOyMENT

tM

build a better
breakfast

Northeast Region

for your

HEalTH

spring 2011

a best-selling author’s
experiment in happiness

Mid-America Region

Producer Support
Program

Information to Keep
You Current

Aetna’s Brand Value

Product
Choices &
B e n e fit s

Fast & Responsive Service

Product Choices
& Benefits

Even More for Members…
Added features, discounts,
and tools that members want

Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering

Extensive networks, so members know
access to health care is available

National PDP
Product Offering

Programs and materials to
promote loyalty

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region
Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Sales Support to Grow
Your Business

32

Information to Keep
You Current

Aetna’s Brand Value

Product
Choices &
B e n e fit s

Fast & Responsive Service

Product Choices
& Benefits

Sales Support to Grow
Your Business

Information to Keep
You Current

2012 Individual Medicare Product Offering

Medicare Overview
Member Programs
& Discounts

MID -AMERIC A

Northeast

National Medicare
Product Offering

ME
AK

National PDP
Product Offering

MT

VT

ND

NH

MN

WA
SD
WY

OR

P l a n o pti o n s b y
r e g i o n a n d s tat e :

ID

MI

IA
NE
IL

Mid-America Region

HI

Northeast Region

NV

KS
UT

IN

MO

NJ
SNJ
DE

OH

KY
MD

WV

VA

OK

Southeast Region
West Region

WEST

AZ

NM

NC

TN
TX

SC

AR
MS

AL

GA

LA
For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

FL

S o u theast

HMO / PPO / PDP

Producer Support
Program

33

HMO / PDP

P D P O n ly

RI
CT

PA

CO

CA

MA

NY

WI

DC

Aetna’s Brand Value

Product
Choices &
B e n e fit s

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Summary of Eligibles by Market (MA-PD)

Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering

Stat e

Market

Stat e T o ta l

Stat e

Market

AZ

Arizona

939,968

NY

Bronx and Kings

480,964

CA

National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Central Valley

110,481

Hudson Valley

197,860

Inland Empire

495,806

613,794

Los Angeles

1,661,268

New York,
Queens
and Richmond

San Diego

401,197

Upstate

164,993

Ventura

111,542

Cincinnati

126,388

2,780,294

CO

Colorado

638,181

CT

Connecticut

459,921

DC

Washington,
D.C.

79,286

DE

Delaware

FL

Jacksonville

152,255

South

887,814

Southwest

361,432

Tampa

469,896

Southeast Region

Stat e T o ta l

152,155

OH

Cleveland

317,562

Columbus

161,173

Toledo

71,450

OK

Oklahoma

PA

Central

302,562

Lehigh Valley

154,814

Northeastern

113,739

1,871,397

Philadelphia

228,510

Southeastern

401,788

Atlanta

351,375

IL

Chicago

708,648

TN

Tennessee

MD

Baltimore

675,085

TX

Dallas/Fort Worth

564,814

Houston

445,902

San Antonio

239,414

Maine

NJ

Northern

908,101

Southern

333,857

NV

Nevada

117,133

1,201,413
80,218

1,250,130

1,241,958
240,559

G r a n d T o ta l

34

676,573
105,038

GA

ME

1,457,611

Source: Aetna LEC Medicare Opportunity Report, June 2011.

VA

Northern

205,941
15,232,884

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview

Fast & Responsive Service

Product Choices
& Benefits

Sales Support to Grow
Your Business

2012 Individual Medicare Prescription
Drug Plan Product Offering

Member Programs
& Discounts

MID -AMERIC A

Northeast

AK

National Medicare
Product Offering

WA

National PDP
Product Offering

VT
MT

MN

NV

MI

Mid-America Region

NE

IL

CA

Northeast Region

CO

PA

IA

UT
KS

AZ

MD

MO

KY

WV

VA

OK

NM

NC

TN

WEST

SC

AR
MS

TX

AL

GA

LA
FL

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

A et n a C V S / pharmac y P rescriptio n D r u g P l a n ( P D P )
a n d A et n a M edicare R x P remier P l a n ( P D P )
A et n a M edicare R x E sse n tia l s P l a n ( P D P )
a n d A et n a M edicare R x P remier P l a n ( P D P )

Producer Support
Program

35

NJ
DE

OH

IN

HI

Southeast Region

NH
MA

NY

WI

SD
WY

P l a n o pti o n s b y
r e g i o n a n d s tat e :

ME

ND

OR
ID

West Region

Information to Keep
You Current

S o u theast

DC

RI
CT

Aetna’s Brand Value

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Product
Choices &
B e n e fit s

New for 2012

Medicare Overview

J O I N I NG F ORCES F OR M ED I C A RE PA R T D

Member Programs
& Discounts
National Medicare
Product Offering
National PDP
Product Offering

 etna and pharmacy industry leader CVS/pharmacy have joined
A
together to offer a Medicare Part D plan in select service areas
that features low plan premiums, savings on prescription drugs,
and the convenience of shopping at a neighborhood pharmacy.

P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

M ORE O P T I ONS F OR M ED I C A RE PA R T D

Southeast Region
West Region

 etna will also offer an enhanced standalone Part D product
A
covering most generic prescription drugs during the gap.

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

36

Aetna’s Brand Value

Product
Choices &
B e n e fit s
Medicare Overview
Member Programs
& Discounts
National Medicare
Product Offering
National PDP
Product Offering
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

Fast & Responsive Service

Sales Support to Grow
Your Business

Product Choices
& Benefits

Information to Keep
You Current

Thanks to the Joint Effort
Between Aetna and Cvs/Pharmacy,
Your Clients Will Enjoy…
VA L U E
M onthly plan premium of only $26
S avings of $6 in cost-sharing on preferred generics and $10 in cost-sharing on
non-preferred generics and preferred brand drugs at CVS/pharmacy locations
First dollar coverage on most generics (i.e. a, $0 deductible on Tiers 1-2)
 embers enrolled in the Aetna CVS/pharmacy Prescription Drug Plan (PDP) will
M
receive a CVS ExtraCare Health Card upon enrollment at no cost to the member,
for extra savings on CVS brand health-related products.

Southeast Region
West Region

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

CON V EN I ENCE
 embers may fill their prescriptions at any of the 65,000 pharmacies in Aetna’s
M
Medicare network, including more than 7,200 CVS/pharmacy locations nationwide
7 5% of the U.S. population lives within three miles of a CVS/pharmacy
M any CVS/pharmacy locations offer 24-hour or extended-hour services and/or
drive-through pharmacies

Aetna + CVS/Pharmacy = a powerful combination for your clients!

Producer Support
Program

37

Aetna’s Brand Value

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Mid-America Region
Northeast Region

Fast & Responsive Service

Product Choices
& Benefits

Information to Keep
You Current

2 012
Mid-America Region
Individual Medicare Product Details

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Sales Support to Grow
Your Business

38

Aetna’s Brand Value

Fast & Responsive Service

Mid-America Region
Northeast Region
Southeast Region

Product Choices
& Benefits

Information to Keep
You Current

Illinois

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

HMO & PPO

H I GHL I GH T S

Chicago Market
Cook

 ental plan available
D
statewide for HMO plans

PDP

HMO and PPO options

Statewide

available

One of the largest hospital

West Region

networks in Cook County
of any MA carrier

Competitive PCP and

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

Specialist copays

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

39

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Chicago Market | Cook
Aetna Medicare
S T A ND A RD P l a n ( P P O )

Aetna Medicare
Va l u e P l a n ( H M O)

Mid-America Region
Northeast Region

Product Choices
& Benefits

Illinois

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

CMS ID

H1419-001

H5521-016

Plan Type

HMO

PPO

Premium

$0

$79

Deductible

$0

$0 INN/$1,000 OON

OOP Max

$3,400

$6,700 INN/$10,000 Combined

Primary Care

$10

$10

Specialist

$40

$40

Inpatient

$225/day 1-8

$200/day 1-8

Skilled Nursing

$0/d 1-7, $75/day 8-15, $100/d 16-100

$0/d 1-10, $50/d 11-20, $100/d 21-100

Home Health

$15

$0

Outpatient

$0-$225

$0-$200

Ambulance

$200

$175

Emergency

$65

$65

Urgent Care

$40

$40

DME

$20

20%

Dialysis

$30

20%

Eyewear Allowance

$50 Every 2 Years

Not Covered

Out of Network

N/A

30%

Dental Rider

$16

N/A

Rx Benefit*

$7/$33/$45/$95/33%

$7/$30/$45/$95/33%

C o mm o n F e atu r e s A c r o s s A l l P l a n s
Lab

$0-$40

Rx Deductible

$0

X-Ray Routine/Complex

$0-$50/$250

Preventive Care

$0

Rx ICL

$2,930

Hearing Aid Allowance

$300 Every 3 Years

Aetna Rx Gap Coverage
(in addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Health & Wellness

Fitness/Nursing Hotline

Preferred Retail Pharmacy

N/A

40

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-051

S5810-187

Plan Type

PDP

PDP

Premium

$26

$80.50

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$35/40%/25%
At All Other Network Pharmacies: $9/$20/$45/40%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(in addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Illinois

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

41

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-049

S5810-185

Plan Type

PDP

PDP

Premium

$26

$84.90

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$29/41%/25%
At All Other Network Pharmacies: $9/$20/$39/41%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Indiana

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

42

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-059

S5810-195

Plan Type

PDP

PDP

Premium

$26

$75.50

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$31/40%/25%
At All Other Network Pharmacies: $9/$20/$41/40%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Iowa

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

43

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-058

S5810-194

Plan Type

PDP

PDP

Premium

$26

$79.40

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$31/40%/25%
At All Other Network Pharmacies: $9/$20/$41/40%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Kansas

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

44

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-049

S5810-185

Plan Type

PDP

PDP

Premium

$26

$84.90

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$29/41%/25%
At All Other Network Pharmacies: $9/$20/$39/41%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Kentucky

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

45

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-047

S5810-183

Plan Type

PDP

PDP

Premium

$26

$68.50

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$33/37%/25%
At All Other Network Pharmacies: $9/$20/$43/37%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Michigan

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

46

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-059

S5810-195

Plan Type

PDP

PDP

Premium

$26

$75.50

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$31/40%/25%
At All Other Network Pharmacies: $9/$20/$41/40%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Minnesota

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

47

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-052

S5810-188

Plan Type

PDP

PDP

Premium

$26

$78

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$37/40%/25%
At All Other Network Pharmacies: $9/$20/$47/40%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Missouri

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

48

Aetna’s Brand Value

Fast & Responsive Service

Southeast Region
West Region

* Rx Benefit: one month supply at
in-network retail pharmacies
** Medicare standard Gap Coverage:
After your total yearly drug costs
reach $2,930, you pay 86% for all
generic drugs and 100% for all
brand drugs, until your yearly
out-of-pocket drug costs reach
$4,700. A 50% discount on
negotiated price (excluding
dispensing fee) will be available
for those brand name drugs from
manufacturers that have signed a
coverage gap discount program
agreement with CMS.

A e t n a C V S / p h a r ma c y
P r e s c r ipti o n D r u g P l a n ( P D P )

Aetna Medicare
R x P r e mi e r ( P D P )

CMS ID

S5810-059

S5810-195

Plan Type

PDP

PDP

Premium

$26

$75.50

Rx Deductible

$0 (Tiers 1-2), $320 (Tiers 3-5)

$0

Rx Benefit*

At CVS Pharmacies: $3/$10/$31/40%/25%
At All Other Network Pharmacies: $9/$20/$41/40%/25%

$4/$25/$35/$80/33%

Rx ICL

$2,930

$2,930

Aetna Rx Gap Coverage
(In addition to Medicare
standard gap coverage**)

No Additional Gap Coverage

Tier 1 and Tier 2 Covered in the Gap

Non Part D Coverage

Not Covered

T1 [Benzos and Barbs]

Preferred Retail Pharmacy

CVS

For Agent Use Only.
Not to be shared with
Medicare beneficiaries.
Aetna Inc. Proprietary
and Confidential.

Producer Support
Program

Information to Keep
You Current

Statewide

Mid-America Region
Northeast Region

Product Choices
& Benefits

Montana

Product
Choices &
B e n e fit s
P l a n o pti o n s b y
r e g i o n a n d s tat e :

Sales Support to Grow
Your Business

49


Related documents


2012 individual
producer ag4 contract sl
medicare part d credible coverage notice
choosing medigap policy 2014
a path forward 762
65brochure

Link to this page


Permanent link

Use the permanent link to the download page to share your document on Facebook, Twitter, LinkedIn, or directly with a contact by e-Mail, Messenger, Whatsapp, Line..

Short link

Use the short link to share your document on Twitter or by text message (SMS)

HTML Code

Copy the following HTML code to share your document on a Website or Blog

QR Code

QR Code link to PDF file 2012_individual.pdf