Aetna Medicare Credit (HMO)

H1609 - 060 - 0
3.5 out of 5 stars (3.5 / 5)

aetna-medicare medicare provider logo

Aetna Medicare Credit (HMO) is a Medicare Advantage Plan by Aetna Medicare.

This page features plan details for 2024 Aetna Medicare Credit (HMO) H1609 – 060 – 0 available in West FL.

IMPORTANT: This page features the 2024 version of this plan. See the 2025 version using the link below:

No 2025 version found. You can use the location links below to find 2025 plans in your area.

Locations

Aetna Medicare Credit (HMO) is offered in the following locations.

Plan Overview

Aetna Medicare Credit (HMO) offers the following coverage and cost-sharing.

Insurer:Aetna Medicare
Health Plan Deductible:$0.00
MOOP:$3,850 In-network
Drugs Covered:Yes

Ready to sign up for Aetna Medicare Credit (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

Aetna Medicare Credit (HMO) qualifies for a monthly Medicare Give Back Benefit of $125.00.

Premium Reduction:$125.00

Premium Breakdown

Aetna Medicare Credit (HMO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$174.70 $0.00 $0.00 $125.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Aetna Medicare Credit (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible:$0.00
Initial Coverage Limit:$5,030.00
Catastrophic Coverage Limit:$8,000.00
Drug Benefit Type:Enhanced Alternative
Additional Gap Coverage:Yes
Formulary Link: Formulary Link

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00. Once you reach that amount, you will enter the next coverage phase.

Gap Coverage Phase

Tier Cost
All other tiers (Generic)25%
All other tiers (Brand-name)25%

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $8,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

Aetna Medicare Credit (HMO) also provides the following benefits.

Health plan deductible

$0

Other health plan deductibles?

In-network No

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

$3,850 In-network

Optional supplemental benefits

No

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-network No

Outpatient hospital coverage

$0-175 copay per visit (Authorization is required.) (Referral is not required.)

Doctor visits

Primary$0 copay (Not applicable.) (Not applicable.)
Specialist$30 copay per visit (Authorization is not required.) (Referral is required.)

Preventive care

$0 copay (Authorization is not required.) (Referral is not required.)

Emergency care/Urgent care

Emergency$135 copay per visit (always covered) (Not applicable.) (Not applicable.)
Urgent care$25 copay per visit (always covered) (Not applicable.) (Not applicable.)

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures$0-125 copay (Authorization is required.) (Referral is required.)
Lab services$0-75 copay (Authorization is required.) (Referral is required.)
Diagnostic radiology services (e.g., MRI)$0-125 copay (Authorization is required.) (Referral is required.)
Outpatient x-rays$0-125 copay (Authorization is required.) (Referral is required.)

Hearing

Hearing exam$30 copay (Authorization is not required.) (Referral is not required.)
Fitting/evaluation$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Hearing aids$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Preventive dental

Oral exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Cleaning$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Fluoride treatmentNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Comprehensive dental

Non-routine services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Diagnostic services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Restorative services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
EndodonticsNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Periodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Extractions$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Prosthodontics, other oral/maxillofacial surgery, other services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Vision

Routine eye exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Other$0 copay (There are no limits.) (Authorization is not required.) (Referral is not required.)
Contact lenses$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglass framesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Eyeglass lensesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Upgrades$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Rehabilitation services

Occupational therapy visit$20 copay (Authorization is not required.) (Referral is required.)
Physical therapy and speech and language therapy visit$20 copay (Authorization is not required.) (Referral is required.)

Ground ambulance

$225 copay (Not applicable.) (Not applicable.)

Transportation

Not covered (Not applicable.) (Not applicable.)

Foot care (podiatry services)

Foot exams and treatment$30 copay (Authorization is not required.) (Referral is not required.)
Routine foot careNot covered (Not applicable.) (Not applicable.)

Medical equipment/supplies

Durable medical equipment (e.g., wheelchairs, oxygen)0-20% coinsurance per item (Authorization is required.) (Not applicable.)
Prosthetics (e.g., braces, artificial limbs)20% coinsurance per item (Authorization is required.) (Not applicable.)
Diabetes supplies0-20% coinsurance per item (Authorization is required.) (Not applicable.)

Wellness programs (e.g., fitness, nursing hotline)

Covered (Authorization is not required.) (Referral is not required.)

Medicare Part B drugs

Chemotherapy0-20% coinsurance (Authorization is required.) (Not applicable.)
Other Part B drugs0-20% coinsurance (Authorization is required.) (Not applicable.)
Part B Insulin drugs$35 copay (Authorization is required.) (Not applicable.)

Inpatient hospital coverage

$200 per day for days 1 through 10
$0 per day for days 11 through 90 (Authorization is required.) (Referral is not required.)

Mental health services

Inpatient hospital – psychiatric$200 per day for days 1 through 10
$0 per day for days 11 through 90 (Authorization is required.) (Referral is not required.)
Outpatient group therapy visit with a psychiatrist$20 copay (Authorization is required.) (Referral is not required.)
Outpatient individual therapy visit with a psychiatrist$20 copay (Authorization is required.) (Referral is not required.)
Outpatient group therapy visit$20 copay (Authorization is required.) (Referral is not required.)
Outpatient individual therapy visit$20 copay (Authorization is required.) (Referral is not required.)

Skilled Nursing Facility

$0 per day for days 1 through 20
$178 per day for days 21 through 100 (Authorization is required.) (Referral is not required.)

Ready to sign up for Aetna Medicare Credit (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

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