2024 H5521 444 - Evidence of Coverage. January 1 - December 31, 2022. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Aetna Medicare Plan (PPO) This booklet gives you the details about your Medicare health care and prescription drug coverage from January 1 - December 31, 2022.

Aetna Medicare Eagle Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services. The most you pay for copays, coinsurance and other costs for medical services for the year. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium and prescription drugs don’t count toward the maximum out‐of‐pocket. $373 per day, days 1‐6; $0 per day, days 7‐90.Sep 13, 2023 · Y0001_H5521_424_NT31_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value Plus Plan (PPO) H5521 ‐ 424. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Medicare Plans. Aetna Medicare Premier Plan (PPO) 4 out of 5 stars* for plan year 2024. Aetna Medicare Premier Plan (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered … Members with Aetna Medicare Advantage (MA) and Aetna Medicare Advantage with Prescription Drug (MAPD) plans can log in or register for an account below. This includes HMO, PPO or HMO-POS plans. Through your Aetna® member account you can manage claims, view plan details and more. Log in for MA/MAPD. Register my MA/MAPD. Aetna Medicare Dual Choice (PPO D-SNP) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $0.00. Copayment for Routine Care $0.00. Maximum 12 Routine Care every year. 2023 Evidence of Coverage for Aetna Medicare Premier Plan (PPO) 7 Chapter 1 Getting started as a member SECTION 1 Introduction Section 1.1 You are enrolled in Aetna Medicare Premier Plan (PPO), which is a Medicare PPOYou can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) benefit catalog, and more. If you’re in a Medicare Advantage plan, your plan name is listed on your member ID card. If you’re in a plan with prescription drug coverage only (PDP), look at the “S ...H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-227: Aetna Medicare Freedom Plan (PPO) 2024: H2293-016: Aetna Medicare Eagle Plan (PPO) 2024: H3288-050: Amerigroup View payer . Plan Name Effective YearAllentown. 1539 Lehigh St, Allentown, PA 18103. Discover Medicare insurance plans accepted at our Allentown health center and find primary care doctors accepting Medicare near you.Call OTC Health Solutions at 1-833-331-1573 (TTY: 711). You can speak with an agent 9 AM to 8 PM local time, Monday through Friday. Call Member Services to order a printed copy of your …H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective YearIn-Network: Copayment for Medicare-Covered Podiatry Services $35.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $70.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $178 per day, days 21-100 in-network| 50% per stay. Out-of-Network: for more information see Evidence of Coverage.Inpatient Hospital Care. $325 per day, days 1-6; $0 per day, days 7-90 in-network | $425 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. Mental Health Inpatient Care. In-Network: Psychiatric Hospital Services: $240.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Plan ID: H5521-437-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …Y0001_H5521_170_PQ20_SB24_M. 2024 Summary of Benefits. Aetna Medicare Premier Plus Plan (PPO) H5521 ‐ 170. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.Urgent Care: Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.View the coverage and benefits provided in the Aetna Medicare SmartFit (PPO) plan from Aetna. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide.You can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) benefit catalog, and more. If you’re in a Medicare Advantage plan, your plan name is listed on your member ID card. If you’re in a plan with prescription drug coverage only (PDP), look at the “S ... The Aetna Medicare SmartFit Plan (PPO) (H5521 - 444) currently has 7,207 members. , and 4,599 members in South Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4 stars. The detail CMS plan carrier ratings are as follows: Customer Service Rating of 4 out of 5 stars The table below outlines some of the specific plan details for Aetna Inc. Medicare Advantage plans available in South Carolina in 2024. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket Max. Prescription Drug Coverage. Medicare.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective YearOFFICE OF CIVIL RIGHTS – CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES. You can also file a civil rights complaint with the California Department of Health Care Services, …H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Cigna View payer . Plan Name Effective Year Benefit Package; Cigna-HealthSpring Preferred (HMO) 2024:Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.This page features plan details for 2024 Aetna Medicare SmartFit Plan (PPO) H5521 – 444 – 0 available in South Carolina. IMPORTANT : This page has been updated with plan and … The Aetna Medicare SmartFit Plan (PPO) (H5521 - 444) currently has 7,207 members. , and 4,599 members in South Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4 stars. The detail CMS plan carrier ratings are as follows: Customer Service Rating of 4 out of 5 stars If you have any questions, you can call and speak to a customer service representative at 1‐833‐859‐6031 (TTY: 711). From October 1 to March 31, you can call us 7 days a week from 8 AM to 8 PM local time. From April 1 to September 30, we’re here Monday through Friday from 8 AM to 8 PM local time.Plan ID: H5521-423-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Washington Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...In-Network: Copayment for Medicare-Covered Podiatry Services $35.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $70.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $178 per day, days 21-100 in-network| 50% per stay. Out-of-Network: for more information see Evidence of Coverage.Plan ID: H5521-214-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Michigan Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $300 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $350 per stay 50% per stay. Outpatient hospital. $45 ... Plan ID: H5521-082-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $77.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ... Aetna Medicare Premier Plus (PPO) | H5521-016 | $34 | Y0001_H5521_016_PP68_SB24_M 2024-H5521.016.1 Aetna Medicare Premier Plus (PPO) H5521 ‑ 016 Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Need a complete list of what …Plan ID: H5521-441-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Ohio Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …Aetna Medicare Dual Choice (PPO D-SNP) | H5521-464 8 2024 Summary of Benefits for H5521-464. Hearing services Benefit Your in‑network costs Your out‑of‑network costs Diagnostic hearing exam $0 20% after your plan deductible Routine hearing exam $0 0% You get one routine hearing exam every year. You can visit a provider in the ...In-Network: Copayment for Medicare-Covered Podiatry Services $35.00. Out-of-Network: Coinsurance for Medicare Covered Podiatry Services 45%. Skilled Nursing Facility Care. $10 per day, days 1-20. $203 per day, days 21-100 in-network| 45% per stay. Out-of-Network: for more information see Evidence of Coverage.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-227: Aetna Medicare Freedom Plan (PPO) 2024: H2293-016: Amerigroup View payer . Plan Name Effective Year Benefit Package; Amerivantage Dual Coordination (HMO D-SNP) …Y0001_H5521_170_PQ20_SB24_M. 2024 Summary of Benefits. Aetna Medicare Premier Plus Plan (PPO) H5521 ‐ 170. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.Enrolling in H5521-369-000 Medicare Advantage Plans in California Medicare beneficiaries from California may have access to Medicare Advantage plans from Aetna and other insurance companies. Get help comparing your local plan options by calling to speak with a licensed insurance agent who can help you find out if your doctor and prescription drugs …If you have any questions, you can call and speak to a customer service representative at 1‐833‐859‐6031 (TTY: 711). From October 1 to March 31, you can call us 7 days a week from 8 AM to 8 PM local time. From April 1 to September 30, we’re here Monday through Friday from 8 AM to 8 PM local time.Aetna Medicare SmartFit Plan (PPO) H5521-444-000 2024 Plan Details and Costs. Home. Medicare Plans. Aetna Medicare SmartFit Plan (PPO) 4 out of 5 stars* for plan year 2024. Aetna Medicare SmartFit Plan (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-444-000.Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective YearFor mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 10 days. You can call 1-833-570-6670 (TTY: 711), 8 AM to 8 PM, 7 days a week, if you do not receive your mail-order drugs within this timeframe.Aetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.Number of Members enrolled in this plan in (H5521 - 081): 27,086 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 4 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Specialty Doctor Visit. $30 in-network | 40% out-of-network. Inpatient Hospital Care. $550 per day, days 1-5; $0 per day, days 6-90 in-network | 45% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency Room Visit.Aetna Medicare Dual Choice (PPO D-SNP) | H5521-469 8 2024 Summary of Benefits for H5521-469. Hearing services Benefit Your in‑network costs Your out‑of‑network costs Diagnostic hearing exam $0 20% after your plan deductible Routine hearing exam $0 0% You get one routine hearing exam every year. You can visit a provider in the ...Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.Aetna Medicare Dual Choice (PPO D-SNP) | H5521-469 8 2024 Summary of Benefits for H5521-469. Hearing services Benefit Your in‑network costs Your out‑of‑network costs Diagnostic hearing exam $0 20% after your plan deductible Routine hearing exam $0 0% You get one routine hearing exam every year. You can visit a provider in the ...Y0001_H5521_243_PQ49_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value Plan (PPO) H5521 ‐ 243. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.Y0001_H5521_403_NT16_SB24_M. 2024 Summary of Benefits. Aetna Medicare SmartFit (PPO) H5521 ‐ 403. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Aetna Medicare SmartFit Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $10.00. Copayment for Routine Care $10.00. Maximum 12 Routine Care every year. Aetna Medicare Premier Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Copayment for Routine Care $15.00. Maximum 12 Routine Care every year. H5521 - 444 - 0 (4 / 5) Aetna Medicare SmartFit Plan (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare. Premium: $0.00 Enroll Now This page features plan ... Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | $450 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | $450 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit.Plan ID: H5521-423-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Washington Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...Aetna Medicare SmartFit Plan (PPO) H5521-444. Includes: Medical (Part C) Prescription (Part D) $0 Open tooltip for information about $0 premiums. Aetna is able to offer $0 monthly premium plans because the federal government covers the cost using your monthly Medicare Part B premium.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective YearH5521:444-0 Aetna Medicare SmartFit Plan (PPO) H5521:445-0 Aetna Medicare SmartFit Plan (PPO) H5521:446-0 Aetna Medicare Discover Plan ... H5521:474-0 Aetna Medicare Value Plus Signature (PPO) H5521:475-0 Aetna Medicare Giveback Choice (PPO) H5521:476-0 Aetna Medicare Giveback Choice (PPO)Aetna Medicare SmartFit Plan (PPO) | H5521-444 | $0 | Y0001_H5521_444_NS99_SB24_M 2024-H5521.444.1 Aetna Medicare SmartFit Plan (PPO) H5521 ‑ 444 Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Need a complete list of what …In-Network: Copayment for Medicare-Covered Podiatry Services $35.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $50.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $196 per day, days 21-100 in-network| 50% per stay. Out-of-Network: for more information see Evidence of Coverage.Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient psychiatric hospital stay. $374 per day, days 1‐5; $0 per day, 30% per stay after your plan days 6‐90 after your plan deductible deductible. Outpatient mental health therapy. $40 30% after your plan deductible. Outpatient psychiatric therapy.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Cigna View payer . Plan Name Effective Year Benefit Package; Cigna Fundamental Medicare (HMO) 2024:Aetna Medicare Dual Choice (PPO D-SNP) | H5521-464 8 2024 Summary of Benefits for H5521-464. Hearing services Benefit Your in‑network costs Your out‑of‑network costs Diagnostic hearing exam $0 20% after your plan deductible Routine hearing exam $0 0% You get one routine hearing exam every year. You can visit a provider in the ...This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $356 per day, days 1‐8; $0 per day, 40% per stay days 9‐90; $0 for additional days. Outpatient hospital observation services. $275 per stay 40% per stay. Outpatient hospital. $25 ...Podiatry services. Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $65.00. Skilled Nursing Facility (SNF) care. $0 per day, days 1-20; $196 per day, days 21-100 in-network| 35% per stay out-of-network, for more information see Evidence of Coverage.Y0001_H5521_352_PR10_SB24_M. 2024 Summary of Benefits. Aetna Medicare Essential Elite Plan (PPO) H5521 ‐ 352. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in …Podiatry services. Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $65.00. Skilled Nursing Facility (SNF) care. $0 per day, days 1-20; $196 per day, days 21-100 in-network| 35% per stay out-of-network, for more information see Evidence of Coverage.3.5 out of 5 stars. Aetna Medicare Eagle (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-440. Have Medicare questions? Talk to a licensed … Members with Aetna Medicare Advantage (MA) and Aetna Medicare Advantage with Prescription Drug (MAPD) plans can log in or register for an account below. This includes HMO, PPO or HMO-POS plans. Through your Aetna® member account you can manage claims, view plan details and more. Log in for MA/MAPD. Register my MA/MAPD. Aetna Medicare Premier Plus (PPO) | H5521-016 | $34 | Y0001_H5521_016_PP68_SB24_M 2024-H5521.016.1 Aetna Medicare Premier Plus (PPO) H5521 ‑ 016 Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Need a complete list of what … In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care. With this plan, the monthly premium you pay to the SSA is reduced by $55. Plan deductible. $0. MOOP. $7,000 for in‐network services $9,500 for in‐ and out‐of‐network services combined. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium doesn’t count toward your MOOP.Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. 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Specialty Doctor Visit. $40 in-network | $70 out-of-network. Inpatient Hospital Care. $250 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. . Kimley horn and associates inc.

Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation. Inpatient hospital care. $365 per day, days 1-6; $0 per day, days 7-90 in-network | $465 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $30.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00.Mar 1, 2024 · Learn more about your plan. Watch this quick video to find out more about the benefits, programs and services your plan offers. Urgent Care. Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.Urgent Care: Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Aetna Medicare Premier Plus (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $150 (Tier 1 and 2 excluded from the Deductible.) Annual Initial Coverage Limit (ICL): You may also contact us at 1-866-241-0356 (TTY: 711) Monday through Friday, 8 AM to 9 PM ET. Aetna Medicare is a HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Y0001_GRP_2022_H5521_M_VZN. 1/1. In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care.If you have any questions, you can call and speak to a customer service representative at 1‐833‐859‐6031 (TTY: 711). From October 1 to March 31, you can call us 7 days a week from 8 AM to 8 PM local time. From April 1 to September 30, we’re here Monday through Friday from 8 AM to 8 PM local time. Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation. Plan ID: H5521-144-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $49.00 Monthly Premium. Maine Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... In-Network: Copayment for Medicare-Covered Podiatry Services $40.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $65.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $196 per day, days 21-100 in-network| 35% per stay. Out-of-Network: for more information see Evidence of Coverage. Aetna Medicare Eagle Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services. Specialty Doctor Visit. $30 in-network | 40% out-of-network. Inpatient Hospital Care. $550 per day, days 1-5; $0 per day, days 6-90 in-network | 45% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency Room Visit. H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective YearY0001_H5521_243_PQ49_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value Plan (PPO) H5521 ‐ 243. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.Plan ID: H5521-144-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $49.00 Monthly Premium. Maine Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...Y0001_H5521_310_PQ91_SB24_M. 2024 Summary of Benefits. Aetna Medicare Elite Plan 3 (PPO) H5521 ‐ 310. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.2023 Evidence of Coverage for Aetna Medicare Premier Plan (PPO) 7 Chapter 1 Getting started as a member SECTION 1 Introduction Section 1.1 You are enrolled in Aetna Medicare Premier Plan (PPO), which is a Medicare PPOH5521 - 374 - 0 (4 / 5) Aetna Medicare Explorer Plan (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare. Premium: $0.00 Enroll Now This page features plan details for 2024 Aetna Medicare Explorer Plan (PPO) H5521 – 374 – 0 available in New Hampshire.You can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) benefit catalog, and more. If you’re in a Medicare Advantage plan, your plan name is listed on your member ID card. If you’re in a plan with prescription drug coverage only (PDP), look at the “S ...Plan ID: H5521-144-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $49.00 Monthly Premium. Maine Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...In-Network: Copayment for Medicare-Covered Podiatry Services $45.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $60.00. Skilled Nursing Facility Care. $10 per day, days 1-20. $196 per day, days 21-100 in-network| 35% per stay. Out-of-Network: for more information see Evidence of Coverage.Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation.Plan ID: H5521-272-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North Aetna-Medicare-SmartFit-Plan-PPO H5521:444-0 | Alight Retiree Health Solutions. Home. Medicare Plans. Dental, Vision & Hearing Plans. Log In. Create Account. View the coverage and benefits provided in the Aetna Medicare SmartFit Plan (PPO) plan from Aetna. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide. Medicare Plans. Dental, Vision & Hearing Plans. Log In. Create Account. View the coverage and benefits provided in the Aetna Medicare SmartFit Plan (PPO) plan from Aetna. Alight Retiree …Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Anthem View payer . Plan Name Effective Year Benefit Package; Anthem MediBlue Access Basic (Regional PPO) 2024:Nov 9, 2023 · The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation. Plan ID: H5521-082-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $77.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ... Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation.Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans contain exclusions and limitations. Aetna offers health insurance, as well as dental, vision and other plans, to meet the ...Evidence of Coverage. January 1 - December 31, 2022. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Aetna Medicare Plan (PPO) This booklet gives you the details about your Medicare health care and prescription drug coverage from January 1 - December 31, 2022.H5521-444. Aetna Medicare. | Local PPO. Why Trust U.S. News. 344. Insurance Companies Evaluated. 6,000+. Individual Plans Evaluated. 3,000+. Searchable Zip Codes. See our Full …Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | $450 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit.Plan ID: H5521-441-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Ohio Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …This page features plan details for 2024 Aetna Medicare SmartFit Plan (PPO) H5521 – 444 – 0 available in South Carolina. IMPORTANT : This page has been updated with plan and …Plan ID: H5521-082-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $77.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ...With this plan, the monthly premium you pay to the SSA is reduced by $70. Plan deductible. $0. MOOP. $4,390 for in‐network services $8,000 for in‐ and out‐of‐network services combined. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium doesn’t count toward your MOOP. Plan ID: H5521-121-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $49.00 Monthly Premium. New York Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ... H5521:247-0 Aetna Medicare Premier Plan (PPO) H5521:249-0 Aetna Medicare Premier Plan (PPO) H5521:251-0 Aetna Medicare Value Plan (PPO) H5521:279-0 Aetna Medicare Eagle Plan (PPO) H5521:319-0 Aetna Medicare Premier Plus Plan (PPO) H5521:373-0 Aetna Medicare Essential Plan (PPO) H5521:444-0 Aetna Medicare SmartFit Plan (PPO) 3.5 out of 5 stars. Aetna Medicare Eagle (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-440. Have Medicare questions? Talk to a licensed …Mental Health Inpatient Care. In-Network: Psychiatric Hospital Services: $240.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%.This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $395 per day, days 1‐5; $0 per day, 45% per stay days 6‐90; $0 for additional days. Outpatient hospital observation services. $335 per stay 45% per stay. Outpatient hospital. $40 ...4 2024 Evidence of Coverage for Aetna Medicare SmartFit Plan (PPO) Table of Contents SECTION 2 Fill your prescription at a network pharmacy or through the plan’s …This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $295 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $325 per stay 50% per stay. Outpatient hospital. $40 ... In-Network: Copayment for Medicare-Covered Podiatry Services $40.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $65.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $196 per day, days 21-100 in-network| 35% per stay. Out-of-Network: for more information see Evidence of Coverage. In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care.4 out of 5 stars* for plan year 2024. Aetna Medicare SmartFit (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-441-000. * Every year, …To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1‐800‐MEDICARE (TTY users should call 1‐877‐486‐2048), 24 hours a day/7 days a week. If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.Y0001_H5521_243_PQ49_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value Plan (PPO) H5521 ‐ 243. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.Plan ID: H5521-082-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $77.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ...Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency room visit. $135 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation.Plan ID: H5521-214-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Michigan Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...Specialty Doctor Visit. $50 in-network | 50% out-of-network. Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $55.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Emergency Room Visit. OFFICE OF CIVIL RIGHTS – CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES. You can also file a civil rights complaint with the California Department of Health Care Services, Ofice of Civil Rights by phone, in writing, or electronically: By phone: Call 916-440-7370. If you cannot speak or hear well, please call 711 (Telecommunications Relay ... Y0001_H5521_170_PQ20_SB24_M. 2024 Summary of Benefits. Aetna Medicare Premier Plus Plan (PPO) H5521 ‐ 170. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.Aetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | $450 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit.Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans contain exclusions and limitations. Aetna offers health insurance, as well as dental, vision and other plans, to meet the ... 2024 Aetna Medicare SmartFit Plan (PPO) H5521 — 444— 0 is a Local PPO offered in South Carolina by Aetna Medicare. It has a monthly premium of $0.00. Premium Breakdown. Standard Part B Premium. $174.80. Part B premium reduction. $0. Part C Premium. $0. Part D Basic Premium. $0. Part D Supplemental Premium. $0. Part D Total. $0.00. Nov 9, 2023 · The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective Year©2023 Aetna Inc. 2584953-01-01 (9/23) Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiaryInpatient hospital care. $365 per day, days 1-6; $0 per day, days 7-90 in-network | $465 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $30.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00.3.5 out of 5 stars. Aetna Medicare Explorer Premier (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-434. Have Medicare questions? …. 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