Aetna Medicare Option 2 (HMO)

4 out of 5 stars* for plan year 2023
$57.00 Monthly Premium

Aetna Medicare Option 2 (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.

Plan ID: H2663-002-000

$57.00 Monthly Premium

Illinois and Missouri 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 and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Illinois and Missouri Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Basic Costs and Coverage

Coverage Details
Monthly plan premium$57.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$4,900.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$7,400.00
Primary care doctor visit$0
Specialty doctor visit$35
Inpatient hospital care$275 per day, days 1-5; $0 per day, days 6-90
Urgent care
Urgent Care:
Copayment for Urgent Care $35.00

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $110.00
Emergency room visit$110 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$300

Health Care Services and Medical Supplies

Aetna Medicare Option 2 (HMO) covers a range of additional benefits. Learn more about Aetna Medicare Option 2 (HMO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

Coverage Details
Chiropractic servicesIn-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $20.00
Prior Authorization Required for Chiropractic Services
Diabetes supplies, training, nutrition therapy and monitoring0% - 20% Higher cost-share applies to non-OneTouch/LifeScan diabetic supplies.
Durable medical equipment (DME)20%
Diagnostic tests, lab and radiology services, and X-raysLab Services: Lab Services: $0 in-network, for more information see Evidence of Coverage
Diagnostic Procedures: Diagnostic Procedures/Tests: $35 in-network, for more information see Evidence of Coverage
Imaging: Xray: $0 in-network / CT Scans: $100 in-network / Diagnostic Radiology other than CT Scans: $100 in-network / Diagnostic Radiology Mammogram: $0 in-network, for more information see Evidence of Coverage
Home health care$0
Mental health inpatient careIn-Network:

Psychiatric Hospital Services:
$275.00 per day for days 1 to 5
$0.00 per day for days 6 to 90
Prior Authorization Required for Psychiatric Hospital Services
Mental health outpatient careMental Health - Group Sessions: $30 in-network/ Mental Health - Individual Sessions: $40 in-network, for more information see Evidence of Coverage

Psychiatric Services - Group Sessions: $30 in-network/ Psychiatric Services - Individual Sessions: $40 in-network, for more information see Evidence of Coverage
Outpatient services/surgeryAmbulatory Surgical Center: $250 in-network / ASC Screening Colonoscopy Polyp Removal and Post-FIT: $0 in-network, for more information see Evidence of Coverage
Outpatient substance abuse careIn-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $40.00
Copayment for Medicare-covered Group Sessions $30.00
Prior Authorization Required for Outpatient Substance Abuse Services
Over-the-counter itemsSeasonal Over-the-Counter (OTC) kit of preselected OTC items mailed twice a year and $90 quarterly OTC allowance, for more information see Evidence of Coverage
Podiatry servicesIn-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $35.00
Copayment for Routine Foot Care $35.00
  • Maximum 6 visits every year
Skilled Nursing Facility (SNF) care$10 per day, days 1-20; $196 per day, days 21-100 in-network, for more information see Evidence of Coverage

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Dental care$1,500 reimbursement every year for preventive and comprehensive services, for more information see the Evidence of Coverage

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Vision benefits$300 every year, see the Evidence of Coverage

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Hearing benefits$1,250 per ear every year, for more information see the Evidence of Coverage

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Preventive services and health/wellness education programs$0 copay for all preventive services covered under Original Medicare at zero cost sharing

When reviewing Illinois and Missouri Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Illinois and Missouri that offer similar benefits at similar or lower prices than the plan above. Call 1-877-890-1409 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents

Illinois Counties Served

Bond Calhoun Clinton Greene Jersey Madison Monroe Randolph Saint Clair Washington

Missouri Counties Served

Audrain Boone Callaway Cole Cooper Crawford Franklin Gasconade Howard Jefferson Knox Lincoln Maries Miller Moniteau Montgomery Osage Perry Pike Saint Charles Saint Francois Saint Louis Saint Louis City Sainte Genevieve Shelby Warren Washington
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