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TTY 711
Your Medicare Advantage plan comparison is just one step away!
On the phone
Our licensed insurance agents can help you compare plans and keep your current doctor.
Aetna Medicare Platinum Plan (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H3748-011-000
Washington 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 Washington Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
| Coverage | Details |
|---|---|
| Monthly plan premium | $99.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $0.00 |
| Out-of-pocket maximum | $6,700.00 |
| 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 | $415 per day, days 1-5; $0 per day, days 6-90 |
| Urgent care | Urgent Care: Copayment for Urgent Care $45.00 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $95.00 |
| Emergency room visit | $95 If you are admitted to the hospital within 0 hours you do not have to pay your cost share may be waived, for more information see the Evidence of Coverage |
| Ambulance transportation | $250 |
Aetna Medicare Platinum Plan (HMO-POS) covers a range of additional benefits. Learn more about Aetna Medicare Platinum Plan (HMO-POS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $20.00 Copayment for Routine Care $20.00
|
| Diabetes supplies, training, nutrition therapy and monitoring | 0% - 20% Higher cost-share applies to non-OneTouch/LifeScan diabetic supplies. |
| Durable medical equipment (DME) | 20% |
| Diagnostic tests, lab and radiology services, and X-rays | Lab Services: Lab Services: $0 in-network, for more information see Evidence of Coverage Diagnostic Procedures: Diagnostic Procedures/Tests: $15 in-network, for more information see Evidence of Coverage Imaging: Xray: $0 in-network / CT Scans: $300 in-network / Diagnostic Radiology other than CT Scans: $300 in-network / Diagnostic Radiology Mammogram: $0 in-network, for more information see Evidence of Coverage |
| Home health care | $0 |
| Mental health inpatient care | In-Network: Psychiatric Hospital Services: Copayment for Psychiatric Hospital Services per Stay $1871.00 Prior Authorization Required for Psychiatric Hospital Services |
| Mental health outpatient care | Mental Health - Group Sessions: $40 in-network/ Mental Health - Individual Sessions: $40 in-network, for more information see Evidence of Coverage Psychiatric Services - Group Sessions: $40 in-network/ Psychiatric Services - Individual Sessions: $40 in-network, for more information see Evidence of Coverage |
| Outpatient services/surgery | Ambulatory 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 care | In-Network: Outpatient Substance Abuse Services: Copayment for Medicare-covered Individual Sessions $40.00 Copayment for Medicare-covered Group Sessions $40.00 Prior Authorization Required for Outpatient Substance Abuse Services |
| Over-the-counter items | Not Covered |
| Podiatry services | In-Network: Podiatry Services: Copayment for Medicare-Covered Podiatry Services $35.00 |
| Skilled Nursing Facility (SNF) care | $0 per day, days 1-20; $196 per day, days 21-100 in-network, for more information see Evidence of Coverage |
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | In-Network: Preventive Dental: Copayment for Oral Exams $0 Copayment for Dental X-Rays $0 Copayment for Prophylaxis (Cleaning) $0 Copayment for Fluoride Treatment $0 Comprehensive Dental: Copayment for Non-routine Services $0 Copayment for Diagnostic Services $0 Copayment for Restorative Services $0 Out-Of-Network: Co-Insurance for Preventive Dental 20% Non-Medicare Covered Comprehensive Dental 20% Frequency limitations may apply. See the Schedule of Benefits in your Evidence of Coverage. $650 maximum benefit for preventive and comprehensive dental services combined - see Evidence of Coverage. |
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Vision benefits | In-Network: Eye Exams: Copayment for Medicare Covered Benefits $0 Copayment for Routine Eye Exams $0 - Maximum one exam every year Eyewear: Copayment for Medicare Covered Benefits $0 Copayment for Contacts $0 Copayment for Eyeglasses $0 Copayment for Eyeglass Frames $0 Copayment for Eyeglass Lenses $0 Copayment for Upgrades $0 Maximum Plan Allowance for all Non-Medicare covered Eyewear $225 reimbursement every year. For more information, see the Evidence of Coverage |
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing benefits | In-Network: Hearing Exams: Copayment for Medicare Covered Benefits $0 Copayment for Routine hearing Exams $0 - Maximum one exam every year Copayment for Fitting/Evaluation for Hearing Aid $0 - Maximum one hearing aid fitting/evaluation every year Hearing Aids: Copayment for Hearing Aids $0 - Maximum two hearing aids every year $1,250 per ear every year, for more information see the Evidence of Coverage |
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 Washington 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 Washington 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.
| Links to plan documents |
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