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paultry  
#41 Posted : Wednesday, October 13, 2021 1:49:01 PM(UTC)
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According to the Aetna book which came in today's mail, Aetna Advantage for 2022 will have "No Part B premium reduction". While it appears the Self +1 premium will remain the same @ $275/mo, losing the $75/each Part B premium reduction will mean a net $150/mo increase. We may have to look at going back to Aetna Direct with its $1,800 pay-back.

https://photos.app.goo.gl/ekhNMCUPoncPmWQn9

Edited by user Wednesday, October 13, 2021 3:07:15 PM(UTC)  | Reason: Not specified

Bob Loblaw  
#42 Posted : Wednesday, October 13, 2021 2:56:54 PM(UTC)
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I haven’t seen the plan book, but the Aetnafeds website still shows the supplement under the 2022 summary of benefits
https://www.aetnafeds.co...a-medicare-advantage.php

Edited by user Wednesday, October 13, 2021 2:57:26 PM(UTC)  | Reason: Not specified

Sante123  
#43 Posted : Wednesday, October 13, 2021 3:02:48 PM(UTC)
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Yes, Paultry, that was disappointing to read when the plan book arrived today. This will have a clearly negative impact on low-expense plan participants. For high-expense folks, however, the picture may be less clear since the plan is retaining a pretty great drug benefit as well as zero deductible, zero copay, and zero coinsurance. Then again, some language in the plan description seems to contradict the last point…will have to call to get a clarification. We may all need to resort to the Checkbook Guide once more to scour next year’s FEHB plan landscape.

@ Bob Loblaw:
The plot thickens. Your post arrived while I was writing mine. Now that I see your link, things maybe looking up. But either the plan book is wrong or the web page is wrong.

Edited by user Wednesday, October 13, 2021 3:09:39 PM(UTC)  | Reason: Not specified

Bob Loblaw  
#44 Posted : Wednesday, October 13, 2021 3:11:23 PM(UTC)
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And I have to add that this seems a little suspicious. Adding $150/mo to the plan premium bumps this up to $425/mo…which is almost the same as BC/BS Basic, which still gives you $800pp annual Medicare supplement. Not to mention the Part D IRMMA bump with Aetna. There would seem to be almost no advantage to this “Advantage” plan. Are we sure they’ve dropped the supplement?

Edit. Now that think about it Aetna isn’t actually increasing costs, so my numbers don’t make sense. But still, the “Advantage” this plan had over BC/BS Basic is much less without the supplement.

Edited by user Wednesday, October 13, 2021 3:19:29 PM(UTC)  | Reason: Not specified

Sante123  
#45 Posted : Wednesday, October 13, 2021 7:13:45 PM(UTC)
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OK, here’s the scoop, coming from the 2022 plan brochure, not the poorly designed Plan Document Notice, aka the “plan book”, that was sent out to all members today.

There is no change to the Medicare premium reduction. It’s the same as 2021.
There is no change to the zero deductible, zero copay, zero coinsurance feature. Same as 2021.
There is essentially no change to the prescription drug benefit either. Same as 2021 except for a modest bump to the annual total drug costs limit and the annual drug out of pocket limit.
There is no change to the additional benefits (Silver Sneakers, non-emergency transportation to/from doctor appointments, hearing aid reimbursement, home-delivered meals following a hospital stay, etc.)
There is no change in the monthly premium either. The same as 2021.

Here is the link to the official 2022 plan brochure, which contains language for both the generic Aetna Advantage Plan (non-Medicare) and the Aetna Medicare Advantage PPO Plan (the one we’re discussing here.). The relevant passages for the Medicare Advantage variant are found on pages 37-38 and 94-96.

https://www.aetnafeds.co...2/2022AetnaAdvantage.pdf

Edited by user Wednesday, October 13, 2021 7:38:43 PM(UTC)  | Reason: Clarified brochure page numbers for MA plan.

Bob Loblaw  
#46 Posted : Thursday, October 14, 2021 2:40:48 AM(UTC)
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Thanks for hunting that down, Sante. Won’t have to start my search all over again now.
paultry  
#47 Posted : Thursday, October 14, 2021 6:33:46 AM(UTC)
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Reduction in benefits really didn't make sense after the recent notice that they had overcharged us and would be making amends in some form.
Sante123  
#48 Posted : Thursday, October 14, 2021 3:22:36 PM(UTC)
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This post doesn’t change anything I’ve written before. I’m adding it just to provide some background and clarity.

Aetna sells lots of different medical plans, some for individuals and some for groups. There is a sort of template of general benefits for group plans, which can be upgraded by the organization (usually an employer) at its expense. As a result, the final plan design for one organization may be VERY different from that of another organization. Some final plans may have deductibles, copays and coinsurance while others may not. Some may lessen or eliminate the impact of the “donut hole” in Medicare Advantage plans, while others may not. Some may apply a credit to reduce Medicare premiums, while others may not. While speaking with an Aetna customer service rep this morning, I was advised that the Aetna Medicare Advantage PPO plan designed for OPM via the FEHB is one of the sweetest deals, if not the sweetest deal, offered by Aetna. The thing is that “Aetna Medicare Advantage PPO” and “Aetna Medicare PPO” are marketing terms Aetna uses to structure and package an assortment of MA plans, one of which (this one) happens to be in the FEHB. This means that their communications regarding such packages often relate to a broader audience than just the one FEHB plan we are discussing here. This leads to various Aetna documents and websites containing a lot of extraneous language which does not apply to the FEHB plan. But there’s more…

Thee are certain things that Aetna is required to do.
1) They must issue the official plan brochure in the format set by OPM. This leads to a somewhat confusing mix of text, which is mostly devoted to the non-Medicare Aetna Advantage plan and only partly devoted to the Aetna Medicare Advantage PPO plan.
2) They must notify members concerning changes in the “plan” from one year to the next. The format is set by Medicare. This was mailed out to arrive (unexpectedly) yesterday. As you may have guessed by now, this mailed document also tries to address more than one type of plan within the Aetna MA universe. Even the Schedule of Costs section tucked away in the middle of the booklet (which is supposed to be just about our FEHB plan) contains language on page 2 concerning copays and coinsurance that has no business being there since our plan does not have any of these things. But the BIG mistake was the one on page 4 of the Annual Notice of Changes for 2022 which claims that there will be no Part B premium reduction in 2022. This is flat out wrong and Aetna didn’t notice their error until after they had sent out the booklet. Aetna will soon send out a notification correcting the error(s). At least that’s what the rep told me. I hope this helps folks understand the situation better and recognize that not much of anything important is changing from 2021 to 2022.
thanks 2 users thanked Sante123 for this useful post.
Bob Loblaw on 10/14/2021(UTC), paultry on 10/15/2021(UTC)
jagfan  
#49 Posted : Saturday, October 16, 2021 9:52:07 AM(UTC)

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Like the Aetna Medicare Advantage (AMA) FEHB plan, Aetna Direct (AD) also offers zero copays, zero co-insurance and zero deductible for medical claim. Both plans offer the $900 fund (self only). Aetna Direct will also cover services outlined in their brochure that Medicare does not cover. An example, is an annual physical exam. From personal experience, Medicare has denied that service, however, AD covered it according to the terms of their contract. In addition, my spouse had a dermatological procedure, part of which, was not covered by Medicare and AD also covered the denied portion. An inquiry with an Aetna rep confirmed the AMA plan will pay only for services approved by Medicare. I understand there is sometimes conflicting information among reps. So I would like to inquire whether those of you with the AMA plan can confirm the accuracy of the coverage information I obtained?
Bob Loblaw  
#50 Posted : Saturday, October 16, 2021 11:42:59 AM(UTC)
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If you look at page 8 of this summary, it says they do pay for annual physical exams.
https://www.aetnafeds.co...agePlanBenefitsGuide.pdf
jagfan  
#51 Posted : Saturday, October 16, 2021 1:02:22 PM(UTC)

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Originally Posted by: Bob Loblaw Go to Quoted Post
If you look at page 8 of this summary, it says they do pay for annual physical exams.
https://www.aetnafeds.co...agePlanBenefitsGuide.pdf


I missed that, Thank you
Bob Loblaw  
#52 Posted : Friday, November 5, 2021 5:31:12 AM(UTC)
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So, has anyone compared this Aetna MA plan with the one offered by United Healthcare? With the info I’ve seen the UHC plan is somewhat cheaper, as they reimburse the entire $148 cost of (pre-IRMMA) Medicare.
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FlowerGirl on 11/5/2021(UTC)
Sante123  
#53 Posted : Friday, November 5, 2021 11:30:38 PM(UTC)
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There are actually several UHC Medicare advantage plans. You should specify the plan code you have in mind. Better yet, look it up in the Checkbook Guide or the OPM website. There are lots of variables such as which plan you are choosing, who is being covered, how old they are, what forms of Medicare coverage they have, what level of medical expense you anticipate, which benefits are most important to you, where you live, etc. One thing to keep in mind is that none of the FEHB UHC Medicare Advantage plans are nationwide. The UHC plan that was an almost-nationwide plan last year is no longer available, and the remaining ones have very limited service areas, mostly centered around the DC area.

Update: The Checkbook Guide describes the five UHC “Retiree Advantage” plans as being “nationwide”, but this is inaccurate. A quick look at the respective plan brochures shows that their service areas range from a handful of states to an even smaller handful of states, plus the District of Columbia. And one must live in those service areas in order to enroll. Inexplicably, the Guide lists the Aetna Medicare Advantage plan as only being available in “Many Areas” despite the fact that it covers all or most counties in all 50 states and the District of Columbia. The Guide also describes coverage using non-preferred providers as being “Reduced” for Aetna Medicare Advantage even though the coverage is the same for all providers who accept Medicare and the plan. The issue of preferred providers (i.e. in-network providers) is actually moot for Medicare A+B enrollees, which by definition includes all plan enrollees. By the way, all of my doctors and hospital providers are “out of network”, yet this has made no difference whatsoever in obtaining the full range of covered services at the usual Medicare-dictated prices.

Edited by user Sunday, November 7, 2021 1:09:28 AM(UTC)  | Reason: To clarify plan service areas and coverage.

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FlowerGirl on 11/6/2021(UTC)
Bob Loblaw  
#54 Posted : Sunday, November 7, 2021 6:50:55 AM(UTC)
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Thanks, Sante. I’ve been looking at the 3 UHC MA choices for my area (Northern Virginia). They are the Choice Primary, Choice Plus Advanced, and Choice Plus Primary. They range from $1000-$1400 less per year than Aetna Advantage. I’ve been looking at the different brochures, and they of course have various benefits, deductibles, and in-network requirements. It’s a little confusing trying to compare them, but it seems like the MA plan, when attached to the main plan, evens them out…no copays, no network requirements (other than participating with Medicare), etc. here’s the Summary of Benefits from the website
https://uhcvirtualretire...of%20Benefits%202022.pdf
What am I missing? It seems like the cheapest UHC plan is about the same as the Aetna Advantage…
Sante123  
#55 Posted : Sunday, November 7, 2021 9:30:27 AM(UTC)
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Originally Posted by: Bob Loblaw Go to Quoted Post
Thanks, Sante. I’ve been looking at the 3 UHC MA choices for my area (Northern Virginia). They are the Choice Primary, Choice Plus Advanced, and Choice Plus Primary. They range from $1000-$1400 less per year than Aetna Advantage. I’ve been looking at the different brochures, and they of course have various benefits, deductibles, and in-network requirements. It’s a little confusing trying to compare them, but it seems like the MA plan, when attached to the main plan, evens them out…no copays, no network requirements (other than participating with Medicare), etc. here’s the Summary of Benefits from the website
https://uhcvirtualretire...of%20Benefits%202022.pdf
What am I missing? It seems like the cheapest UHC plan is about the same as the Aetna Advantage…


It might be helpful if you started a separate UHC MA topic for folks who, like you, live in one of their service areas. My reason for saying so is that apples to apples comparisons between those plans and Aetna MA can quickly get into the weeds re: covered services, max payables per year, etc. Each topic would benefit from a full, focused and separate discussion. Having said that, you are noticing a cost advantage for the three plans you mentioned. (For those who might not have noticed, you seem to be quoting comparisons based on Self+One figures, which is what I prefer to quote as well.) That $1000-1400 per year is a definite plus…..for those three plans and for the folks who are allowed to enroll in them. There is no equivalent plus for the other two UHC Retiree Advantage plans (MD-IPA Retiree Advantage and UHC Choice Open Access Retiree Advantage) which are more expensive. That’s why I wanted you to spell out which plan you were referring to in your earlier post. Since the folks who will be able to join the three plans you mentioned all live in relatively restricted geographic areas, the costs to the plans are less. Similar to, though not the exact same as, how cheaper commercial MA plans often feature “skinny networks.” Once you get out into the rest of the US, however, the Aetna MA plan generally comes out on top because those three UHC plans are often not available to enroll in.

Edited by user Sunday, November 7, 2021 3:08:09 PM(UTC)  | Reason: Not specified

wyre  
#56 Posted : Friday, November 19, 2021 1:35:06 PM(UTC)
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Looking into this in 2021, but thought I’d add this note here anyway, in case anyone is following this older thread. One difference is the “Advantage” plan would trigger an additional part D IRMAA , for those who are already subject to the part B surcharge. ( it’s in the small print). I was tempted by the $900 rebate for part B … but I think I will stick with GEHA standard this year. I hope additional FEHB plans come up with similar variations for retirees who have signed up for Part B, as I feel we’re duplicating coverage.

Edit: forgot to add that GEHA high option is worth considering if you have high Rx costs, since that option also offers a partial rebate to compensate for your Part B premium ( but it’s more expensive than standard), without restricting you to network-only doctors. For me, it doesn’t pay, since the monthly cost would be about $100 more than standard, but I’m glad to see other FEHB plans are beginning to consider compensation for our having Part B ( which saves them a lot of money!)

Edited by user Friday, November 19, 2021 1:44:51 PM(UTC)  | Reason: Not specified

Sante123  
#57 Posted : Saturday, November 27, 2021 2:08:00 PM(UTC)
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Originally Posted by: wyre Go to Quoted Post
…the “Advantage” plan would trigger an additional part D IRMAA , for those who are already subject to the part B surcharge. ( it’s in the small print). I was tempted by the $900 rebate for part B … but I think I will stick with GEHA standard this year…


Even if a Part D IRMAA surcharge applies to higher-income enrollees in FEHB Medicare Advantage plans, (something I could not confirm after three separate calls to Aetna reps), the impact is much more modest than for Part B IRMAA surcharges. By way of example, the Part D IRMAA range per month for a single-filer is:

$12.40 for income above $91,000 up to $114,000
$32.10 for income above $114,000 up to $142,000
$51.70 for income above $142,000 up to $170,000
$71.30 for income above $170,000 but less than $500,000
$77.90 for income of $500,000 and above

Back in May, when commenting on Part D IRMAA in a separate thread in the Medicare and Health Care section, you indicated that the surcharge for you would be $12.30/month, a level which has since been raised to $12.40/month for 2022. That’s only $148.80 per year. But, even if your IRMAA income bracket exceeded $500,000, the premium surcharge would still only be $77.90/month, or $934.80 per year.

To avoid being subject to a potential IRMAA surcharge of $148.80 per year, you’ve chosen to stick with GEHA Standard. But does this choice save you money? It doesn’t appear so.

The Checkbook Guide shows that, regardless of income level, a retired self-only enrollee with average health expenses will save over $2,000 per year with Aetna Medicare Advantage versus GEHA Standard. If health expenses are high, the difference climbs to over $4,000. Since the Guide’s input parameters include one’s income level, I must assume that its cost-to-you numbers make allowance for Part B IRMAA. I am not as certain that it also makes allowance for potential Part D IRMAA. Let’s assume that it does NOT. Even so, you would still save somewhere between $2,000 and $4,000 per year by choosing the Aetna MA plan. And everyone else who is subject to a Part D IRMAA surcharge would also come out ahead, even at the top bracket where the comparative savings would range from around $1,000 to $3,000, depending on whether expenses were average or high for the year.
wyre  
#58 Posted : Saturday, November 27, 2021 2:54:56 PM(UTC)
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I’m still looking into it … there were a few other things about the Aetna ( not sure if it was the Direct or “advantage” plan that I flagged as questionable ) — foreign medical coverage other than emergency was one item missing — unfortunately travel has been severely curtailed recently, but I’m hoping that will change. Off the top of my head I can’t recall the others specifically, but there were a few things that gave me pause. My $ problem really stems from my doctor’s decision to join a “concierge” style group … I have to tally that extra cost in, as well as FEHB, medicare part B + IRMAA ( and long term care) … all of which is definitely getting expensive. I’m less concerned about part D IRMAA, and you’re right - that’s a minor add on compared to part B. I do think Aetna is definitely the cheapest way to go …and I think more FEHB plans should be offering some rebate for Medicare B picking up a significant portion of the cost. I don’t necessarily want to trigger changes in doctors. On the Aetna site they had an odd phrasing along the lines of “ any doctor who accepts medicare AND Aetna” that rang an alarm bell. It’s not that easy to get info out of them! I will run the numbers again — GEHA standard is slightly more, but it has some added benefits for dental and vision and they’ve been reliable service providers in the past. If it were just a matter of $ I probably would give Aetna a try this year … and may still do so. United Health care has an FEHB Medicare plan too … but you have to call for info. I prefer reading the fine print! Hoping there will be more Medicare - focused FEHB options in the future. Once I have to start taking RMD I will no doubt have an even bigger problem, as that may bump me up one or possibly two IRMAA tiers, so shopping around makes a lot of sense.
Citrine  
#59 Posted : Sunday, November 28, 2021 6:41:51 AM(UTC)
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can you link us to where it says people have to pay part D irmaa even though they are not paying for part D?
Sante123  
#60 Posted : Sunday, November 28, 2021 10:08:05 AM(UTC)
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Originally Posted by: Citrine Go to Quoted Post
can you link us to where it says people have to pay part D irmaa even though they are not paying for part D?


I haven’t found anything in the FEHB plan materials that says that explicitly. However, related text which suggests as much is in Chapter 1, Section 6 of the Evidence of Coverage (EOC), located at the bottom of page 12. https://www.aetnafeds.co...OC_2022_ESAwithRX_EN.pdf

An additional reference is at the bottom of page 96 in the 2022 plan brochure. https://www.aetnafeds.co...2/2022AetnaAdvantage.pdf

Finally, here is a non-FEHB source which seems to be on point.
https://q1medicare.com/q...rtDQA/FAQ.php?faq_id=654
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