This somewhat confusing under-the-radar plan for Medicare A+B enrollees was new for 2020 but has been substantially improved for 2021. It now features a Medicare premium rebate of up to $1800 ($900 for Self Only) that gets automatically added to your Social Security check at a rate of $75 per month. No need to file reimbursement claims. No deductibles, coinsurance or copays except for drugs, and Rx copays are really low. The plan works the same for any provider who accepts Medicare, whether in or out of network. It’s a nationwide plan that also pays benefits for overseas urgent and emergency care. It’s both a FEHB plan AND a Medicare Advantage Plan. No need to suspend FEHB to enroll. It has all the extra freebies that Advantage plans have but Original Medicare doesn’t. What’s more, it protects you against the “donut hole” shift in RX prices that regular Advantage plans suffer from. There is only one payer, this plan, which means that you use only one insurance card (the plan’s) and get only only one claim statement (the plan’s). No need to show providers your Medicare card and no waiting for both an MSN and an EOB. The plan premiums are also amazingly low, even better than Aetna Direct.

So, what’s the catch? No catch really, but some things are not what you’d expect. First, sign up is a two-step process. Step one is you sign up as usual for the ordinary Aetna Advantage FEHB plan. Step two is you wait 7-10 business days and then for each adult enrollee you provide Aetna with the respective Medicare Part A+B ID number(s) and initial date(s) of Medicare coverage. Afterwards, you get a special Aetna Medicare Advantage card which replaces the generic Advantage Plan card that they first send you after step one is completed. What else? Well, the Aetna Advantage plan is very different (in a bad way) if you (and any covered spouse/partner) are not enrolled in Medicare Parts A+B or have not completed step two above. The official brochure has only one set of enrollment codes regardless of your Medicare status. But very importantly, It is the completion of step two that transforms the plan from a so-so FEHB plan into a supercharged hybrid FEHB/Medicare Advantage plan. Most of the official brochure is devoted to explaining the coverage and benefits for non-Medicare enrollees. Only a few pages are devoted to what happens if you have Parts A+B and complete step two of the sign up process. To get more specific details about the Medicare Advantage option under this plan, you need to consult a separate Aetna document that lays it all out. To make things easy, I am attaching links to the generic plan brochure, the Aetna Medicare Advantage plan guide, and Aetna’s plan overview page. In my opinion, this plan is well worth checking out.

2021 Plan Brochure
Aetna Medicare Advantage Plan Guide
Aetna Plans Overview for Medicare Enrollees

With its latest update issued today, the Checkbook Guide for FEHB health plans now lists this Aetna Medicare Advantage plan as the top rated plan in the country for Medicare A&B enrollees, everywhere except Washington, DC and its suburbs. In that area, Aetna Medicare Advantage is #2. So there you have it. I guess from now on it will no longer be the best plan that no one has ever heard of.

We have had Aetna Direct for the past few years. This plan sounds better but am trying to figure out why it is less expensive. What is missing that Aetna Direct covers? Can you go to any doctor who accepts Medicare?

I too want to know what is rated #1!

The UHC Advantage is probably going to be competitive with the Aetna.

https://uhcvirtualretire...hbmvp/how-the-plan-works

Santee123 - Thank you so much for your detailed reply. I just finished listening to the link you provided. He didn't go into detail the differences between Aetna Direct and the Aetna Advantage other than the way they are set up (one is a supplement to Medicare and the other is really an Advantage plan in that it replaces Medicare and has enhanced benefits and features.

I also listened to Mike Causey today who had Walton Francis on his show Your Turn. Not much new info. He will be back again next Wednesday. We are Narfe members so I went to their website and see that tomorrow afternoon Tammy Flanigan is doing a webinar about FEHB and Medicare Parts A & B. I signed up for that.

Most likely this research will be a head start for next year because we currently are in Aetna Direct and we still have $1086 in the health fund (I have another health fund through my former employer that I can only use for Part B premiums reimbursement so I have gone back and forth between them and Aetna. Sadly my other fund won't let me use it to reimburse the monthly FEHB premium because, even though it is self + 1, it is taken out of husband's annuity and not mine. I'm guessing, but will have to check, that Aetna won't transfer our remaining fund balance from Aetna Direct to Aetna Advantage.

Edited by user Wednesday, November 18, 2020 1:00:46 PM(UTC)  | Reason: Not specified

@OUTside:

Because the folks at Checkbook Guide forgot that you can’t enroll in a Medicare Advantage plan at all unless you have signed up for both Parts A and B. So that comparison is inaccurate.

In all fairness, there is no way to know whether that will be much of a factor. First, most FEHB Medicare Advantage option plans are new for 2021. So they have never paid a claim yet and so are guesstimating what their cost profile will be. Second, over 90% of all providers accept Medicare assignment, and folks in such plans would logically avoid providers that don’t participate. Third, Blue Cross Basic is far more restrictive. It pays zero benefits both to non-participating providers and to participating providers who are not “preferred”. If your analysis were true, that should make their premiums cheap. Yet, BCBS Basic premiums are 50% higher than Aetna Medicare Advantage. That’s because folks who want to use non-preferred providers would be foolish to sign up for a plan that offers zero coverage for those who do. So, there are no material “savings” for that plan. And I’d bet the same is true for the Medicare Advantage plans.

I would not take Aetna Medicare Advantage Plan. I have Medicare Parts A and B as primary insurance and GEHA Standard as secondary insurance. GEHA pays more for certain procedures that Medicare does not cover. For example recently I had a physical exam with tests that cost about six hundred dollars. Medicare paid about 150 dollars and GEHA paid about 300 dollars. The internist is a participating provider with Medicare. GEHA paid far more than Medicare did. In addition, I have had to have numerous CT scans MRI's and Bypass surgery. I have never had to have pre-certification for any procedures. With Aetna I called them and they said I would have to have all of that pre-certified. I have been to Europe. On a couple times I have to go to the doctor. Medicare paid nothing-and GEHA, picked up most of the cost. Per Aetna if I had their Advantage plan, they would have paid nothing. I would not change or take the Medicare Advantage Plan. The devil is in the details-and there are plenty of devils in that Aetna Advantage Plan. I would advise people to consider the Aetna Direct Plan, GEHA or other plains where Medicare is primary.

Sante,
Thank you for your very well thought out response. If you don't mind me asking: if you are a federal retiree, which one have you chosen, or which one you choose?
Thanks

The Aetna Medicare Advantage plan sounds interesting. In my situation, however, I'm not sure it would be a good fit. I use Mayo Clinic in Florida for all medical care, primary and specialty. Upon reviewing the types of insurance accepted at the clinic, Medicare Advantage plans are mentioned but it is unclear whether any are currently under contract. Their list of contracted plans does not include any Medicare Advantage plans, however, the list is always being updated and a phone call could be made to confirm. I don't want to take any chances, so I will stay with Aetna Direct.