Why members chose Aetna
Learn about 2020 plansWatch National Medicare Advantage program story
Hello and welcome to the webinar just for Fraternal Order of Police (FOP) retirees and spouses. My name is Julie and I’m with Aetna.
We’re here today to help you understand the four Medicare Advantage plans being offered through the FOP and Aetna. We’ll answer some of the most commonly asked questions, too.
The FOP teamed up with Aetna to design four MedicareSM Advantage PPO plans. These are highly customized group plans — just for Medicare-eligible retired FOP police officers, their spouses, and their surviving widows or widowers. These plans start January 1, 2020.
Today we’ll cover:
- The Aetna and FOP plan offering
- What’s different with a Medicare Advantage plan
- How to keep seeing your current doctors
- Your new benefits, and
- What’s next
First, we’ll talk about the offering from Aetna and the FOP.
The FOP decided to team up with Aetna to design plans for their retired police officers. They did this to:
- Protect pension benefits
- Provide affordable, high-quality retiree health care
- Take care of those who risked their lives for us daily, and
- Work with community partners to provide personalized care
At Aetna, we’re committed to the health of you and your fellow retirees.
- We’re dedicated to improving health with a holistic focus. Our goal is to support every member in achieving their best health. We’re working on ways to increase health engagement and continue to personalize the health care experience.
- One of the most significant differences between a traditional Supplement plan and the Aetna Medicare Advantage plan is Aetna’s care and disease management programs. These programs are built into our Medicare Advantage plans at no extra cost, but are not part of traditional Supplement plans. They help to improve the health of our retirees and manage their long-term care.
- We’re committed to FOP retirees and their families. We look forward to growing with you and helping you achieve health, happiness and peace of mind.
Now, let’s talk a little more about who we are at Aetna. Aetna is one of the country’s largest health insurers. We have over 165 years of experience in providing health benefits. We’re devoted to helping over 2 million Medicare Advantage members manage and improve their health.
We’re also a highly rated plan. The Centers for Medicare and Medicaid Services (CMS) measures the quality of Medicare Advantage plans using its Five-Star Quality Rating System. CMS does this to ensure all patients get the very best health care. Quality measurements such as these are not a part of a Medicare Supplement plan. Medicare Advantage plans are given a score called a star rating, and Aetna’s national plan received 4 out of 5 stars in 2018. This means our plan is highly rated on important measures such as:
- Member satisfaction and service
- Helping you stay healthy, and
- Helping you manage your long-term conditions
Our mission is dedicated to health. The Aetna plans are designed to build a healthier world — and we know this is especially important in retirement. We also want to simplify the health care experience and help you reach your full potential in life, however you define it.
We think you’ll find that the Aetna Medicare Advantage plans are different than plans you might be used to, and we’ll show you how easy to use they are.
Medicare is composed of four main parts:
- Original Medicare consists of Part A and Part B.
- Part A helps with hospital costs.
- Part B helps with doctor and ancillary medical costs.
- Part C and Part D are handled by private insurance companies.
- Part C includes everything covered under parts A and B, and it also includes many extra benefits beyond Original Medicare.
- Part D plans help pay for prescription drug benefits.
- “Supplement” plans are sold by private insurance companies and help cover gaps in Original Medicare. These types of plans are referred to as Supplemental or Medigap plans.
The FOP plans you can choose are Medicare Advantage plans (which are Part C) with prescription drug coverage (which is Part D).
To better understand the new Aetna Medicare Advantage plans, I want to first give you a quick refresher on how many “traditional” or supplemental plans work. When you see your doctor, you show two ID cards. One, is the red, white and blue Medicare card, and the other is your medical insurance card. Then after each visit, Medicare and the insurance plan pay a portion of the doctor’s claim, and you’ll get at least two Explanations of Benefits. Now, let’s look at how these pieces are different for Medicare Advantage.
Medicare Advantage offers you the convenience of all of your Medicare A and B benefits, so that’s everything you get with Original Medicare. Plus it has many additional benefits, all in one package.
To be eligible, you have to be enrolled in Parts A and B and pay your Part B premium. You can only be enrolled in one Medicare Advantage plan at a time.
Again, we want things to be easy. With Aetna Medicare Advantage:
- You only need one ID card for all your medical and pharmacy needs.
- You get more benefits than traditional supplemental plans.
- Care advocacy and wellness benefits are included, and we’ll discuss those shortly.
- You get one monthly Explanation of Benefits for medical and one for prescription drugs.
Keep your red, white and blue Medicare ID card safe, but if you enroll in this plan you would only need to show your Aetna ID card for all medical and prescription drug costs.
Next we’ll talk about seeing your doctors. We know the most important thing for our members when reviewing health plan options is “Will my doctor take this plan?”
Aetna Medicare Advantage PPO plans provide coverage nationwide. Your doctor doesn’t have to be in our network, and you get the same benefits in or out of network. The Aetna plans also cover you when you’re traveling outside the country in case you have an urgent need for medical care. When traveling away from home, Aetna can help you find a doctor that accepts your plan.
Your plan is designed to give you the flexibility to see any provider, whether or not they are in our network. You should know that many doctors do in fact accept Medicare and accept Aetna Medicare Advantage, but there may be some who don’t.
Generally, in a PPO plan you pay more for out-of-network services, but with this type of plan you pay the same cost for any doctor or hospital, according to the costs listed on your plan benefits summary. The provider must be eligible to receive Medicare payment and accept your plan.
At any time, you can call us if you have questions about certain doctors or need help finding a new provider. Just call 1-866-246-8060 (TTY: 711). Our representatives are available Monday – Friday, 8 AM to 6 PM, all time zones. Our Member Services team will be happy to help you, and they even call your doctor’s office on your behalf to confirm whether they will accept our plan.
Now let’s discuss the benefits you get as part of these plans, designed just for retired police officers and their spouses.
We’ll review the plans side by side. You’ll see there are four different plans to choose from. On the left are plans where you pay more up front with a higher premium, and on the right are plans where you pay as you use the benefits with copayments or coinsurance. The difference between coinsurance and a copayment is a percentage vs. a flat dollar amount. With coinsurance, you pay a percentage of the total cost for your portion of a health care service. On the other hand, a copayment is a set dollar amount that you pay for your portion of the cost of the service.
The benefits you see, such as a primary care office visit or inpatient hospital stay, are just some of the commonly used benefits that we offer. You can find a full listing of benefits online at fop.aetnamedicare.com. Or you can call our Member Services number and request a packet with the full plan information in it.
We went over your medical benefits, so now let’s discuss prescription drug benefits.
With each Medicare Advantage plan, you can use over 66,000 network pharmacies nationwide, including over 23,000 preferred pharmacies where you may pay a lower cost for certain prescriptions. You can also get your regular maintenance prescriptions delivered to your home through the CVS Caremark Mail Service PharmacyTM program. Our online tools include a drug lookup tool and a pharmacy finder.
Prescription drug benefits through Medicare Part D can be confusing sometimes. So we want to show you the four different Part D plan phases and what you’ll pay in each phase.
- The deductible phase is first. This is the amount you pay before the plan begins to pay. Your plan may or may not have a deductible, depending on which option you choose.
- Second is the initial coverage limit phase. You will pay a copayment or coinsurance during this phase.
- Third is the coverage gap or “donut hole” phase. In this phase you may pay a different level of copayments or coinsurance. Your plan will have partial or enhanced gap coverage, depending on which you choose.
- Finally, fourth is the catastrophic phase. Very few people reach this phase. You’ll pay a smaller cost share and the plan will pay most of the cost.
Next we’ll look at what you’ll pay with each plan option you have.
Again, you can see the four different plans and what you’ll pay for a deductible and prescription drugs in each tier. The costs are lowest for tier 1, or preferred generic drugs, and they are highest for tier 5, or specialty drugs. If you want to check on the cost of a certain drug, you can call our Member Services number or go online to fop.aetnamedicare.com to begin enrollment and use our drug lookup tools.
We talked about the simplicity of the Aetna Medicare Advantage plans, and we talked about the benefits you’ll get. Now, I’d like to share with you some of the support programs you get with these plans.
We value your total health — physical, emotional and social. We want to help you reach your full potential in life, however you define it. So we want to support you wherever you are on your health journey.
- Our prevention programs remind you of key health screenings and activities to keep you in your best health.
- For those who want to focus on wellness, we have programs that go a step further, such as our Healthy Home Visits. In that program you can have a licensed provider come to your house to review your health needs. We also offer a 24-hour nurse line and the SilverSneakers fitness benefit.
- For those who want to prevent health challenges from getting worse, we have programs to help with complex or chronic conditions such as diabetes and heart disease. We also offer nurse care management, help to prevent you from being readmitted to the hospital, and compassionate care for advanced illnesses.
All of these are included at no extra cost to you. They are intended to complement your current health care benefits and are not meant to replace your relationship with your doctor.
Let’s talk more about a few of the programs we just highlighted. The Healthy Home Visit is completely voluntary. About 400,000* of our members choose to take part in it each year. If you decide to have a visit, a nurse will come to your home to review your health needs and do a home safety assessment. The visit doesn’t replace care from your doctors. Rather, we work with them to help meet your health needs.
- The nurse focuses on safety in your home, does a medication review, and asks about your medical and family history.
- We may recommend any of our support programs that could be helpful for you. We’ll talk about some of these programs next.
- We share the results of your visit with your primary care doctor to help coordinate your care.
- This program is available at no extra cost to you and will help you take advantage of all the benefits available to you.
*2019 Aetna Book of Business results
To help police officers who risked their lives daily, we’ve also included extra hearing and vision care for you. You can get a hearing aid reimbursement of up to $2,000 every 36 months and a vision eyewear reimbursement of up to $250 every 24 months.
A popular benefit with an Aetna Medicare Advantage plan is the SilverSneakers fitness program. With this program you get a gym membership to any of over 15,000 locations nationwide. Or if you can’t make it out to the gym, you can have a home fitness kit delivered to you. Visit silversneakers.com to learn more or find a location near you.
After a career full of stressful situations, police officers sometimes need extra support, and we’re here to help. The AbleTo behavioral health program helps coach you through conditions such as PTSD, depression and anxiety. You’ll have access to a coach and a therapist who can talk with you on a regular basis by phone or video chat. AbleTo even has next-day appointments and 24/7 support if you need it.
Another program that’s unique to Aetna is the Resources For Living referral service. The program can connect you with resources in your local community. They can help you find services such as transportation, help around the house, home health care and more. You’d pay the cost of any services you decide to use, but our research is no extra cost to you.
If you like what you’ve heard so far, you’re not alone. Our current members are happy with their plans: 96%* of our Medicare Advantage members said they’re satisfied overall with Aetna Medicare Advantage.
*Q2 2019 Aetna Medicare Advantage plan member satisfaction survey
So what’s next if you want to enroll in an Aetna plan?
So how do you enroll?
- Call Aetna at 1-866-246-8060 (TTY: 711), Monday – Friday, 8 AM to 6 PM all time zones.
- Or visit fop.aetnamedicare.com where you can enroll yourself online.
The enrollment period has started for the FOP Aetna Medicare Advantage plans, and it ends November 8, 2019.
If you decide to enroll in an Aetna Medicare Advantage plan, you will receive:
- A plan confirmation letter in November that confirms your enrollment in the Aetna Medicare Advantage plan
- An Aetna ID card in December to use for all your medical and prescription drug needs, and
- An Aetna member handbook in December that includes information to get the most from your new plan. That handbook also includes your Evidence of Coverage with full plan coverage details and explains how to get a provider directory.
On January 1, 2020, your new Aetna plan will begin. That’s when you can start enjoying your new benefits. After January 1, you may get a call to schedule a Healthy Home Visit or be invited to participate in other health programs.
If you have more questions after watching this video, feel free to call us at 1-866-246-8060 (TTY: 711), Monday – Friday, 8 AM to 6 PM, all time zones. Or visit us online at fop.aetnamedicare.com. Again, if you decide to enroll, you need to do so by November 8. Thank you for your time today.
You can keep your doctors
Hear from the Hodges about the many ways that Aetna joins them and works with the doctors they already have.Watch The Hodge's story
Philip: My name is Philip Hodge. I worked for General Motors for forty six years. I’m thankful for the job that I had, that I was able to provide for my family, take care of them, send them to school and do all the other nice things that people want to do for their families.
Catharine: So I was telling my husband I said you know I think we’re going to go on Aetna because I liked it. I wasn’t sure if all my doctors were in there, but I made a choice that if all of my husband’s doctors were in there, because you know he has diabetes, I’ll just go ahead if I have to and change doctors. But when I got there, every one of the doctors was on there.
Philip: And then we had an Aetna meeting. The Aetna representatives—they went pretty much from A to Z and we made the final decision that was it.
Catharine: So we just went right to Aetna.
Catharine: Being 60 and 70 now is not like being 60 and 70 back during my mother’s time. Being healthy, like you know I can go in my garden and work. I can take care of myself and I can help with my grandchildren. I can take care of my husband. We go on cruises.
Philip: We do have relatives in Florida but we also like Florida. We had considered moving but she didn’t want to leave the children.
Catharine: I’m not gonna leave.
Philip: But the idea of coverage is great. Because one time when we were there we were in the bed sleeping in the middle of the night and something bit me and I had to go to the hospital.
When you’re sick away from home, something happens. You know, you don’t have your family doctor or your local hospital and you’re in a strange place and that’s comforting to know that atlas you have insurance to go to someplace, you know, where you can get help.
Catherine: So I want to tell anybody that wants to go Aetna. We’re here and we’re glad that we’re here.
Philip: I have diabetes. And through the Aetna program they supply all of my medical supplies such as my blood meter, my test strips that I use for the meter, my lancets, all of this is free of charge for me which makes a big difference.
Joining Aetna was the “best decision”
Phillip is happy he switched to Aetna. He was able to keep his doctors …Watch Phillip's story
Philip Manes: My name is Philip Manes. I’m retired and came here three years ago…And we’re just living the dream now.
I got married pretty late in life. Getting married and had a baby at my age was the best. My daughter is fifteen. I like to see her grow up. Working out in the gym and playing golf, I just try and do as much as I can outdoors. I gotta keep myself active in order to be able to spend that time with my daughter, ‘cause I wanna do it for as long as I possibly can.
I chose Aetna, it was very hard because as you get older, nobody like change. But then after you get into it and you see how much Aetna cares, I wouldn’t have had it any other way. Aetna called me, they said that they would like to have a couple of nurses come in and speak with me. They came in and they gave me a physical. And then when that was done we had some conversations. They were excellent, they wrote everything down that I had talked about. I feel Aetna is very caring to the people that are on Social Security. They follow up all the time to see if I’m okay, I even got phone calls to see how I was feeling. That’s big.
And they had my doctors, which was very important, because I’ve had my doctor for ten years. And I’m glad that I changed, because now with Aetna I’ve got everything that I could ever ask for. And they think more of me personally, and not just a number.
It was a hard decision but looking back now and where I’m at right now, it was the best decision. I’m very happy with Aetna.
Managing high blood pressure
How Aetna doctors helped John manage his blood pressureWatch John's story
John – Aetna Medicare Advantage member since August, 2016
“The company that I originally started with was Harrison Radiator, which was a division of General Motors. We took pride in what we did. We were making all the heating and air conditioning units for the General Motors cars, and in fact, I spotted several cars where my sticker was put on one of the heaters that was in the car, so I knew that was a job I did and I was very proud of that.”
[John loves a good joke]
“The plant at Harrison Radiator was a smaller plant and it was a lot like family. There were tricks that people played on one another. I would just say with grease and things like that and gloves and maybe in a sandwich.”
[But his real love is for cars]
“When I was a kid, I built model cars and I loved draw automobiles. I did want to be an auto designer and originally when I was thinking about going to college, I did want to go to General Motors Institute and study car design.”
[So Aetna ensured he’s always in the driver’s seat]
“When you join up with Aetna, first they have a doctor, which they hire to assign and come over and give you an initial physical to see what kind of help you might need with your medications or your overall health. He took my blood pressure. The blood pressure was abnormally high, so when he saw my medication that I was on he said I really think I should get ahold of your doctor, and if it wasn’t for the Aetna physician, I may not have the results that I have. I have to watch my diet specifically now because I am diabetic. Walking was the exercise that I always liked to do and that’s an important part of being healthy.”
[And we’re with him every step of the way]
“Aetna has been a big blessing in providing us with really excellent health care. They’ve encouraged us to take advantage of a lot of the programs that they have and we’ve done that. It’s been just a wonderful service to have. I would have to say a word that describes my relationship with Aetna would be excellence.”
[Drive on, John]
Lowering health care costs
Aetna lowered Mary’s health care costs and helps her continue to make the most of retirement.Watch Mary's story
My girlfriends and I, we go listen to people and bands. I have a good friend, that’s a Willy Johnson impersonator, and he’s got a friend that sounds like Willie Nelson so we go listen to the Willies really.
I’ve got Elvis impersonators too and I’ve watched Elvis ever since I was like four years old.
My sister was a big Elvis fan. She had all his records and everything and I’ll never forget when I went and saw Elvis for the first time. I couldn’t even walk up and ask for tickets. I paid 15 cents to see it and it was called “Love me Tender”.
I was part of the generation of women lived, men or women we were all equal and worked at General Motors Assembly. I went to work there in 1973. I was 23 years old and I had to take care of my son and I didn’t get child support so the insurance that I had, I had to pay full price for my office visits and if I went to specialist it was 400 dollars so of course I did not go to specialists too much [laugh].
With Aetna, every time your visit is about 20 dollars but if you go to a specialist it’s 25 dollars. The doctors are great. They’ve really been very sensitive, very thoughtful. They take care of me real well.
Everybody I’ve ever talked to with Aetna has always helped me.
I guess it’s be good to people. [Crying] Excuse me, and treat them like I want to be treated. I’ve been very fortunate with my health and I retired at 51. I just enjoy my retirement. If I want to do that I do, if I don’t, I don’t.
Can I show you my drinking cup [laugh]? Aetna is really good. I always take this where I go and I let people see that I’ve got insurance.
[Aetna Logo & tagline]
Staying active & mobile
Hear from Doreen who credits Aetna with saving her mobility. She talks about staying active and how Aetna has always been there for her.Watch Doreen's story
Doreen – Aetna Medicare Advantage member since January, 2012
“My husband and I had great times together. It’s bad luck being home because his garden meant so much to him. Another thing I miss is noise, because the game was always on TV. The house is very quiet without him around.”
“My husband was very fond of the UAW. He gave the UAW credit for a lot of the benefits we had.”
“Being healthy is ultra-important to me, especially at my age. I go to the aquatic center, get my exercise and at the same time, seeing people and seeing human faces– interaction. It keeps me connected, and the exercise keeps me limber.”
[Comfort and care]
“I’m very pleased with Aetna Insurance. There is never a problem; I don’t worry about a thing. Online I have all the information I need. If I have to look anything up, it’s right there. I had the knee replacements. If it weren’t for those knee replacements I right now would be in a wheel chair. Aetna saved my mobility for sure.”
“If I had to choose an insurance company now I would go with Aetna again. Because they’ve shown me– I have no worries. They’re always there for me. “
You don’t join us, we join you]