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Retiree plan benefits

Highlights of Aetna Medicare Advantage for MHBP Standard Option 

Get to know your Retiree plan and extras

As an Aetna Medicare Advantage for MHBP member, you’ll get benefits and programs that address the whole you — physical, emotional and social — at no additional cost to you.

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Benefits wherever you are

This plan lets you use any doctors and hospitals that are licensed to receive Medicare payment and willing to accept and bill your plan.

And with the Aetna Medicare Advantage for MHBP Standard Option, your coverage follows you wherever you travel, nationwide.

*It allows you to see any provider (whether in the network or not), and you pay the same out-of-pocket cost for both covered in-network and out-of-network medical benefits, as long as the provider is:

  • Eligible to receive payment under Medicare
  • Willing to bill and accept payment from Aetna®

Wellness and value-added programs

A licensed and board-certified nurse practitioner or doctor will come to your home to provide an assessment. After your visit, we share the information with your doctor.

Your Aetna Medicare Advantage plan includes an over-the-counter (OTC) benefit. It offers a convenient way to get generic OTC health and wellness products delivered straight to your home.

Your OTC allowance can be used on items like pain relief, cold and allergy remedies, first aid supplies, dental and eye care, vitamins and minerals and personal care items including sunscreen, lotions, and cotton swabs. Learn more about over the counter supplies.

Aetna Medicare Advantage members receive $30 to spend every three months.

Physical activity can improve your health and well-being. As a Medicare Advantage member, you get access to:

  • Membership at thousands of participating SilverSneakers® gym locations nationwide, at no extra cost
  • Home fitness kit if you can’t make it to a local gym or exercise class
  • On-demand fitness classes from the comfort of your own home or while traveling

This program helps you make it to and from doctor or hospital appointments without having to rely on family or friends. 

After inpatient hospital stay, Aetna partners with NationsMarket to deliver healthy, precooked meals. The program offers 14 home delivered meals at no extra cost — convenient quality nutrition while you focus on recuperating. 

This program helps you find the resources you need in your daily life. With just one call, a life consultant can help you find local resources to make life easier and support your physical and mental well-being. 

MHBP and Medicare brochure cover

Get to know the Aetna Medicare Advantage plan

MHBP and Medicare: A guide for MHBP retiree health and prescription drug plans. As an Aetna Medicare Advantage for MHBP Standard Option plan member, you have a suite of programs and services available at no extra cost to you. Download the brochure to learn more.

Benefit comparison

MHBP Standard Option with Medicare compared to Aetna Medicare Advantage for MHBP Standard Option

Benefits at a glance

The MHBP Standard Option column shows benefits when Medicare Parts A and B are your primary coverage.

MHBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and MHBP.

Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.

Benefit type MHBP Standard Option with Medicare Aetna Medicare Advantage for MHBP
Annual Part B premium credit N/A Each eligible member receives a $900 ($75 per month) Medicare Part B premium reduction.
Deductible $0 $0
Out-of-pocket maximum $6,000 per person, limited to $12,000 per Self Plus One or Self and Family enrollment (medical and prescription) $2,000 per person (prescription only)
Coinsurance $0, except prescription drugs $0, except prescription drugs

Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. MHBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov

Medical coverage

The MHBP Standard Option column shows benefits when Medicare Parts A and B are your primary coverage.

MHBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and MHBP.

Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.

Benefit MHBP Standard Option with Medicare – What you pay Aetna Medicare Advantage for MHBP – What you pay
Adult annual physical exam $0 $0
Lab, X-ray and other diagnostic tests $0 $0
Primary care and specialty physician visits $0 $0
Chiropractic services $0, limited to 40 visits $0, unlimited visits
Physical, occupational and speech therapy $0, limited to 40 combined visits $0, unlimited visits
Home health services $0, limited to 50 visits $0*
Routine vision exam All charges $0
Inpatient hospital $0 $0
Hearing aids $0 up to $2,000/60 months $0 up to $2,000/60 months
Outpatient hospital $0 $0

*Part-time or intermittent skilled nursing and home health aide services up to 8 hours per day and 35 hours per week.

Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. MHBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov

Prescription drug benefits

The MHBP Standard Option column shows benefits when Medicare Parts A and B are your primary coverage.

MHBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and MHBP.

Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.

Benefit MHBP Standard Option with Medicare – What you pay Aetna Medicare Advantage for MHBP – What you pay
Preferred generic N/A Preferred pharmacies: $0 (30 days), $0 (90 days) Standard pharmacies: $2 (30 days), $4 (90 days)
Generic $5 (30 days), $10 (90 days) $5 (30 days), $10 (90 days)
Preferred brand 25% max $200 (30 days) $60 (90 days) $35 (30 days), $50 (90 days)
Non-preferred brand 50% max $200 (30 days) $120 (90 days) $40 (30 days), $60 (90 days)
Specialty generic/ preferred brand 15% max $225 (30 days) 15% max $425 (90 days) 15% max $200 (30 days) 15% max $425 (90 days)
Specialty non- preferred brand 25% max $275 (30 days) 25% max $500 (90 days) 15% max $200 (30 days) 15% max $425 (90 days)

Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. MHBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov

Wellness and value-added programs

The MHBP Standard Option column shows benefits when Medicare Parts A and B are your primary coverage.

MHBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and MHBP.

Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.

Benefit MHBP Standard Option with Medicare Aetna Medicare Advantage for MHBP
Over-the-counter supplies Limited to ACA requirements You get a $30 allowance every three months via mail order.
SilverSneakers® Not included Included
Meal benefit program Not included Included – up to 14 meals after inpatient stay discharge per patient
Routine transportation Not included Included – 24 one-way trips up to 60 miles each
Resources for Living℠ Not included Included
Healthy Home Visits Not included Included
Care management Not included Included

Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. MHBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov

Getting access to Aetna Medicare Advantage

Everyone covered under your plan who has Medicare Parts A and B as primary coverage has the choice to opt into the new Aetna Medicare Advantage plan.

To complete your enrollment in Aetna Medicare Advantage, we will need to confirm your Medicare information. Please call us at 1-866-241-0262 (TTY: 711) Monday-Friday, 8 AM–8 PM ET. You can also visit your Retiree benefits website (below). You’ll need to provide your Original Medicare effective date for Parts A and B and your Medicare Beneficiary ID (MBI).

Retiree plan resources to help you with your benefits

Aetna Medicare Advantage for
MHBP Standard Option

It’s easy to opt in (with Aetna).

Monday–Friday, 8 AM–8 PM ET

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Aetna Medicare is an HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. The formulary, provider and/ or pharmacy network may change at any time. You will receive notice when necessary. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. Plan features and availability may vary by service area.

SilverSneakers is a registered trademark of Tivity Health, Inc. © 2021 Tivity Health, Inc. All rights reserved. Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies. For accommodation of persons with special needs at meetings, call 1-833-497-2416 (TTY: 711).

Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). Aetna Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice.

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