Allina Health Aetna Medicare Plan

The Allina Health Aetna Medicare Plan is a collaborative offering that combines the extensive provider network of Allina Health with the insurance expertise of Aetna. Designed for Medicareeligible individuals, the plan aims to give seniors and people with certain disabilities access to quality care while controlling outofpocket costs.

Who Is Eligible?

Eligibility follows standard Medicare guidelines:

• Age 65 or older, or younger than 65 with a qualifying disability.
• Enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance).
• Resides in a service area where the Allina Health Aetna Medicare Plan is offered (mostly Minnesota and surrounding regions).

Key Features

• Combined Network: Access to Allina Health hospitals, clinics, and specialty centers as well as Aetnas nationwide provider network.
• Prescription Drug Coverage: Integrated Part D coverage with a tiered formulary and preferred pharmacy network.
• Care Coordination: Dedicated nurse care managers help members navigate appointments, chronicdisease programs, and preventive services.
• Cost Predictability: Fixed copayments for office visits, lowcost generic drugs, and an annual outofpocket maximum.
• Wellness Benefits: Free annual wellness visit, fitness class discounts, and telehealth services.

Benefits Overview

Medical Coverage (Part A & B)

Members receive the same Medicare Part A and Part B benefits as feeforservice (FFS) Medicare, plus extra advantages:

• No annual deductible for Part A hospital stays when admitted to an Allina Health facility.
• Reduced Part B coinsurance for primary care and specialist visits (often $20$30 per visit).
• Coverage for preventive services at no cost, including flu shots, mammograms, and colorectal cancer screenings.

Prescription Drug Coverage (Part D)

The plans Part D component includes:

• Tier1 generic drugs: $0$10 copay.
• Tier2 preferred brand drugs: $25$35 copay.
• Tier3 nonpreferred brand drugs: $50$70 copay.
• Specialty drugs: negotiated discounts, often with a $100$150 copay.
• Annual $0 deductible for all drugs when using a preferred pharmacy.

Additional Services

• Telehealth: Unlimited virtual visits with primary care providers.
• Transportation: Nonemergency medical transport to Allina Health facilities for members who qualify.
• Home Health: Inhome nursing and therapy services for eligible members.
• Dental & Vision: Optional addon plans available at discounted rates.

How to Enroll

Enrollment follows Medicares annual enrollment periods:

• Initial Enrollment Period (IEP): The sevenmonth window that begins three months before the month you turn 65.
• Annual Election Period (AEP): October 15 December 7 each year, when you can switch to or from the Allina Health Aetna Medicare Plan.
• Special Enrollment Period (SEP): Qualifying life events such as moving to a new service area, losing other coverage, or gaining eligibility for Medicaid.

To enroll, call Aetnas Medicare enrollment line, visit the Aetna website, or work with an Allina Health representative. You will need your Medicare card, Social Security number, and a list of current prescription drugs.

Cost Summary (2024 Estimates)

Comparing to Other Medicare Options

When evaluating the Allina Health Aetna Medicare Plan, consider these points against Original Medicare, other Medicare Advantage (Part C) plans, and standalone Part D policies:

• Original Medicare + Medigap: Greater flexibility to see any provider, but higher outofpocket costs and separate premiums for Medigap and Part D.
• Other Medicare Advantage Plans: May have lower premiums but could limit you to a narrower network or higher pharmacy copays.
• Allina Health Aetna Plan: Strong network for those who prefer Allina facilities, predictable costs, and added caremanagement services.

Member Resources

Allina Health and Aetna provide several tools to help members stay informed:

• Aetna Medicare Member Portal view claims, find providers, and manage prescriptions.
• Allina Health Provider Directory searchable list of hospitals, clinics, and specialists.
• Monthly newsletters with wellness tips, medication reminders, and updates on plan changes.
• 24/7 nurse line for medical advice and care coordination assistance.

Frequently Asked Questions

1. Can I keep my current primary care doctor?

If your doctor participates in the Allina Health network or is part of Aetnas national network, you can keep them. Use the provider directory to verify participation.

2. What happens if I travel outside the plans service area?

Emergency care is covered nationwide under Medicare. For nonemergency care, you can use Aetnas outofnetwork benefits, though you may face higher copays.

3. Are there any penalties for switching plans?

Switching during the Annual Election Period incurs no penalty. However, if you drop a plan and later reenroll outside of an SEP, a lateenrollment penalty may apply to the Part D portion.

4. How does the plan handle chronic conditions?

The plan offers diseasespecific programs for diabetes, heart disease, COPD, and more. Participants receive personalized care plans, regular monitoring, and education resources.

Conclusion

The Allina Health Aetna Medicare Plan is a solid choice for Medicareeligible residents who value integrated care, predictable costs, and the convenience of a robust health system network. By combining Allinas clinical expertise with Aetnas insurance administration, the plan offers a balanced blend of coverage, convenience, and support services that can help seniors stay healthy while minimizing financial surprises.

For personalized assistance, contact Aetnas Medicare enrollment specialists at 1800555MEDI or speak with an Allina Health representative at your local clinic.