Featuring reductions in prescription drug
costs and money-saving Medicare Advantage benefits and extras that
make a difference
WOONSOCKET, R.I., Oct. 1, 2022
/PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS),
announced its 2023 Medicare offerings, featuring more affordable
medical and prescription drug coverage and expanded money-saving
benefits that support members' whole health and well-being. We'll
offer new Medicare Advantage plan options, including Dual Eligible
Special Needs Plans in new markets, a new Institutional Special
Needs Plan and expanded Aetna Medicare Eagle® plans designed
with Veterans in mind.
"In addition to the health challenges that typically come with
getting older, we recognize the heavy financial strain on
older adults and people with disabilities, who often live on fixed
incomes," said Christopher
Ciano, president of Aetna Medicare. "To help lower
their health care costs, we expanded our Aetna Medicare Solutions
portfolio of products to include improved prescription drug
coverage that will save members money, more essential benefits that
make a meaningful difference in members' lives and plans that fit
their unique needs and budget. As part of the CVS Health
family, Aetna wants our 10.6 million Medicare members nationwide to
feel protected and supported through every moment of their personal
Expanded Medicare Advantage plans to meet diverse
More than 3.2 million Medicare beneficiaries are currently
enrolled in an Aetna Medicare Advantage (MA) plan, which
often includes valuable benefits, such as prescription drug
coverage, dental, vision, hearing and fitness. To keep plans
affordable, Aetna continues to offer many $0 premium plan options. Aetna estimates 84% of
the Medicare-eligible beneficiaries in the U.S. will have access to
a $0 monthly premium Aetna MA
For 2023, Aetna is offering Medicare Advantage Prescription
Drug (MAPD) plans in 46 states plus Washington, D.C. Aetna added 141 new counties
across the country, providing 1 million more Medicare beneficiaries
access to an Aetna plan. In total, Aetna will offer MAPD plans in
2,014 counties in 2023, accessible by 55 million Medicare
For those who qualify for both Medicare and Medicaid benefits,
Aetna expanded its Dual Eligible Special Needs Plan
(D-SNP) offerings across 30 states, including new markets
in South Carolina, South Dakota and Utah, and new PPO plan options in Georgia and South
Dakota. All plans offer prescription drugs at no
out-of-pocket cost and additional benefits for members who qualify
for Low-Income Subsidy (LIS). Coverage varies by plan and may
include healthy foods, utilities, over-the-counter items,
additional transportation, companionship and fall prevention
New for 2023, Aetna will introduce the Aetna Medicare
Longevity Plan, an Institutional Special Needs Plan
(I-SNP), in Pennsylvania. This
plan is specifically designed for people living in nursing homes.
It includes prescription drug coverage and provides enhanced access
to onsite care in the facility. Members receive extra benefits
tailored to improve their quality of life by caring for their
unique medical, social and emotional needs.
Aetna also expanded its Aetna Medicare Eagle MA plans to
42 states and 1,383 counties — reaching more than 6.1 million
Veterans over age 65. These plans are designed with Veterans in
mind3 to complement their VA health care coverage and
ensure access to important benefits for this population. All
2023 Aetna Medicare Eagle plans will feature a
$0 monthly plan premium, $0 primary care copay (including walk-in
clinics), dental, vision, hearing, over-the-counter allowance,
SilverSneakers® fitness program and $0 lab copay.
Robust standalone prescription drug plans with lower
The Aetna standalone prescription drug plans (PDP) serve
6.1 million members. In 2023, Aetna Medicare will continue to offer
three individual, standalone plans. SilverScript SmartRx (PDP) will
be renamed SilverScript SmartSaver (PDP) in 2023 and will feature
an average monthly premium of $5.92,
along with $10 copays for select
insulins at preferred pharmacies. SilverScript Choice (PDP) will be
available to members with full Extra Help for a $0 monthly plan premium in all 50 states and
D.C., while SilverScript Plus (PDP) has the most robust
prescription drug coverage of our PDPs. All three plans are
available in all 50 states and D.C and feature increased formulary
coverage from 2022.4
Big reductions in prescription drug costs across the
Aetna made major changes to our formularies (drug lists) for
2023 to remove many cost and access obstacles and help our members
be more adherent with their medications. Prescription drug benefit
changes will result in significant cost savings for our 2023
Individual MAPD members. Highlights include:
- $0 deductibles: 100% of
MAPD members will enjoy a $0
deductible on all Tier 1 drugs, with 74% of plans offering a
$0 deductible on all tiered drugs
(Tiers 1 – 5).
- $0 copays at preferred network
pharmacies: Over 97% of our MAPD plans will offer $0 copay on Tier 1 drugs, and 50% of our MAPD
plans will offer $0 copay on Tier 1
and Tier 2 drugs, for 30-, 60- or 100-day supply.
- Robust drug coverage: New for 2023, our most widely used
formulary will move nearly 300 drugs from higher-cost drug tiers to
lower tiers. This means direct cost-share savings for our members,
giving them access to many more drugs for a $0 or low copay. Plans using our other
formularies can count on similar savings. For example, a member who
had a drug (like Ezetimibe/generic Zetia used to treat high
cholesterol) down-tiered from Tier 3 in 2022 to Tier 2 in 2023 on a
plan with a $0 Tier 2 copay in 2023
and a $47 Tier 3 copay in 2022 would
save $564 next year.
- Pharmacy network: 99.9% of our MAPD plans offer
prescription drug coverage with access to nearly 66,000 network
pharmacies, with 24,000 preferred options offering additional
- 100-day supply at no extra cost: All MAPD plans will
offer 100-day supply5 for drugs on Tiers 1-4 at both
retail and mail-order pharmacies with no increase in
copay/coinsurance. Members who choose to use our preferred
mail-order pharmacy to fill their 100-day supply prescriptions can
count on convenient, no-cost standard shipping. Extended-day
supplies will save members money and help them stay on their drug
- Tier 1/Tier 2 Coverage Gap: 99.3% of our MAPD plans
provide robust Tier 1 and Tier 2 gap coverage at the same
cost-share as in the initial coverage phase, allowing predictable
copays through the donut hole and reducing the possibility of
members reaching the catastrophic phase.
- $0 copays and $0 deductibles on Dual Eligible Special Needs
Plans: All D-SNPs will share one set of common features —
robust drug coverage, $0 deductibles
and $0 prescription drug copays.
Members simply need to qualify for D-SNP enrollment to receive this
- Insulin: Members won't pay more than $35 for a one-month supply of each insulin
product covered by our plan.
- Vaccines: Many covered Part D vaccines will be available
at $0 copay for Medicare
Money-saving MA benefits and extras that make a
"We know our members want to feel confident that their Medicare
plans offer the coverage they need, when and where they want it —
and at a price they can afford," said Ciano. "So, for 2023 we
expanded some popular benefits and added new ones to empower
members to get important preventive care, stay healthy and keep
doing the things they enjoy most." Individual MA plan features that
will make care more affordable, convenient and accessible in 2023
- Aetna Medicare Extra Benefits Card (new): Select plans
will include a new, preloaded debit card with a quarterly allowance
that can be used towards the purchase of over-the-counter (OTC)
items and/or a combination of support services6 such as:
healthy foods; utilities (including water, electricity, gas, phone
and internet service); and transportation. The card can be swiped
at thousands of participating retailers for OTC and healthy
- Aetna Medicare Payment Card: Aetna is expanding this
debit card to more plans and states and making it more convenient.
Qualifying members will receive a quarterly allowance to use
towards either out-of-pocket expenses for in-network care; approved
OTC wellness items; or both. Members whose benefit includes an
allowance for OTC items can buy a wide selection of items at any
CVS Pharmacy® retail location7 or place orders online
through OTC Health Solutions, a CVS Health company.
- Memory Fitness (new): Select Aetna Medicare plan members
will get access to brain games, exercises and a huge library of
information on activities that promote brain health. Memory Fitness
can be accessed through BrainHQ on computers, smartphones and
- Fresh Food Boxes (new): Qualifying members of select
Individual Aetna MA plans can receive a produce box containing
fresh fruits and vegetables delivered to their homes either
biweekly, monthly or quarterly.
- Dental, vision and hearing: Aetna believes benefits like
dental, vision and hearing care are essentials and not simply
extras. Aetna will continue to offer most MA members access to
routine dental, vision and hearing coverage.8
- Improved dental: In 2023, 95% of our MA plans will
include a comprehensive dental benefit. Aetna will expand the Total
Choice dental benefit introduced in 2022 to additional Individual
MA HMO-POS and PPO plans. This benefit provides coverage of
preventive and comprehensive dental services up to a benefit
maximum and allows the member to choose any licensed dentist, in or
out of network. Members may save money when visiting a dentist
within our network. As one of the nation's largest MA dental
networks, Aetna is continuing to expand the Aetna Dental® PPO
network across the country to meet our members' need to find
affordable dental care. We're also improving the member experience
by removing dental deductibles from some other dental benefit
- Vision: In 2023, 96% of our MA plans will include an
- Hearing: In 2023, 93% of our MA plans will include a
hearing aid benefit.
- Telehealth: All Aetna MA plans will continue to cover
telehealth visits for primary care, urgent care and specialty care
provided by a doctor, including mental health services. In 2023,
additional telehealth services will be available including
physical, occupational, and speech therapy, substance abuse and
opioid treatment, kidney disease education and diabetes
self-management training services. Depending on location, members
will be able to schedule telehealth visits 24/7 via MinuteClinic®,
Teladoc® or another network provider offering this service.
- Meals: In 2023, 85% of MA plans will include
home-delivered meals after an inpatient stay.
- OTC: Aetna is making its OTC benefit offered through OTC
Health Solutions, a CVS Health company, available to more members
and increasing the OTC allowance amount on many MA plans. With the
OTC benefit, members can choose certain health care products by
phone, catalog or online for home delivery. They'll also be able to
present their ID cards to receive items directly from 3,800 select
CVS Pharmacy or Navarro Discount Pharmacy® locations across 39
states. Select Aetna plans will offer an OTC kit mailed directly to
the member's home. These kits contain curated OTC items that help
support our members' health.
- $0 cost-shares on select
benefits: To ensure important services are affordable, Aetna
continues to expand services available at no extra cost to the
member. Most MA plans will have $0
copay for primary care visits and many plans will offer labs at no
cost to the member.
- Stable or reduced member out-of-pocket costs limits: All
Aetna MA plans include maximum out-of-pocket cost protection for
covered plan services. Aetna will keep member in-network maximum
out-of-pocket costs limits the same or decrease them in 82% of its
Individual MA plans for 2023.
- Fall prevention: Aetna continues to expand its fall
prevention benefit through CVS Pharmacy to additional states and
plans. In select MA plans, eligible members will receive an annual
allowance for certain clinically appropriate safety items that help
lower the risk of injury from falls in the home.
- Hospice: Aetna understands some members may need extra
support at critical points in their lives. So, we're expanding the
number of plans that offer our Compassionate Care Transitions
program. On select MA plans in Ohio and Pennsylvania, Aetna will be responsible for
members' full medical coverage and hospice services. Members
enrolled in this program will have access to supplemental benefits
to support their end-of-life journey. These benefits include extra
transportation, additional meals, in-home support and access to a
personal emergency response system.9
In addition, Aetna will continue to offer the following
supplemental benefits and programs as part of its MA plans:
- Healthy Rewards Program: The program helps members
improve their health and well-being with personalized reward
activities. All Individual MA members will be able to earn
$150 or more annually, depending on
plan, to use at an expanded set of merchants, such as local grocery
and national restaurant chains, by completing certain healthy
- SilverSneakers® fitness memberships are available to all
Individual MA members at no additional cost.10 Through
SilverSneakers, members have access to over 15,000 fitness
locations. SilverSneakers FLEX® also gives members access to
exercise programs outside of traditional gyms, such as recreation
centers, malls and parks. Individuals can also connect to a support
network and virtual resources through SilverSneakers LIVE™,
SilverSneakers On-Demand™ and our mobile app, SilverSneakers GO™.
New in 2023, members can access mental enrichment and well-being
classes through GetSetUp.
- All MA plans will offer an annual healthy home visit at
no extra cost that includes a comprehensive health risk assessment
and non-invasive physical exam from the comfort of the member's
home. The clinician will also evaluate the home environment to
identify social support needs and risks that could result in early
detection of health problems. Follow up with the member's doctor
can lead to treatment and a better quality of life.
- The Aetna Resources For Living® program helps
address loneliness and other social needs by connecting members
with important community resources, such as transportation,
housing, food programs, caregiver support and utility assistance,
based on individual member needs. The program serves as an early
point of intervention for the many issues that affect our members'
physical and mental health.
Competitive Medicare Supplement and ancillary plan
To complete our portfolio of products, Aetna also offers
Medicare Supplement plans. With more than 1.3 million members, our
competitively priced Individual Medicare Supplement plans utilize a
simplified underwriting process. We also offer popular dental,
vision and hearing products in 37 states. Our ancillary plan
options cover 45 states and can provide members with life
insurance coverage, benefits paid directly to them after being
diagnosed with cancer, or for hospital stays, and home or skilled
nursing facility recovery care.
Visit AetnaMedicare.com to learn more about the 2023
Aetna Medicare plans. Or call 1-844-588-0041 (TTY: 711), 7
days a week, 8 AM to 8 PM. The
Medicare Annual Enrollment Period runs from October 15 through December 7, 2022. A licensed
agent may answer your call.
Enrollment data, August 2022.
2This number includes Aetna's Joint Venture in Minnesota
(with Allina Health).
3These plans do not include prescription drug coverage.
They are available to all Medicare-eligible individuals and could
be a good fit for beneficiaries who already have prescription drug
coverage at least as good as Medicare Part D.
4Source: CMS 2023 PDP Landscape Source Files available
5Not all medications are dispensable
in 100-day supply due to unbreakable package sizing
(e.g., inhalers), or as a result of being a controlled
6Some services may be limited to those with qualifying
7Excludes CVS Pharmacy in Target locations.
8Level and type of coverage vary by plan.
9See Evidence of Coverage for details.
10Exception: SilverSneakers is not available with the
Aetna Medicare Longevity Plan (I-SNP).
About CVS Health
CVS Health® is the leading health solutions company, delivering
care like no one else can. We reach more people and improve the
health of communities across America through our local presence,
digital channels and over 300,000 dedicated colleagues – including
more than 40,000 physicians, pharmacists, nurses and nurse
practitioners. Wherever and whenever people need us, we help them
with their health – whether that's managing chronic diseases,
staying compliant with their medications or accessing affordable
health and wellness services in the most convenient ways. We help
people navigate the health care system – and their personal health
care – by improving access, lowering costs and being a trusted
partner for every meaningful moment of health. And we do it all
with heart, each and every day. Follow @CVSHealth on social
Aetna, a CVS Health business, serves an estimated 34
million people with information and resources to help them make
better informed decisions about their health care. Aetna offers a
broad range of traditional, voluntary and consumer-directed health
insurance products and related services, including medical,
pharmacy, dental and behavioral health plans, and medical
management capabilities, Medicaid health care management services,
workers' compensation administrative services and health
information technology products and services. Aetna's customers
include employer groups, individuals, college students, part-time
and hourly workers, health plans, health care providers,
governmental units, government-sponsored plans, labor groups and
expatriates. For more information, visit www.aetna.com.
Aetna Medicare is a HMO, PPO plan with a Medicare
contract. Our DSNPs also have contracts with State Medicaid
programs. Enrollment in our plans depends on contract renewal. Plan
features and availability may vary by service area. The formulary,
provider and/or pharmacy network may change at any time. You will
receive notice when necessary. Aetna Medicare's pharmacy network
includes limited lower cost, preferred pharmacies in Suburban
Arizona, Suburban Illinois, Urban
Kansas, Rural Michigan, Suburban Michigan, Urban Michigan,
Urban Missouri, Suburban Utah, Suburban West Virginia and Suburban
Wyoming. The lower costs advertised in our plan materials for these
pharmacies may not be available at the pharmacy you use. For
up-to-date information about our network pharmacies, including
whether there are any lower-cost preferred pharmacies in your area,
members please call the number on your ID card, non-members please
call 1-833-278-3928 (TTY: 711) or consult the online
pharmacy directory. Other pharmacies and providers are available in
our network. Out-of-network/non-contracted providers are under no
obligation to treat plan members, except in emergency situations.
Please call our customer service number or see your Evidence of
Coverage for more information, including the cost-sharing that
applies to out-of-network services. Members who get "Extra Help"
are not required to fill prescriptions at preferred network
pharmacies in order to get Low Income Subsidy (LIS) copays.
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.
Medicare rules don't allow earned rewards to be used for
Medicare-covered goods or services, including medical or
prescription drug out-of-pocket costs. Earned rewards may not be
used to pay for medical copays, prescription costs, or any other
Medicare covered good or services. Earned rewards may also not be
used on alcohol, tobacco or firearms or be converted to cash. This
material is for informational purposes only and is not medical
advice. Health information programs provide general health
information and are not a substitute for diagnosis or treatment by
a physician or other health care professional. Contact a health
care professional with any questions or concerns about specific
health care needs. Providers are independent contractors and are
not agents of Aetna. Provider participation may change without
notice. Aetna is not a provider of health care services and,
therefore, cannot guarantee any results or outcomes. The
availability of any particular provider cannot be guaranteed and is
subject to change. Information is believed to be accurate as of the
production date; however, it is subject to change. For more
information about Aetna plans, refer to our website. The benefits
mentioned are a part of special supplemental program for the
chronically ill. Not all members qualify.
SilverScript is a Prescription Drug Plan with a Medicare
contract marketed through Aetna Medicare. Enrollment in
SilverScript depends on contract renewal.
Aetna, CVS Pharmacy and MinuteClinic, LLC (which either operates
or provides certain management support services to
MinuteClinic-branded walk-in clinics) are part of the CVS Health
family of companies.
Resources For Living is the brand name used for products
and services offered through the Aetna group of subsidiary
SilverSneakers is a registered trademark of Tivity Health, Inc.
©2022 Tivity Health, Inc. All rights reserved. GetSetUp is a
third-party service provider and is not owned or operated by Tivity
Health, Inc. ("Tivity") or its affiliates. Users must have internet
service to access GetSetUp service. Internet service charges are
the responsibility of the user. Charges may apply for access to
certain GetSetUp classes or functionality.
©2022 Aetna Inc.
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