If you’re thinking about becoming an Aetna Medicare Dual Eligible Special Needs, or D-SNP, member, you likely have questions about the Annual Enrollment Period. Get the answers you need here.
Annual enrollment is your chance to choose a new health insurance plan with new benefits. It’s a great time to explore your options and make sure your plan is still the right one for you.
Benefits change from year to year, as do your own personal health goals and needs.
Still, there’s a lot of information to read through and think about. We want to make things easier for you. So here are answers to some of the most common questions about how to enroll in an Aetna® plan.
Annual enrollment is the time of year when you can enroll in a new plan. For Medicare plans, including Aetna D-SNPs, it happens from October 15 to December 7. If you do make a change, your new coverage will begin January 1.
Aetna® care teams can help you find a doctor, schedule appointments, manage a condition, access the right benefits and more. It’s a personal benefit designed for Aetna Dual Eligible Special Needs Plan members.
Great question! The answer is different for everyone. But knowing what benefits you have now makes it easier to compare your current plan to possible new ones.
One place to look: your Summary of Benefits (SB). When you first sign up for any health plan, you get the SB. It gives answers to common questions about your coverage and costs, including ones like:
You can also usually find this information on your plan’s website. If you still can’t find all the answers you need, you can call the Aetna customer support team.
You should get notified by your plan about any upcoming changes. For example, Aetna members get an Annual Notice of Change (ANOC) letter in the mail or via email in late September. It explains any changes in the plan’s cost and coverage for next year.
Every year, we make changes to the benefits we offer. So be sure to read the ANOC carefully. You want to be sure the changes are right for you.
This is an important question when you’re looking for continuity in your care. To find out, you can call an Aetna licensed sales agent who can check for you. But if you forget to ask, don’t worry.
After you enroll in your new plan, you’ll get a welcome call from Aetna. You can double-check that all your doctors and prescriptions are covered on the new plan and that you understand everything that’s offered. If your PCP is not covered, the Aetna licensed agent can help you look for another doctor.
Most of the time, you can. Members can make changes to their coverage during the Annual Enrollment Period.
The Annual Enrollment Period for health insurance plans runs every year from October 15 to December 7. During this time, you can pick a new Medicare Advantage plan, switch from Original Medicare to Medicare Advantage, or change your coverage.
Then you don’t have to do anything. Generally, your plan will automatically renew on January 1. If your plan is not renewing on January 1, you will get a notice from your plan to let you know.
If you qualify for both Medicare and Medicaid, you may be eligible for an Aetna Dual Eligible Special Needs Plan (D-SNP).
If you're 65 or older and have diabetes or an eligible heart disease, you may qualify for an Aetna Chronic Condition Special Needs Plan (C-SNP). C-SNPs are currently available in select counties in IL and PA.
You may be eligible for an Institutional Special Needs Plan (I-SNP) if you’ve lived (or plan to live) in a participating facility for 90+ days or you have Medicare Part A (hospital insurance) and Part B (medical insurance).
To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week. If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.
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 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.
For members in California, New Jersey and New York FIDE plans: The benefits mentioned are part of special supplemental program for the chronically ill. Eligibility is determined by whether you have a chronic condition associated with this benefit. Standards may vary for each benefit. Conditions include Hypertension, Hyperlipidemia, Diabetes, Cardiovascular Disorders, Cancer. Other eligible conditions may apply. Contact us to confirm your eligibility for these benefits.
Eligibility for the Model Benefit or Reward and Incentive (RI) Programs under the Value-Based Insurance Design (VBID) Model is not assured and will be determined by Aetna after enrollment, based on relevant criteria (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).
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