What you need to know about annual enrollment
If you’re thinking about becoming an Aetna® Dual Eligible Special Needs Plan, 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. 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.
What is annual enrollment?
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 change plans, your new coverage will begin January 1.
Get the support of a personal care team
Aetna® care teams are here to help manage your care and connect you with the health and community services you may need.
What is my current coverage level?
Great question! The answer is different for everyone. But knowing what benefits you have 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 an SB. It gives answers to common questions about your coverage and costs, including ones like:
- Do you have an annual deductible?
- What are your copays?
- What is your dental or over-the-counter (OTC) coverage?
Aetna members can 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.
How do I find out about plan changes coming in the new year?
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 coverage and costs 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 you understand the changes and see if the plan is still right for you.
Is my primary care provider (PCP) in network on the new plan I want to enroll in?
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. During the call, you can confirm that your doctors and prescriptions are covered, learn more about your plan benefits and costs and get answers to any questions. If your PCP isn't in the network, the Aetna licensed agent can help you look for another doctor.
What if I find out later that I don’t like my plan? Can I switch?
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.
What if I don’t want to change my plan?
Then you don’t have to do anything. Generally, your plan will automatically renew on January 1with any benefit changes. If your plan isn’t renewing on January 1, you'll get a notice that lets you know.
A big selling point of an Aetna D-SNP for members is that they have a dedicated care team. This is a support team that helps you manage your care and get the health and community services you may need.
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.
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.
The Aetna C-SNP is available to Medicare members who have at least one of the qualifying chronic conditions. To ensure a successful enrollment process, we’ll confirm with your healthcare provider that you have one of these eligible conditions. If verification of eligible condition is not received, involuntary disenrollment will occur.
The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include certain cardiovascular disorders, chronic heart failure and diabetes. Eligibility is determined by whether you have a chronic condition associated with the benefit(s) and you meet all other criteria. Even if you have a listed chronic condition, you may not necessarily receive the benefit because other eligibility and coverage criteria may apply. Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility.
For accommodation of persons with special needs at meetings, call 1-833-278-3924 (TTY: 711).
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.
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