Aetna Medicare Part D 2022 Review
Aetna has extra Medicare Half D members than every other firm. Greater than 6 million Medicare beneficiaries have Aetna Half D plans as of April 2022.
Aetna is a CVS Well being firm, and it sells prescription drug plans underneath the SilverScript model identify. Its Half D premiums are among the many lowest in the marketplace, however Aetna plans fall behind most rivals in high quality rankings from the Facilities for Medicare & Medicaid Companies, or CMS.
Right here’s what it is best to find out about Aetna Medicare Half D prescription drug plans.
Aetna Medicare Half D professionals and cons
Medicare prescription drug plans from Aetna have benefits and downsides.
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Accessible Medicare Half D prescription drug plans
Medicare beneficiaries with Authentic Medicare (Half A and/or Half B) can buy a Medicare Half D plan for prescription drug protection. Half D plans are bought by personal insurance coverage corporations. The prices and protection can differ considerably, so it’s essential to match choices.
Aetna presents three stand-alone Medicare prescription drug plans for 2022:
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SilverScript SmartRx: Aetna highlights this plan’s low premiums, $0 deductibles and $1 copays for sure medication.
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SilverScript Selection: Aetna highlights this plan’s $0 copay for Tier 1 generic medication and $0 deductible for Tier 1 and Tier 2 generic medication.
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SilverScript Plus: Aetna highlights this plan’s protection of extra medication, nutritional vitamins and dietary supplements, financial savings on sure insulins and protection of Tier 1 and Tier 2 medication within the protection hole.
Aetna Medicare Half D service space
Stand-alone Medicare prescription drug plans from Aetna can be found in all 50 states and Washington, D.C..
Aetna presents all three of its Medicare Half D plan choices in all of its markets.
Aetna Medicare Half D premiums and deductibles
Listed here are the 2022 premiums and deductibles for Aetna’s stand-alone Medicare prescription drug plans:
Aetna Medicare Half D drug formulary tiers
A formulary is a listing of the prescribed drugs lined by an insurance coverage plan. The plans usually manage completely different varieties of medicine into tiers in line with the price of the medication.
Aetna’s Medicare prescription drug plans use a five-tier formulary:
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Tier 1: Most well-liked generic |
Many widespread, lower-cost generic medication. |
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Increased-cost generic medication. |
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Many widespread, lower-cost brand-name medication and not using a generic model and a few generic medication that value as a lot as brand-name medication. |
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Tier 4: Non-preferred drug |
Increased-cost brand-name medication and generic medication for which a less expensive different is obtainable. |
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Excessive-cost medication that meet Medicare’s definition of a specialty drug. |
Every tier has copay or coinsurance necessities. You’ll usually pay extra for medication listed in larger tiers as much as Tier 4, however Tier 5 specialty medication have a decrease coinsurance requirement than Tier 4 medication.
The medication included in tiers and what you’ll pay for every tier is determined by your selection of prescription drug plan and what sort of pharmacy you utilize. For instance, Aetna plans have the bottom copays for prescriptions from most popular (in-network) pharmacies. Not like another corporations, nevertheless, Aetna doesn’t have completely different cost-sharing necessities for retail and mail-order pharmacies.
$0-deductible choices
All of Aetna’s Medicare Half D plans have a $0 deductible for sure lined medication:
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SilverScript SmartRx: $0 deductible for Tier 1 (most popular generic) medication. The deductible is $480 for Tier 2-5 medication.
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SilverScript Selection: $0 deductible for Tier 1 (most popular generic) and Tier 2 (generic) medication. The deductible is $480 for Tier 3-5 medication.
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SilverScript Plus: $0 deductible for all lined medication.
$0-copay choices
The SilverScript Selection and SilverScript Plus plans have $0 copays for Tier 1 medication from most popular pharmacies. The SilverScript SmartRx plan will get shut with a $1 copay for Tier 1 generic medication from most popular pharmacies.
The entire plans have copay or coinsurance necessities for Tier 2 and above, which might rapidly get dearer. Because of this, it’s essential to verify the place your drugs and pharmacies fall on every plan’s formulary.
Coinsurance vs. copay necessities
You’ll need to verify whether or not you’ll pay a copay or coinsurance on your drugs. Copays are set greenback quantities, so it’s simple to see what you’ll pay. Coinsurance is a share of the value on your drugs, so coinsurance necessities might be extra unpredictable and dearer.
Aetna begins requiring coinsurance somewhat than copays at both Tier 3 or Tier 4, relying on the plan:
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SilverScript SmartRx: Copays for Tiers 1-3; coinsurance for Tiers 4-5.
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SilverScript Selection: Copays for Tiers 1-2; coinsurance for Tiers 3-5.
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SilverScript Plus: Copays for Tiers 1-3; coinsurance for Tiers 4-5.
You may enter your drugs and pharmacy data on Aetna’s web site to see which medication are lined and evaluate your estimated prices with completely different plan choices.
Aetna Medicare Half D star rankings
Common Half D star score: 3.5
The Facilities for Medicare & Medicaid Companies charges Medicare Half D plans on 12 high quality measures. (You will discover definitions for every of those components within the CMS Star Scores Technical Notes.)
These rankings use a 5-point scale the place 5 is one of the best and 1 is the worst. The company bases its rankings on drug plans’ high quality of service and buyer experiences, and rankings are up to date yearly.
Based mostly on the latest yr of information, stand-alone Aetna prescription drug plans get an total score of three.5 stars. The 2022 common for all stand-alone Medicare Half D plans from all suppliers, weighted by enrollment, was 3.7 stars.
Evaluate Aetna Half D star rankings
Stand-alone Medicare Half D plans from Aetna outperformed the nationwide common on two Half D measures, however fell behind the nationwide common on the remaining 10 measures.
Right here’s how stand-alone Aetna prescription drug plans in contrast with nationwide averages for every of the 12 Half D measures:
Measures on which Aetna plans outperformed
Measures on which Aetna fell behind
American Buyer Satisfaction Index: 73 out of 100
The American Buyer Satisfaction Index, or ACSI, charges client satisfaction with services and products primarily based on a scientific mannequin developed on the College of Michigan. Scores are derived from surveys that measure customers’ expectations and perceived high quality and worth of services and products.
In 2021, Aetna scored 73 out of 100 on the ACSI medical health insurance satisfaction benchmark. ACSI measures satisfaction with the medical health insurance trade as an entire — Aetna’s rating represents all of its medical health insurance merchandise, not simply Medicare Half D insurance coverage. For comparability, the very best rating was 75 and the medical health insurance trade common was 73.
AM Finest Monetary Power Score: A
AM Finest is a credit standing company that makes a speciality of the insurance coverage trade. In December 2021, AM Finest affirmed its Monetary Power Score of A (Glorious) for Aetna Life Insurance coverage Firm and the opposite members of Aetna Well being & Life Group which might be wholly owned subsidiaries of CVS Well being.
An A score on this class signifies that AM Finest believes Aetna has a superb capacity to fulfill its ongoing insurance coverage obligations.
Aetna was based in 1853 in Hartford, Connecticut, and the insurer turned a subsidiary of CVS Well being in 2018. The corporate’s headquarters are nonetheless in Hartford.
Aetna’s medical health insurance choices embrace medical, dental, pharmacy and behavioral well being. Aetna presents each particular person and group medical health insurance, together with Medicare Benefit plans, Medicare prescription drug plans and Medicare Complement Insurance coverage. As of June 2021, Aetna covers virtually 9.8 million Medicare members within the U.S.
CVS Well being posted annual revenues of $292.1 billion in 2021.
Discover the suitable Medicare Half D prescription drug plan
The interactive device on Medicare.gov can assist discover a Medicare Half D plan that covers your prescriptions. It additionally helps you evaluate prices amongst Medicare Half D and Medicare Benefit plans out there to you.
Listed here are some issues to remember when evaluating plans:
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Verify the formulary: You’ll need to be sure that the medicines you at the moment take and, importantly, any you assume you would possibly want sooner or later, are lined underneath every of the plans you’re contemplating. Discuss to your well being care suppliers about what brand-name and generic medicines to search for and any options that will additionally work in case you may’t discover your present medicines on the plans out there in your space.
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Search for plan adjustments: Formularies change continuously. Your insurer ought to ship you a Discover of Plan Change when the formulary adjustments. Learn this doc fastidiously.
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Verify the pharmacy community: Most Medicare Half D plans negotiate with a community of pharmacies for the bottom value. Verify to see in case your pharmacy or an equally handy one is within the plan’s community. Additionally, evaluate costs for utilizing mail order.
In case your plan does change, and the change impacts the prescribed drugs you want, you may change plans throughout Medicare’s open enrollment interval, Oct. 15 to Dec. 7. Modifications go into impact on the next Jan. 1.
If in case you have further questions on Medicare, go to Medicare.gov or name 800-MEDICARE (800-633-4227, TTY 877-486-2048).
