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paultry  
#41 Posted : Wednesday, October 13, 2021 1:49:01 PM(UTC)
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According to the Aetna book which came in today's mail, Aetna Advantage for 2022 will have "No Part B premium reduction". While it appears the Self +1 premium will remain the same @ $275/mo, losing the $75/each Part B premium reduction will mean a net $150/mo increase. We may have to look at going back to Aetna Direct with its $1,800 pay-back.

https://photos.app.goo.gl/ekhNMCUPoncPmWQn9

Edited by user Wednesday, October 13, 2021 3:07:15 PM(UTC)  | Reason: Not specified

Bob Loblaw  
#42 Posted : Wednesday, October 13, 2021 2:56:54 PM(UTC)
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I haven’t seen the plan book, but the Aetnafeds website still shows the supplement under the 2022 summary of benefits
https://www.aetnafeds.co...a-medicare-advantage.php

Edited by user Wednesday, October 13, 2021 2:57:26 PM(UTC)  | Reason: Not specified

Sante123  
#43 Posted : Wednesday, October 13, 2021 3:02:48 PM(UTC)
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Yes, Paultry, that was disappointing to read when the plan book arrived today. This will have a clearly negative impact on low-expense plan participants. For high-expense folks, however, the picture may be less clear since the plan is retaining a pretty great drug benefit as well as zero deductible, zero copay, and zero coinsurance. Then again, some language in the plan description seems to contradict the last point…will have to call to get a clarification. We may all need to resort to the Checkbook Guide once more to scour next year’s FEHB plan landscape.

@ Bob Loblaw:
The plot thickens. Your post arrived while I was writing mine. Now that I see your link, things maybe looking up. But either the plan book is wrong or the web page is wrong.

Edited by user Wednesday, October 13, 2021 3:09:39 PM(UTC)  | Reason: Not specified

Bob Loblaw  
#44 Posted : Wednesday, October 13, 2021 3:11:23 PM(UTC)
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And I have to add that this seems a little suspicious. Adding $150/mo to the plan premium bumps this up to $425/mo…which is almost the same as BC/BS Basic, which still gives you $800pp annual Medicare supplement. Not to mention the Part D IRMMA bump with Aetna. There would seem to be almost no advantage to this “Advantage” plan. Are we sure they’ve dropped the supplement?

Edit. Now that think about it Aetna isn’t actually increasing costs, so my numbers don’t make sense. But still, the “Advantage” this plan had over BC/BS Basic is much less without the supplement.

Edited by user Wednesday, October 13, 2021 3:19:29 PM(UTC)  | Reason: Not specified

Sante123  
#45 Posted : Wednesday, October 13, 2021 7:13:45 PM(UTC)
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OK, here’s the scoop, coming from the 2022 plan brochure, not the poorly designed Plan Document Notice, aka the “plan book”, that was sent out to all members today.

There is no change to the Medicare premium reduction. It’s the same as 2021.
There is no change to the zero deductible, zero copay, zero coinsurance feature. Same as 2021.
There is essentially no change to the prescription drug benefit either. Same as 2021 except for a modest bump to the annual total drug costs limit and the annual drug out of pocket limit.
There is no change to the additional benefits (Silver Sneakers, non-emergency transportation to/from doctor appointments, hearing aid reimbursement, home-delivered meals following a hospital stay, etc.)
There is no change in the monthly premium either. The same as 2021.

Here is the link to the official 2022 plan brochure, which contains language for both the generic Aetna Advantage Plan (non-Medicare) and the Aetna Medicare Advantage PPO Plan (the one we’re discussing here.). The relevant passages for the Medicare Advantage variant are found on pages 37-38 and 94-96.

https://www.aetnafeds.co...2/2022AetnaAdvantage.pdf

Edited by user Wednesday, October 13, 2021 7:38:43 PM(UTC)  | Reason: Clarified brochure page numbers for MA plan.

Bob Loblaw  
#46 Posted : Thursday, October 14, 2021 2:40:48 AM(UTC)
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Thanks for hunting that down, Sante. Won’t have to start my search all over again now.
paultry  
#47 Posted : Thursday, October 14, 2021 6:33:46 AM(UTC)
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Reduction in benefits really didn't make sense after the recent notice that they had overcharged us and would be making amends in some form.
Sante123  
#48 Posted : Thursday, October 14, 2021 3:22:36 PM(UTC)
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This post doesn’t change anything I’ve written before. I’m adding it just to provide some background and clarity.

Aetna sells lots of different medical plans, some for individuals and some for groups. There is a sort of template of general benefits for group plans, which can be upgraded by the organization (usually an employer) at its expense. As a result, the final plan design for one organization may be VERY different from that of another organization. Some final plans may have deductibles, copays and coinsurance while others may not. Some may lessen or eliminate the impact of the “donut hole” in Medicare Advantage plans, while others may not. Some may apply a credit to reduce Medicare premiums, while others may not. While speaking with an Aetna customer service rep this morning, I was advised that the Aetna Medicare Advantage PPO plan designed for OPM via the FEHB is one of the sweetest deals, if not the sweetest deal, offered by Aetna. The thing is that “Aetna Medicare Advantage PPO” and “Aetna Medicare PPO” are marketing terms Aetna uses to structure and package an assortment of MA plans, one of which (this one) happens to be in the FEHB. This means that their communications regarding such packages often relate to a broader audience than just the one FEHB plan we are discussing here. This leads to various Aetna documents and websites containing a lot of extraneous language which does not apply to the FEHB plan. But there’s more…

Thee are certain things that Aetna is required to do.
1) They must issue the official plan brochure in the format set by OPM. This leads to a somewhat confusing mix of text, which is mostly devoted to the non-Medicare Aetna Advantage plan and only partly devoted to the Aetna Medicare Advantage PPO plan.
2) They must notify members concerning changes in the “plan” from one year to the next. The format is set by Medicare. This was mailed out to arrive (unexpectedly) yesterday. As you may have guessed by now, this mailed document also tries to address more than one type of plan within the Aetna MA universe. Even the Schedule of Costs section tucked away in the middle of the booklet (which is supposed to be just about our FEHB plan) contains language on page 2 concerning copays and coinsurance that has no business being there since our plan does not have any of these things. But the BIG mistake was the one on page 4 of the Annual Notice of Changes for 2022 which claims that there will be no Part B premium reduction in 2022. This is flat out wrong and Aetna didn’t notice their error until after they had sent out the booklet. Aetna will soon send out a notification correcting the error(s). At least that’s what the rep told me. I hope this helps folks understand the situation better and recognize that not much of anything important is changing from 2021 to 2022.
thanks 2 users thanked Sante123 for this useful post.
Bob Loblaw on 10/14/2021(UTC), paultry on 10/15/2021(UTC)
jagfan  
#49 Posted : Saturday, October 16, 2021 9:52:07 AM(UTC)

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Like the Aetna Medicare Advantage (AMA) FEHB plan, Aetna Direct (AD) also offers zero copays, zero co-insurance and zero deductible for medical claim. Both plans offer the $900 fund (self only). Aetna Direct will also cover services outlined in their brochure that Medicare does not cover. An example, is an annual physical exam. From personal experience, Medicare has denied that service, however, AD covered it according to the terms of their contract. In addition, my spouse had a dermatological procedure, part of which, was not covered by Medicare and AD also covered the denied portion. An inquiry with an Aetna rep confirmed the AMA plan will pay only for services approved by Medicare. I understand there is sometimes conflicting information among reps. So I would like to inquire whether those of you with the AMA plan can confirm the accuracy of the coverage information I obtained?
Bob Loblaw  
#50 Posted : Saturday, October 16, 2021 11:42:59 AM(UTC)
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If you look at page 8 of this summary, it says they do pay for annual physical exams.
https://www.aetnafeds.co...agePlanBenefitsGuide.pdf
jagfan  
#51 Posted : Saturday, October 16, 2021 1:02:22 PM(UTC)

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Originally Posted by: Bob Loblaw Go to Quoted Post
If you look at page 8 of this summary, it says they do pay for annual physical exams.
https://www.aetnafeds.co...agePlanBenefitsGuide.pdf


I missed that, Thank you
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