Aetna Medicare Solutions

Author

Allina Health | Aetna

Posted on

Jun 22, 2022

Book/Edition

Minnesota - Twin Cities Metro Area

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How do Medicare Advantage HMO-POS plans work?

HMO-POS plans generally offer you more choice than traditional health maintenance organization (HMO) plans. You typically choose an in-network primary care physician and most of our HMO-POS plans require you to use a participating provider for medical care. Most of our HMO-POS plans provide you with flexibility to go to licensed dentists either in or out of our network for routine dental care. However, you may pay more for out-of-network care you receive.

Aetna Medicare Advantage plans at a glance

Our HMO-POS plans

Our HMO plans

Our PPO plans

Requires you to use a provider network

Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers.

Yes, unless it's an emergency

No. But seeing out-of-network providers generally costs more.

Requires you to have a primary care physician (PCP)

Yes, in many plans

Yes, in many plans

Usually no PCP required

Requires referral to see a specialist

Some plans

Some plans

No referral required

Monthly premiums

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Medical deductible

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Limits what you pay out-of-pocket for medical care each year

Yes

Yes

Yes

Includes prescription drug (Rx) coverage

Yes, in most plans

Yes, in most plans

Yes, in most plans

Includes Rx mail-order benefit 

Yes, if plan has Rx coverage

Yes, if plan has Rx coverage

Yes, if plan has Rx coverage

Dental, vision and hearing coverage

Yes, in most plans

Yes, in most plans

Yes, in most plans

ER and urgent care coverage worldwide

Yes

Yes

Yes

Fitness benefit

Yes, through SilverSneakers

Yes, through SilverSneakers

Yes, through SilverSneakers

Over-the-counter (OTC) benefit

Yes, in many plans

Yes, in many plans

Yes, in many plans

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Yes, in most plans

Yes, in many plans

Yes, in most plans

Medicare Advantage plans for every need

In addition to HMO-POS plans, Aetna offers you other Medicare Advantage plan options some with a $0 monthly plan premium. We can help you find a plan thats right for you.

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