Aetna Medicare Advantage for MHBP Standard Option retirees – Plan Details
MHBP Standard Option offers an Aetna MedicareSM Plan (PPO). This plan offers enhanced benefits and programs for members who have Medicare Parts A and B as their primary coverage.
How the plan works
You’ll have waived cost sharing for deductibles, copayments and coinsurance meaning you’ll pay nothing for most medical care. With Aetna Medicare Advantage for MHBP, members will get enhanced benefits and added programs that aren’t included with the MHBP Standard Option for no additional FEHB premium.
With Medicare Advantage for MHBP, members will get enhanced benefits and added programs that aren’t included with the MHBP Standard Option for the same FEHB premium as MHBP Standard Option.
- $900 Medicare Part B premium reduction for eligible members
- Added programs like SilverSneakers® and Healthy Home Visits
- $0 deductible and coinsurance for medical care
- Prescriptions as low as $0 (be sure to check the formulary to confirm your cost for your prescription)
- Nationwide network and coverage
- No referrals
Prescription Drug Documents
Use the Find a Pharmacy Tool
View the Full Formulary List
View the Prior Authorization Document
View the Step Therapy Document
View the Drug List Changes
View the Non-Part D Supplemental Benefit
MHBP Standard Option with Medicare and Aetna Medicare Advantage for MHBP Standard Option – benefit comparison
The MHBP Standard Option column shows benefits when Medicare Parts A and B are your primary coverage. MHBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and MHBP. Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.
|MHBP Standard Option with Medicare||Aetna Medicare Advantage|
|Annual Part B premium credit||N/A||Each eligible member receives a
$900 Medicare Part B premium reduction.
|Out-of-pocket maximum||$6,000 per person, limited to
$12,000 per Self Plus One or Self and Family enrollment (medical and prescription)
|$3,500 per person (prescription only)|
|Coinsurance||$0, except prescription drugs||$0, except prescription drugs|
|Medical coverage||MHBP Standard Option with Medicare – You pay||Aetna Medicare Advantage – You pay|
|Adult annual physical exam||$0||$0|
|Lab, X-ray and other diagnostic tests||$0||$0|
|Primary care and specialty physician visits||$0||$0|
|Chiropractic services||$0, limited to 40 visits||$0, unlimited visits|
|Physical, occupational and speech therapy||$0, limited to 40 combined visits||$0, unlimited visits|
|Home health services||$0, limited to 50 visits||$0, unlimited visits|
|Routine vision exam||All charges||$0|
|Hearing aids||$0 up to $2,000/60 months||$0 up to $2,000/60 months|
|Prescription coverage||MHBP Standard Option with Medicare – You pay||Aetna Medicare Advantage – You pay|
|Preferred generic||N/A||Preferred pharmacies:
$0 (30 days), $0 (90 days)
$2 (30 days), $4 (90 days)
|Generic||$5 (30 days), $10 (90 days)||$5 (30 days), $10 (90 days)|
|Preferred brand||25% max $200 (30 days)
$60 (90 days)
|$35 (30 days), $50 (90 days)|
|Non-preferred brand||50% max $200 (30 days)
$120 (90 days)
|$40 (30 days), $60 (90 days)|
|Specialty generic/ preferred brand||15% max $225 (30 days)
15% max $425 (90 days)
|15% max $200 (30 days)
15% max $425 (90 days)
|Specialty non- preferred brand||25% max $275 (30 days)
25% max $500 (90 days)
|15% max $200 (30 days)
15% max $425 (90 days)
|Wellness and value- added programs||MHBP Standard Option with Medicare||Aetna Medicare Advantage|
|Over-the-counter supplies||Limited to ACA requirements||You get a $30 allowance every three months via mail order.|
|Meal benefit program||Not included||Included – up to 14 meals after discharge per patient|
|Routine transportation||Not included||Included – 24 one-way trips up to 60 miles each|
|Resources for Living||Not included||Included|
|Healthy Home Visits||Not included||Included|
|Care management||Not included||Included|
This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. MHBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call
1-800-MEDICARE TTY or visit Medicare.gov
Find a Provider
Benefits wherever you are
This plan lets you use any doctors and hospitals that are licensed to receive Medicare payment and willing to accept your plan. And with the Aetna Medicare Advantage plan, your coverage follows you wherever you travel, nationwide.
Aetna Medicare is an HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. The formulary, provider and/ or pharmacy network may change at any time. You will receive notice when necessary. 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 physicians, hospitals and other 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. Plan features and availability may vary by service area. SilverSneakers is a registered trademark of Tivity Health, Inc. © 2021 Tivity Health, Inc. All rights reserved. Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies. For accommodation of persons with special needs at meetings, call 1-800-410-7778 (TTY: 711).
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). Aetna Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice.
This is a summary of the MHBP Standard Option Plan. Before making a final decision, please read the 2023 official Plan Brochure (RI 71-007). A single annual $52 associate membership fee makes all MHBP plans available to you. All benefits are subject to the definitions, limitations and exclusions set forth in the official Plan Brochure. External websites links are provided for your information and convenience only and does not imply or mean that Aetna endorses the content of such linked websites or third party services. Aetna has no control over the content or materials contained therein. Aetna therefore makes no warranties or representations, express or implied, about such linked websites, the third parties they are owned and operated by, and the information and/or the suitability or quality of the products contained on them.
© 2022 Aetna Inc.
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