Benefits
The Connecticut State Retiree Health Plan will automatically transition from UnitedHealthcare® to an Aetna Medicare℠ Plan (PPO)
Your Connecticut Medicare patients have a new plan for 2023
Starting January 1, 2023, all retirees enrolled in the Connecticut State Retiree Health Plan will automatically transition from UnitedHealthcare to an Aetna Medicare℠ Plan (PPO).
We’ll help you help them during their transition.
Aetna Medicare Advantage PPO plan benefit highlights
You can help your patients better understand their plan. Here’s a summary of key benefits:
|
|
Your patients’ responsibility when visiting either a network or out-of-network provider |
|---|---|
|
Member coinsurance |
0% |
|
Deductible |
$0 |
|
Annual out-of-pocket maximum This amount includes deductibles, copayments and coinsurance |
$2,000 |
|
Primary care physician visits |
Retired prior to July 1999: $5 Retired after July 1999/Partnership retirees: $15 |
|
Specialist visits |
Retired prior to July 1999: $5 Retired after July 1999/Partnership retirees: $15 |
|
Urgent care/walk-in clinic visits |
Retired prior to July 1999: $5 Retired after July 1999/Partnership retirees: $15 |
|
Diagnostic testing, X-rays, lab work, complex radiology, radiation therapy, dialysis, therapy (PT, OT, ST), cardiac and pulmonary rehab, home health, DME, oxygen and equipment |
$0 |
Benefits |
Member coinsurance |
|---|---|
Your patients’ responsibility when visiting either a network or out-of-network provider |
0% |
Benefits |
Deductible |
Your patients’ responsibility when visiting either a network or out-of-network provider |
$0 |
Benefits |
Annual out-of-pocket maximum This amount includes deductibles, copayments and coinsurance |
Your patients’ responsibility when visiting either a network or out-of-network provider |
$2,000 |
Benefits |
Primary care physician visits |
Your patients’ responsibility when visiting either a network or out-of-network provider |
Retired prior to July 1999: $5 Retired after July 1999/Partnership retirees: $15 |
Benefits |
Specialist visits |
Your patients’ responsibility when visiting either a network or out-of-network provider |
Retired prior to July 1999: $5 Retired after July 1999/Partnership retirees: $15 |
Benefits |
Urgent care/walk-in clinic visits |
Your patients’ responsibility when visiting either a network or out-of-network provider |
Retired prior to July 1999: $5 Retired after July 1999/Partnership retirees: $15 |
Benefits |
Diagnostic testing, X-rays, lab work, complex radiology, radiation therapy, dialysis, therapy (PT, OT, ST), cardiac and pulmonary rehab, home health, DME, oxygen and equipment |
Your patients’ responsibility when visiting either a network or out-of-network provider |
$0 |
Support your Aetna Medicare Advantage PPO patients
You can’t be there for them 24/7, but you can still give them extra support. With the Aetna Medicare Advantage PPO plan, members get added benefits at no additional cost. These programs are meant to complement the care you provide to your patients.
Our programs can help your patients:
- Manage a chronic condition, such as diabetes or high blood pressure
Let your patients know we offer personalized nurse support to help them. Our nurses can ensure that your patients are taking their medications as prescribed, help them make healthy lifestyle choices and answer questions they may have about their condition. In some cases, patients may benefit from having a case manager assigned to help coordinate their care.
- Find resources in their communities
A Resources For Living® life consultant can refer members to services in their area that make life easier and more enjoyable. We can help with home care, social and recreational activities, caregiver support, and more. The referral service is offered at no extra cost, but members do have to pay the cost of any services they decide to use.
- Check for health, wellness and safety concerns in their homes
Patients can sign up for a Healthy Home Visit. A licensed doctor or nurse will come to their home to review their health needs, do a home safety assessment, review medications, and ask about their medical and family history. The visit is offered at no extra cost, but Aetna® services may be recommended to help support their health journey.
- Treat depression and anxiety
Help your patients get fast, affordable and convenient access to virtual behavioral health services. Patients can confidentially meet with an MDLIVE® licensed therapist or board-certified psychiatrist by phone or video appointment. MDLIVE providers are specially trained in common issues such as anxiety, depression, grief and loss, stress management, and more.
- Get answers to health questions
The 24-Hour Nurse Line offers 24-hour access to nurses who can help answer members’ health questions. It doesn’t replace care from their regular doctor, but it can help them get the information they need after hours.
Members can visit the State of Connecticut retirees page for more information about the programs available to them.
Helpful resources
If you have questions about a patient’s medical plan, just call our Provider Contact Center at 1-800-624-0756, Monday through Friday, 8 AM to 5 PM local time.
You can also visit our Availity provider portal for access to electronic transactions, online resources, patient care programs and more.* Use of the Availity® provider portal does not cost extra, but you will need to register.
*Availity is available only to providers in the U.S. and its territories.
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Health benefits and health insurance plans contain exclusions and limitations.