Aetna US Healthcare (Medicare HMO)
For more information regarding Aetna US Healthcare’s Medicare services, consult the chart below.
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Benefits
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Golden Medicare Plan
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Golden Choice Plan (out-of-network benefit)
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Doctor and Hospital Choice
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You must go to network doctors, specialists, and hospitals.
You need a referral to go to network hospitals and certain doctors, including specialists forcertain services. |
You do not need a referral to go to network doctors, specialists and hospitals.
You can go to doctors, specialists, and hospitals in orout of the network. Higher costs apply for out-of-network services. |
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Monthly Premium
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$0-$25
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$95-$130
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Inpatient Hospital Care
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$100-$150/day for days 1-5, $0 days 6-90
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$350 for each Medicare-covered stay in a network hospital, no copayment for additional days in a network hospital, covered for unlimited days each benefit period
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Skilled Nursing Facility
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$20-$25/day for days 1-100 for Medicare-covered stay
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No copayment, covered for 100 days each benefit period
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Home Health Care
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$20 for Medicare-covered visits
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No copayment
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Doctor Office Visits
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$10-$30 for each primary care doctor office visit; $15-$35 for each specialist visit
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$10-$20 for each primary care doctor office visit, $20 for each specialist visit
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Prescription Drugs
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You pay 100% for most prescription drugs; some plans offer $10 for each prescription or refill of generic drugs up to a 30-day supply and $20 for mail order generic drugs up to a 90-day supply
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For each prescription or refill, $15 for generic drugs up to a 30-day supply, $30 for mail order generic drugs up to a 90-day supply
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Routine Physical Exam
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$10-$20 for each exam, covered for 1 exam every year
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$20 for each exam, covered for 1 exam every year
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For more information regarding Aetna US Healthcare, visit the company website at www.Aetna.com.
