Aetna’s Medicare Advantage plans, which are named Advantra, include the same basic coverage as Original Medicare (parts A and B), plus a wide range of other benefits.
Aetna provides health insurance to millions of people in the United States, and many of its plans cover people who are enrolled in Medicare. These plans are a type of Medicare Advantage plan called Advantra.
Aetna Advantra offers Medicare Advantage plans in several areas throughout the country, including Health Maintenance Organization (HMO) plans, Paid Provider Organization (PPO) plans, and Dual Eligible Special Needs Plans (D-SNPs).
These plans offer the same coverage as Original Medicare, plus additional benefits that vary according to the specific plan.
This article reviews the primary types of Advantra plans, including how much they cost and what services they offer.
What are Medicare Advantage plans (Part C)?
Medicare Advantage (Part C) plans are a private alternative to Original Medicare, which is made up of Part A and Part B.
All Medicare Advantage plans are offered by private insurance companies, but the U.S. government mandates that the plans cover at least the same benefits as the ones you’d get through Original Medicare.
In addition to the mandated benefits, Medicare Advantage plans often provide extra perks and benefits like vision care, dental care, fitness programs, and foot care.
Aetna’s Advantra Medicare Advantage plans offer the same basic coverage as Original Medicare (parts A and B), along with a wide range of other benefits. This may make them a good option for some people.
Advantra HMO plans
Some Advantra plans are Health Maintenance Organization (HMO) plans.
HMO plans require plan members to be evaluated and treated by doctors and other healthcare professionals who are in the HMO network. You may also be limited to certain hospitals.
In an HMO, your first stop for medical care is your primary care physician. If you need more specialized care, you’ll usually need a referral from your primary care doctor.
Advantra PPO plans
Some Advantra options are Preferred Provider Organization (PPO) plans.
In a PPO, you’re provided with a list of doctors who are part of that network. Your costs will be lower if you use in-network doctors, healthcare professionals, pharmacies, and facilities.
You can go outside the network to see other doctors, but your costs will be higher.
Advantra D-SNP plans
Advantra Cares is a Dual Eligible Special Needs Plan (D-SNP). D-SNPs are designed for people enrolled in both Medicare and Medicaid.
To enroll in Advantra Cares D-SNP, you may have to supply Aetna with documentation that confirms you’re enrolled in both Medicare and Medicaid.
D-SNPs often have no or very low premiums, deductibles, and copays. They also often provide extended benefits that make it easier to get good healthcare on a tighter budget.
Here are some of the benefits provided by the Advantra Cares D-SNP:
- one-way transportation to plan-approved locations, such as medical appointments
- a service called Resources for Living, which helps you locate housing, adult day care, food subsidies, and local activities
- home healthcare
- a $250 stipend every 3 months to cover over-the-counter health products from CVS pharmacies
- programs to quit smoking
- nutritional supplements
- personal emergency response systems
- fall prevention devices
In addition to providing the same coverage as Original Medicare (parts A and B), Advantra Medicare Advantage plans offer extended benefits that differ from plan to plan.
Some of these benefits can include:
- eye care
- dental care
- hearing aids
- membership in online or in-person fitness programs
- chiropractic care
- foot care
- home delivery of meals after hospital inpatient care
- substance use disorder counseling
- 24/7 nurse consult line
Questions to consider when choosing a healthcare plan
As you consider the different Advantra Advantage plans, think about questions like:
- Does this plan have premiums, deductibles, out-of-pocket expense limits, and copays that fit into my budget?
- Does this plan cover the services that I value the most?
- Does this plan allow me to use healthcare professionals and facilities that are close to my home?
Most Advantra Medicare Advantage plans come with Medicare Part D prescription drug coverage. Deductibles vary from plan to plan.
The cost of your prescription medications will depend on how your plan lists your medication on its formulary. A formulary is a list of medications that the plan covers. Those medications are then divided into tiers based on cost.
Your costs will also depend on whether you use a preferred pharmacy or mail-order service to fill your prescriptions.
Aetna offers many different Advantra plans in many locations. The chart below shows the 2024 costs for different plans in various coverage areas:
| Location/plan | Monthly premium | Health deductible; drug deductible | Out-of-pocket max | Primary care visit | Specialist visit |
|---|---|---|---|---|---|
| Philadelphia, PA: Aetna Medicare Advantra Value (HMO) | $0 | $0; $0 | $7,550 annual in network | $0 | $30 |
| Springfield, IL: Aetna Medicare Value Advantra (PPO) | $0 | $0; $0 | $4,650 annual in network; $7,000 out of network | $0 in network; 35% out of network | $40 in network; 35% out of network |
| Marietta, GA: Aetna Medicare Advantra Preferred Plan (PPO) | $49 | $0; $195 | $7,550 in network; $12,450 out of network | $0 in network; 35% out of network | $35 in network; 35% out of network |
| Jefferson City, MO: Aetna Medicare Option 1 (HMO-POS) | $34 | $0; $0 | $6,000 in network; $8,950 out of network | $5 in network; 30% out of network | $45 in network; 30% out of network |
The above prices are just a sample to give you an idea of 2024 rates. To get precise costs for the Medicare Advantra plans available in your area, use Aetna’s plan finder tool or contact a locally licensed insurance agent.
Aetna, one of the nation’s largest insurance carriers, offers Advantra Medicare Advantage plans in several markets within the United States.
Some Advantra plans are HMOs and others are PPOs — their premiums, benefits, and deductibles vary accordingly. Advantra also offers a D-SNP option for people dually enrolled in Medicare and Medicaid.
Some of these plans include alternative care services like chiropractic care or acupuncture services, and most offer prescription drug (Medicare Part D) benefits as well.
To find out if Medicare Advantra plans are available where you live, you can use Aetna’s plan finder tool or talk with an insurance agent in your area.