at a glance
- Advantra Medicare Advantage plans are offered through Aetna, one of the largest insurance companies in the United States.
- Aetna Advantra offers HMO, PPO, and D-SNP Medicare Advantage plans in several areas throughout the country.
- Advantra Medicare Advantage plans offer the same coverage as original Medicare, plus additional benefits that vary according to the specific plan.
Aetna provides health insurance to millions of people in the United States, and many of its policies cover people who are enrolled in Medicare.
Aetna’s Advantra Medicare Advantage plans offer the same basic coverage as original Medicare (parts A and B) but offer a wide range of other benefits. This may make them a good option for some people.
Let’s look at the types of Advantra plans offered, including how much they cost and what services they offer.
As you consider the plans outlined below, 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 providers and facilities that are close to my home?
Advantra HMO plans
Some Advantra policies are Health Maintenance Organization (HMO) plans.
HMO plans require plan members to be evaluated and treated by doctors and other healthcare providers that are inside 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 providers, pharmacies, and facilities.
You can go outside the network to see other providers, 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
- programs to quit smoking
- nutritional supplements
- personal emergency response systems
- fall prevention devices
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 covered by the plan; those prescriptions are 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.
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
Aetna offers many different Advantra plans in many locations. The chart below shows the 2022 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 in network||$0||$45|
|Springfield, IL: Aetna Medicare Value Advantra (PPO)||$0||$0; $0||$4,650 in network; $7,000 out of network||$0 in network; 35% coinsurance out of network||$40 in network; 35% coinsurance out of network|
|Marietta, GA: Aetna Medicare Advantra Preferred Plan (PPO)||$49||$0; $195||$7,550 in network; $11,300 out of network||$5-$35 in network; 35% coinsurance out of network||$45 in network; 35% coinsurance out of network|
|Jefferson City, MO: Aetna Medicare Option 1 (HMO-POS)||$34||$0; $0||$6,900 in network; $11,300 out of network||$5 in network; 30% coinsurance out of network||$45 in network; 30% coinsurance out of network|
The above prices are just a sample to give you an idea of this year’s rates. To get precise costs for the plans available in your area, use Medicare’s plan finder tool or contact a locally licensed insurance agent.
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 carriers, 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.
This is why it’s important to review each plan carefully before you decide to enroll.
- 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 Advantra plans are available where you live, you can use Medicare’s plan finder tool or talk with an insurance agent in your area.