Medicare Advantage Plan Benefit Details in Plain Text | |||||||||||||||||||||||||||
The following Medicare Advantage plan benefits apply to the Aetna Medicare OH Connect Gold 2 (Regional PPO) (R6694 - 005) in Montgomery, Ohio . This plan is administered by . To switch to a different Medicare Advantage plan or to change your location, click here. | |||||||||||||||||||||||||||
Click here to see the Aetna Medicare OH Connect Gold 2 (Regional PPO) health and prescription benefit details in chart format
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Plan Premium | |||||||||||||||||||||||||||
The Aetna Medicare OH Connect Gold 2 (Regional PPO) has a monthly premium of $165.00. That is $1,980.00 for 12 months. There are a few factors that can increase or decrease this premium.
If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher.
Please remember that the $165.00 montly premium is in addition to your Medicare Part B premium. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA). | |||||||||||||||||||||||||||
This Medicare Advantage Plan with Prescription Drug Coverage is a Regional PPO plan. | |||||||||||||||||||||||||||
Plan Membership | |||||||||||||||||||||||||||
The Aetna Medicare OH Connect Gold 2 (Regional PPO) (R6694 - 005) currently has 53 members. . | |||||||||||||||||||||||||||
Prescription Drug Coverage: Deductible, Cost-sharing, Formulary | |||||||||||||||||||||||||||
This plan has a $245 deductible. So, you are 100% responsible for the first $245 in medication costs. After you have met the deductible, the Aetna Medicare OH Connect Gold 2 (Regional PPO) will share the costs of your medications with you (see cost-sharing below). The maximum deductible for 2017 is $400, but this plan (Aetna Medicare OH Connect Gold 2 (Regional PPO)) has a $245. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible. | |||||||||||||||||||||||||||
The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $245, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The Aetna Medicare OH Connect Gold 2 (Regional PPO)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows:
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The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where
you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 49% of your generic drug prescription costs in the donut hole on your behalf. The brand-name drug manufacturer will pay 50% and your plan will pay an additional 10% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 60% discount. The 50% paid by the brand-name drug manufacturer is paid on your behalf and therefore counts toward your TrOOP (or True Out-of-Pocket) costs. The portion paid by your plan, does not count toward TrOOP. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage". This plan (Aetna Medicare OH Connect Gold 2 (Regional PPO)) offers No Coverage during the Coverage Gap phase. | |||||||||||||||||||||||||||
The Aetna Medicare OH Connect Gold 2 (Regional PPO) offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail. | |||||||||||||||||||||||||||
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