Aetna Medicare: HMO Plan Analysis and Detailed Report

This report analyzes Aetna's Medicare HMO plan, focusing on its structure and benefits. The plan is categorized as an HMO, which emphasizes coverage within a specific healthcare network. The report discusses the plan's reimbursement structure, including the coverage of catastrophic expenses and formulary drugs, with a specific reference to the $3820 coverage amount. Furthermore, the report mentions the Aetna Medicare Rx Value Plus plan, detailing its monthly premium, annual cost, and drug coverage through the client's drug list and pharmacy network. The report concludes by providing contact information and a website link for further details. The report is a valuable resource for understanding the specifics of Aetna's Medicare plans.

CONCLUSION
Manged care is plan is basically the health
insurance plans. Health Maintenance
Organization (HMO) only pay for the care
within the health care network. Preferred
Provider Organizations (PPO) pays more in the
health care network.Point of Service (POS)
provides the choice to the client between HMO
and PPO (Layton et al., 2017). Based on this it
can be stated that AETNA developed several
plans that would help the clients in
sustaining the costs of health care.
Contact us for information.
Reimbursement
The plan covers the factor of the
catastrophic level of the patient that is the
ultimate condition of the patient. Hence, it
covers the threshold value of the amount
that is $5100. This plan also provides the
support in the tier 1 and 2 formulary drugs.
Hence, the reimbursement of the money
can be stated as the coverage of the
insurance plan. However, basic coverage is
$3820.
AETNA Medicare Rx Value Plus
The plan states that it would cover all the
costs of the drugs prescribed. Hence, the
premium of the plan per month is $58.70
and the annual cost would be $704. Based
on the plan total coverage is $3820 . The
drugs would be covered in thsi plan on the
basis of the my drug list and comparison of
prescribed drug of the client. The plan also
would cover the phermacies within the
health care network of the company. (Aetna,
2019) Hence, it can be stated as a HMO plan.
https://www.aetnamedicare.com/pharmacyhelp
1-888-247-1051
BACKGROUND
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The plan covers the factor of the
catastrophic level of the patient that is the
ultimate condition of the patient. Hence, it
covers the threshold value of the amount
that is $5100. This plan also provides the
support in the tier 1 and 2 formulary drugs.
Hence, the reimbursement of the money
can be stated as the coverage of the
insurance plan. However, basic coverage is
$3820.
The plan covers the factor of the
catastrophic level of the patient that is the
ultimate condition of the patient. Hence, it
covers the threshold value of the amount
that is $5100. This plan also provides the
support in the tier 1 and 2 formulary drugs.
Hence, the reimbursement of the money
can be stated as the coverage of the
insurance plan. However, basic coverage is
$3820 (Aetna, 2019).
Based on this discussion it can be stated
that the managed care insurance plans
should be provided to the clients with
consideration of the clients physical
condition and th e profit of the company.
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out of Medicare
References
Aetna. (2019). Aetna Medicare | Medicare
Advantage, Part D & Supplement Plans. Retrieved
19 July 2019, from
https://www.aetnamedicare.com/
Layton, T. J., Ellis, R. P., McGuire, T. G., & Van Kleef
(2017). Measuring efficiency of health plan payment