2024 H5521 444 - Specialty Doctor Visit. $50 in-network | 50% out-of-network. Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $55.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Emergency Room Visit.

 
Aetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.. H5521 444

Specialty Doctor Visit. $30 in-network | 50% out-of-network. Inpatient Hospital Care. $300 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit.Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $55.00Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Emergency Room Visit. Plan ID: H5521-344-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium Urgent care. Urgent Care: Copayment for Urgent Care $15.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation. Mental health services. Inpatient hospital - psychiatric. In-Network: $385 per day for days 1 through 5 / $0 per day for days 6 through 90. Out-of-Network: 50% per stay. Outpatient group therapy ... TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Aetna Medicare Premier Plan (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $150 (Tier 1 and 2 excluded from the Deductible.) Annual Initial Coverage Limit (ICL): Mental health services. Inpatient hospital - psychiatric. In-Network: $385 per day for days 1 through 5 / $0 per day for days 6 through 90. Out-of-Network: 50% per stay. Outpatient group therapy ...Aetna Medicare Eagle Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.With this plan, the monthly premium you pay to the SSA is reduced by $55. Plan deductible. $0. MOOP. $7,000 for in‐network services $9,500 for in‐ and out‐of‐network services combined. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium doesn’t count toward your MOOP. By clicking on “I Accept”, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluat Urgent Care: Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Maximum Plan Benefit of $250000.00. Emergency room visit. $120 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage.In-Network: Copayment for Medicare-Covered Podiatry Services $45.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $60.00. Skilled Nursing Facility Care. $10 per day, days 1-20. $196 per day, days 21-100 in-network| 35% per stay. Out-of-Network: for more information see Evidence of Coverage.Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient psychiatric hospital stay. $374 per day, days 1‐5; $0 per day, 30% per stay after your plan days 6‐90 after your plan deductible deductible. Outpatient mental health therapy. $40 30% after your plan deductible. Outpatient psychiatric therapy.Number of Members enrolled in this plan in (H5521 - 081): 27,086 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 4 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ... Aetna-Medicare-SmartFit-Plan-PPO H5521:444-0 | Alight Retiree Health Solutions. Home. Medicare Plans. Dental, Vision & Hearing Plans. Log In. Create Account. View the coverage and benefits provided in the Aetna Medicare SmartFit Plan (PPO) plan from Aetna. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide. H5521 - 344 - 0 Click to see other plans: Member Services: 1-833-570-6670 TTY users 1-833-570-6670 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. 2024 Summary of Benefits. Aetna Medicare Value Plus Plan (PPO) H5521 ‐ 424. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. …This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $295 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $325 per stay 50% per stay. Outpatient hospital. $40 ...Aetna Medicare SmartFit Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $10.00. Copayment for Routine Care $10.00. Maximum 12 Routine Care every year.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Aetna Medicare Premier Plus (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $150 (Tier 1 and 2 excluded from the Deductible.) Annual Initial Coverage Limit (ICL):In-Network: Copayment for Medicare-Covered Podiatry Services $35.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $60.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $191 per day, days 21-100 in-network| 30% per stay. Out-of-Network: for more information see Evidence of Coverage.Aetna Medicare SmartFit Plan (PPO) H5521-444-000 2024 Plan Details and Costs. Home. Medicare Plans. Aetna Medicare SmartFit Plan (PPO) 4 out of 5 stars* for plan year 2024. Aetna Medicare SmartFit Plan (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-444-000.4 out of 5 stars* for plan year 2024. Aetna Medicare Value Plus Plan (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-424-000. * Every …Specialty Doctor Visit. $30 in-network | 40% out-of-network. Inpatient Hospital Care. $550 per day, days 1-5; $0 per day, days 6-90 in-network | 45% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency Room Visit.The table below outlines some of the specific plan details for Aetna Inc. Medicare Advantage plans available in South Carolina in 2024. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket Max. Prescription Drug Coverage. Medicare.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective Year Aetna Medicare SmartFit Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $10.00. Copayment for Routine Care $10.00. Maximum 12 Routine Care every year. Y0001_H5521_269_PQ65_SB24_M. 2024 Summary of Benefits. Aetna Medicare Premier (PPO) H5521 ‐ 269. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective YearIn-Network: Psychiatric Hospital Services: $315.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care. In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care. Specialty Doctor Visit. $30 in-network | 50% out-of-network. Inpatient Hospital Care. $300 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $395 per day, days 1‐5; $0 per day, 45% per stay days 6‐90; $0 for additional days. Outpatient hospital observation services. $335 per stay 45% per stay. Outpatient hospital. $40 ...Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency room visit. $135 If you are admitted to the hospital within 24 hours your cost share may be waived, for more information see the Evidence of Coverage. Ambulance transportation.Basic Costs and Coverage. $350 per day, days 1-6; $0 per day, days 7-90 in-network | $450 per day, days 1-6; $0 per day, days 7-90 out-of-network. $100 If you are admitted to the hospital within 0 hours your cost share may be waived, for more information see the Evidence of Coverage.Specialty Doctor Visit. $50 in-network | 50% out-of-network. Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $55.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Emergency Room Visit.This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $395 per day, days 1‐5; $0 per day, 45% per stay days 6‐90; $0 for additional days. Outpatient hospital observation services. $335 per stay 45% per stay. Outpatient hospital. $40 ...Medicare Plans. Dental, Vision & Hearing Plans. Log In. Create Account. View the coverage and benefits provided in the Aetna Medicare SmartFit Plan (PPO) plan from Aetna. Alight Retiree …H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-227: Cigna View payer . Plan Name Effective Year Benefit Package; Cigna Rx Medicare (PDP) 2024: S5617-807: Cigna True Choice Medicare (PPO) 2024:Specialty Doctor Visit. $30 in-network | 50% out-of-network. Inpatient Hospital Care. $300 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit.The table below outlines some of the specific plan details for Aetna Inc. Medicare Advantage plans available in South Carolina in 2024. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket Max. Prescription Drug Coverage. Medicare.2023 Evidence of Coverage for Aetna Medicare Premier Plan (PPO) 7 Chapter 1 Getting started as a member SECTION 1 Introduction Section 1.1 You are enrolled in Aetna Medicare Premier Plan (PPO), which is a Medicare PPOAetna Medicare SmartFit (PPO) H5521-441. Includes: Medical; Prescription; $0 Open tooltip for information about $0 premiums. Aetna is able to offer $0 monthly premium plans because the federal government covers the cost using your monthly Medicare Part B premium.Aetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services. Specialty Doctor Visit. $35 in-network | $70 out-of-network. Inpatient Hospital Care. $290 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $25.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. Inpatient Hospital Care. $325 per day, days 1-6; $0 per day, days 7-90 in-network | $425 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit.This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $295 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $325 per stay 50% per stay. Outpatient hospital. $40 ...The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural NorthTTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Aetna Medicare Premier Plus (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $150 (Tier 1 and 2 excluded from the Deductible.) Annual Initial Coverage Limit (ICL): Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | $450 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit. 2024 Aetna Medicare SmartFit Plan (PPO) H5521 — 444— 0 is a Local PPO offered in South Carolina by Aetna Medicare. It has a monthly premium of $0.00. Premium Breakdown. Standard Part B Premium. $174.80. Part B premium reduction. $0. Part C Premium. $0. Part D Basic Premium. $0. Part D Supplemental Premium. $0. Part D Total. $0.00. Plan ID: H5521-404-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Michigan Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...Y0001_H5521_434_NS17_SB24_M. 2024 Summary of Benefits. Aetna Medicare Explorer Premier (PPO) H5521 ‐ 434. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Aetna Medicare Premier Plus (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $150 (Tier 1 and 2 excluded from the Deductible.) Annual Initial Coverage Limit (ICL):H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective YearH5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-227: Anthem View payer . Plan Name Effective Year Benefit Package; Anthem MediBlue Plus (HMO) 2024: H4346-012: Anthem MediBlue Dual Advantage (HMO D-SNP) 2024: …Plan ID: H5521-437-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …Y0001_H5521_218_PQ35_SB24_M. 2024 Summary of Benefits. Aetna Medicare Freedom (PPO) H5521 ‐ 218. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural NorthAetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.Sep 13, 2023 · This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $300 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $350 per stay 50% per stay. Outpatient hospital. $45 ... Specialty Doctor Visit. $35 in-network | 40% out-of-network. Inpatient Hospital Care. $265 per day, days 1-5; $0 per day, days 6-90 in-network | 40% per stay out-of-network. Urgent Care. Copayment for Urgent Care $50.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00.Nov 9, 2023 · The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North Aetna Medicare SmartFit (PPO) H5521-441. Includes: Medical; Prescription; $0 Open tooltip for information about $0 premiums. Aetna is able to offer $0 monthly premium plans because the federal government covers the cost using your monthly Medicare Part B premium. In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care. Nov 9, 2023 · The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North Your OTC benefit helps you save money on a wide range of over-the-counter health and wellness products. You can use your benefit amount to purchase products such as pain relief, first aid, cold and allergy medicine, dental care items and more. Check your OTC catalog for the list of items covered by your benefit.Inpatient Hospital Care. $325 per day, days 1-6; $0 per day, days 7-90 in-network | $425 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit.Inpatient Hospital Care. $325 per day, days 1-6; $0 per day, days 7-90 in-network | $425 per day, days 1-6; $0 per day, days 7-90 out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Maximum Plan Benefit of $250000.00. Emergency Room Visit.Basic Costs and Coverage. $375 per day, days 1-6; $0 per day, days 7-90 in-network | $475 per day, days 1-6; $0 per day, days 7-90 out-of-network. $100 If you are admitted to the hospital within 0 hours your cost share may be waived, for more information see the Evidence of Coverage.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-227: Aetna Medicare Freedom Plan (PPO) 2024: H2293-016: Amerigroup View payer . Plan Name Effective Year Benefit Package; Amerivantage Dual Coordination (HMO D-SNP) … Specialty Doctor Visit. $40 in-network | $70 out-of-network. Inpatient Hospital Care. $250 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. 2024 Summary of Benefits. Aetna Medicare Value Plus Plan (PPO) H5521 ‐ 424. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. …Specialty Doctor Visit. $50 in-network | $50 out-of-network. Inpatient Hospital Care. $395 per day, days 1-4; $0 per day, days 5-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $95.00. Emergency Room Visit.The table below outlines some of the specific plan details for Aetna Inc. Medicare Advantage plans available in South Carolina in 2024. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket Max. Prescription Drug Coverage. Medicare.Y0001_H5521_269_PQ65_SB24_M. 2024 Summary of Benefits. Aetna Medicare Premier (PPO) H5521 ‐ 269. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. H5521 - 344 - 0 Click to see other plans: Member Services: 1-833-570-6670 TTY users 1-833-570-6670 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. Allentown. 1539 Lehigh St, Allentown, PA 18103. Discover Medicare insurance plans accepted at our Allentown health center and find primary care doctors accepting Medicare near you.Aetna Medicare Dual Choice (PPO D-SNP) | H5521-469 8 2024 Summary of Benefits for H5521-469. Hearing services Benefit Your in‑network costs Your out‑of‑network costs Diagnostic hearing exam $0 20% after your plan deductible Routine hearing exam $0 0% You get one routine hearing exam every year. You can visit a provider in the ...H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Anthem View payer . Plan Name Effective Year Benefit Package; Anthem MediBlue Access Basic (Regional PPO) 2024:H5521 - 374 - 0 (4 / 5) Aetna Medicare Explorer Plan (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare. Premium: $0.00 Enroll Now This page features plan details for 2024 Aetna Medicare Explorer Plan (PPO) H5521 – 374 – 0 available in New Hampshire.Aetna Medicare Eagle Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.OFFICE OF CIVIL RIGHTS – CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES. You can also file a civil rights complaint with the California Department of Health Care Services, … In-Network: Copayment for Medicare-Covered Podiatry Services $45.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $60.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $196 per day, days 21-100 in-network| 35% per stay. Out-of-Network: for more information see Evidence of Coverage. Podiatry services. In-Network: Podiatry Services: Copayment for Medicare-Covered Podiatry Services $30.00. Skilled Nursing Facility (SNF) care. $10 per day, days 1-20; $196 per day, days 21-100 in-network| 35% per stay out-of-network, for …Aetna Medicare SmartFit Plan (PPO) H5521-444. Includes: Medical (Part C) Prescription (Part D) $0 Open tooltip for information about $0 premiums. Aetna is able to offer $0 monthly premium plans because the federal government covers the cost using your monthly Medicare Part B premium.Y0001_H5521_214_PQ31_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value (PPO) H5521 ‐ 214. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.H5521 - 159 - 0 Click to see other plans: Member Services: 1-888-268-9800 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.4 out of 5 stars* for plan year 2024. Aetna Medicare Value Plus Plan (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-424-000. * Every …Reynolds motorsports, Napolis hoboken, Laurel nursery, Careoregon, Washing machine man, Integrity animal hospital, Buy for less, Takingcarababies, National wwii museum new orleans, Goodwill yuma, Pure and gentle, Sam's club gainesville fl, Norcostco, Metal museum

Specialty Doctor Visit. $30 in-network | 40% out-of-network. Inpatient Hospital Care. $550 per day, days 1-5; $0 per day, days 6-90 in-network | 45% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency Room Visit.. Lemos feed and pet supply

h5521 444halls market west hartford connecticut

Plan ID: H5521-272-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …4.64. 951 N 6th Street, Suite 221, Reading, PA 19601. Discover Medicare insurance plans accepted at our Reading health center and find primary care doctors accepting Medicare near you. H5521 - 444 - 0 (4 / 5) Aetna Medicare SmartFit Plan (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare. Premium: $0.00 Enroll Now This page features plan ... Specialty Doctor Visit. $35 in-network | $70 out-of-network. Inpatient Hospital Care. $290 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $25.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. 2023 Evidence of Coverage for Aetna Medicare Premier Plan (PPO) 7 Chapter 1 Getting started as a member SECTION 1 Introduction Section 1.1 You are enrolled in Aetna Medicare Premier Plan (PPO), which is a Medicare PPOAetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.3.5 out of 5 stars. Aetna Medicare Premier Plan (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H5521-344. Have Medicare questions? Talk to a …Allentown. 1539 Lehigh St, Allentown, PA 18103. Discover Medicare insurance plans accepted at our Allentown health center and find primary care doctors accepting Medicare near you.Specialty Doctor Visit. $50 in-network | 50% out-of-network. Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $55.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Emergency Room Visit.Specialty Doctor Visit. $30 in-network | 50% out-of-network. Inpatient Hospital Care. $300 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit.Sep 13, 2023 · Y0001_H5521_424_NT31_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value Plus Plan (PPO) H5521 ‐ 424. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Sep 27, 2022 · The most you pay for copays, coinsurance and other costs for medical services for the year. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium and prescription drugs don’t count toward the maximum out‐of‐pocket. $373 per day, days 1‐6; $0 per day, days 7‐90. Y0001_H5521_243_PQ49_SB24_M. 2024 Summary of Benefits. Aetna Medicare Value Plan (PPO) H5521 ‐ 243. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%. Mental Health Outpatient Care.Plan ID: H5521-214-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Michigan Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Anthem View payer . Plan Name Effective Year Benefit Package; Anthem MediBlue Access Basic (Regional PPO) 2024:Aetna Medicare Dual Choice (PPO D-SNP) | H5521-469 8 2024 Summary of Benefits for H5521-469. Hearing services Benefit Your in‑network costs Your out‑of‑network costs Diagnostic hearing exam $0 20% after your plan deductible Routine hearing exam $0 0% You get one routine hearing exam every year. You can visit a provider in the ...H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective Year Plan ID: H5521-082-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $77.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ... H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Anthem View payer . Plan Name Effective Year Benefit Package; Anthem MediBlue + Kroger Access (PPO) 2024:Mental Health Inpatient Care. In-Network: Psychiatric Hospital Services: $385.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Prior authorization required. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-224: Aetna Medicare Freedom (PPO) 2024: H5521-227: Cigna View payer . Plan Name Effective Year Benefit Package; Cigna Fundamental Medicare (HMO) 2024: Specialty Doctor Visit. $30 in-network | 50% out-of-network. Inpatient Hospital Care. $300 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. Y0001_H5521_403_NT16_SB24_M. 2024 Summary of Benefits. Aetna Medicare SmartFit (PPO) H5521 ‐ 403. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $295 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $325 per stay 50% per stay. Outpatient hospital. $40 ...Plan ID: H5521-423-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Washington Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...2024 Aetna Medicare SmartFit Plan (PPO) H5521 — 444— 0 is a Local PPO offered in South Carolina by Aetna Medicare. It has a monthly premium of $0.00. Premium Breakdown. …Mar 1, 2024 · Learn more about your plan. Watch this quick video to find out more about the benefits, programs and services your plan offers. If you have any questions, you can call and speak to a customer service representative at 1‐833‐859‐6031 (TTY: 711). From October 1 to March 31, you can call us 7 days a week from 8 AM to 8 PM local time. From April 1 to September 30, we’re here Monday through Friday from 8 AM to 8 PM local time.Plan ID: H5521-431-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Washington Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...Aetna Medicare SmartFit Plan (PPO) | H5521-444 | $0 | Y0001_H5521_444_NS99_SB24_M 2024-H5521.444.1 Aetna Medicare SmartFit Plan (PPO) H5521 ‑ 444 Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Need a complete list …Y0001_H5521_403_NT16_SB24_M. 2024 Summary of Benefits. Aetna Medicare SmartFit (PPO) H5521 ‐ 403. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary.The most you pay for copays, coinsurance and other costs for medical services for the year. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium and prescription drugs don’t count toward the maximum out‐of‐pocket. $373 per day, days 1‐6; $0 per day, days 7‐90. H5521 - 344 - 0 Click to see other plans: Member Services: 1-833-570-6670 TTY users 1-833-570-6670 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. Aetna Medicare Discover Value Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services. Specialty Doctor Visit. $40 in-network | $70 out-of-network. Inpatient Hospital Care. $250 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. View the coverage and benefits provided in the Aetna Medicare SmartFit (PPO) plan from Aetna. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide.2023 Evidence of Coverage for Aetna Medicare Premier Plan (PPO) 7 Chapter 1 Getting started as a member SECTION 1 Introduction Section 1.1 You are enrolled in Aetna Medicare Premier Plan (PPO), which is a Medicare PPOH5521 - 374 - 0 (4 / 5) Aetna Medicare Explorer Plan (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare. Premium: $0.00 Enroll Now This page features plan details for 2024 Aetna Medicare Explorer Plan (PPO) H5521 – 374 – 0 available in New Hampshire.Specialty Doctor Visit. $35 in-network | $70 out-of-network. Inpatient Hospital Care. $290 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $25.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. You may also contact us at 1-866-241-0356 (TTY: 711) Monday through Friday, 8 AM to 9 PM ET. Aetna Medicare is a HMO, PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Y0001_GRP_2022_H5521_M_VZN. 1/1. Aetna Medicare Premier Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Copayment for Routine Care $15.00. Maximum 12 Routine Care every year.The most you pay for copays, coinsurance and other costs for medical services for the year. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium and prescription drugs don’t count toward the maximum out‐of‐pocket. $373 per day, days 1‐6; $0 per day, days 7‐90.OFFICE OF CIVIL RIGHTS – CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES. You can also file a civil rights complaint with the California Department of Health Care Services, …If you have any questions, you can call and speak to a customer service representative at 1‐833‐859‐6031 (TTY: 711). From October 1 to March 31, you can call us 7 days a week from 8 AM to 8 PM local time. From April 1 to September 30, we’re here Monday through Friday from 8 AM to 8 PM local time.H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective Year H5521 - 444 - 0 (4 / 5) Aetna Medicare SmartFit Plan (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare. Premium: $0.00 Enroll Now This page features plan ... H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: ... H5521-227: Aetna Medicare Freedom Plan (PPO) 2024: H2293-016: Amerigroup View payer . Plan Name Effective Year Benefit Package; Amerivantage Dual Coordination (HMO D-SNP) … Plan ID: H5521-121-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $49.00 Monthly Premium. New York Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ... Aetna Medicare Eagle Plan (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services.To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1‐800‐MEDICARE (TTY users should call 1‐877‐486‐2048), 24 hours a day/7 days a week. If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.Inpatient Hospital Care. $350 per day, days 1-6; $0 per day, days 7-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $55.00Worldwide Coverage: Copayment for Worldwide Urgent Coverage $100.00. Emergency Room Visit.2024 Aetna Medicare SmartFit Plan (PPO) H5521 — 444— 0 is a Local PPO offered in South Carolina by Aetna Medicare. It has a monthly premium of $0.00. Premium Breakdown. …H5521:247-0 Aetna Medicare Premier Plan (PPO) H5521:249-0 Aetna Medicare Premier Plan (PPO) H5521:251-0 Aetna Medicare Value Plan (PPO) H5521:279-0 Aetna Medicare Eagle Plan (PPO) H5521:319-0 Aetna Medicare Premier Plus Plan (PPO) H5521:373-0 Aetna Medicare Essential Plan (PPO) H5521:444-0 Aetna Medicare SmartFit Plan (PPO)H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective YearH5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective YearH5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: AmeriHealth Caritas VIP View payer . Plan Name Effective YearIt’s generally known as the Evidence of Coverage (EOC). The EOC is the legal contract between you and the Medicare plan. It’s generally available starting in September and describes costs and benefits of your plan that will take effect on January 1 of the following year. If you have questions about your Medicare plan, start here.Aetna Medicare SmartFit Plan (PPO) H5521-444. Includes: Medical (Part C) Prescription (Part D) $0 Open tooltip for information about $0 premiums. Aetna is able to offer $0 monthly premium plans because the federal government covers the cost using your monthly Medicare Part B premium. In-Network: Copayment for Medicare-Covered Podiatry Services $35.00. Out-of-Network: Copayment for Medicare Covered Podiatry Services $60.00. Skilled Nursing Facility Care. $0 per day, days 1-20. $191 per day, days 21-100 in-network| 30% per stay. Out-of-Network: for more information see Evidence of Coverage. Aetna’s mailing address: Aetna Inc. P.O. Box 14088. Lexington, KY 40512. Page last updated: January 04, 2024. Aetna Medicare members, contact us with questions about your Medicare plan.Plan ID: H5521-082-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $77.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part ...H5521-444: Aetna Medicare SmartFit Plan (PPO) 2024: H5521-445: Aetna Medicare Discover Plan (PPO) 2024: H5521-446: Aetna Medicare Value Plus (PPO) 2024: H5521-447: ... H5521-227: Aetna Medicare MyMichigan Prime (HMO-POS) 2024: H3192-017: Blue Cross Blue Shield View payer . Plan Name Effective Year Specialty Doctor Visit. $30 in-network | 40% out-of-network. Inpatient Hospital Care. $550 per day, days 1-5; $0 per day, days 6-90 in-network | 45% per stay out-of-network. Urgent Care. Copayment for Urgent Care $35.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $135.00. Emergency Room Visit. H5521-444. Aetna Medicare. | Local PPO. Why Trust U.S. News. 344. Insurance Companies Evaluated. 6,000+. Individual Plans Evaluated. 3,000+. Searchable Zip Codes. See our Full …2024 Summary of Benefits. Aetna Medicare Value Plus Plan (PPO) H5521 ‐ 424. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. …4.64. 951 N 6th Street, Suite 221, Reading, PA 19601. Discover Medicare insurance plans accepted at our Reading health center and find primary care doctors accepting Medicare near you.Basic Costs and Coverage. $375 per day, days 1-6; $0 per day, days 7-90 in-network | $475 per day, days 1-6; $0 per day, days 7-90 out-of-network. $100 If you are admitted to the hospital within 0 hours your cost share may be waived, for more information see the Evidence of Coverage.Aetna Medicare SmartFit Plan (PPO) | H5521-444 | $0 | Y0001_H5521_444_NS99_SB24_M 2024-H5521.444.1 Aetna Medicare SmartFit Plan (PPO) H5521 ‑ 444 Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. Keep in mind: This is just a summary. Need a complete list …It’s generally known as the Evidence of Coverage (EOC). The EOC is the legal contract between you and the Medicare plan. It’s generally available starting in September and describes costs and benefits of your plan that will take effect on January 1 of the following year. If you have questions about your Medicare plan, start here.Plan ID: H5521-272-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part …The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Rural Michigan, Urban Michigan, Urban Missouri, Rural North2024 Summary of Benefits. Aetna Medicare Value Plus Plan (PPO) H5521 ‐ 424. Here’s a summary of the services we cover from January 1, 2024 through December 31, 2024. … Specialty Doctor Visit. $30 in-network | 50% out-of-network. Inpatient Hospital Care. $300 per day, days 1-7; $0 per day, days 8-90 in-network | 50% per stay out-of-network. Urgent Care. Copayment for Urgent Care $40.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $120.00. Emergency Room Visit. If you have any questions, you can call and speak to a customer service representative at 1‐833‐859‐6031 (TTY: 711). From October 1 to March 31, you can call us 7 days a week from 8 AM to 8 PM local time. From April 1 to September 30, we’re here Monday through Friday from 8 AM to 8 PM local time.Sep 13, 2023 · This is called prior authorization or pre‐certification. Benefit. Your in‐network costs Your out‐of‐network costs. Inpatient (unlimited number of days) $300 per day, days 1‐7; $0 per day, 50% per stay days 8‐90; $0 for additional days. Outpatient hospital observation services. $350 per stay 50% per stay. Outpatient hospital. $45 ... . 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