Aetna Medicare Advantage Plans Maine 2025

If you’re in Maine and considering Aetna Medicare Advantage plans, this article details the options and highlights key information to help in your decision-making for Aetna Medicare Advantage plans in Maine. Learn about the varied plan types, including potential $0 premium plans and the additional benefits that set Aetna apart.


Key Takeaways

  • Aetna offers a diverse range of Medicare Advantage plans in Maine, including HMO-POS, PPO, and D-SNP, ensuring comprehensive healthcare coverage catered to various needs and preferences, with potential options for $0 premium plans.


  • Aetna Medicare Advantage plans provide additional benefits that may go beyond Original Medicare, such as wellness visits, SilverSneakers fitness memberships, dental coverage, and the Resources For Living concierge service.


  • Prescription drug coverage is integrated into Aetna Medicare Advantage plans, with a formulary of covered drugs and a convenient mail-order delivery service, and enrollees are kept informed of any changes to the formulary.

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Aetna Medicare Advantage in Maine: An Overview


Aetna Medicare Advantage Plans Maine 2025, Aetna Medicare Advantage in Maine: An Overview


Aetna has been a leading player in the healthcare industry, and their Medicare Advantage plans in Maine are a testament to their commitment to providing quality healthcare at affordable prices.

With a whopping 55 different plans, including a $0 premium option, Medicare beneficiaries in Maine have a plethora of options to choose from. Each plan is meticulously designed to ensure comprehensive health coverage, focusing on holistic healthcare for members.

Whether you’re a retiree looking for a plan that caters to your specific health needs or a young individual in need of a comprehensive plan that provides a wide range of services, Aetna has you covered. By offering a private alternative to traditional Medicare, Aetna ensures that you get all the benefits of Original Medicare and more.


Types of Aetna Medicare Advantage Plans

Aetna offers different types of Medicare Advantage plans in Maine. From HMO-POS and PPO plans to Dual Special Needs Plans (D-SNP), Aetna offers a variety of options to cater to the diverse healthcare needs of residents.

Aetna offers different types of Medicare Advantage plans, also known as Medicare Plan options, to cater to different healthcare needs.

These include:

  • HMO-POS plans: These plans provide coverage within a specific network of healthcare providers. You may need a referral from your primary care physician to see a specialist.


  • PPO plans: These plans offer more flexibility in choosing healthcare providers. You can see both in-network and out-of-network providers, but you may pay higher out-of-pocket costs for out-of-network care.


  • Dual Special Needs Plans (D-SNP): These plans are designed for individuals who are eligible for both Medicare and Medicaid. They provide comprehensive coverage and additional benefits for those with dual entitlements.


Plan Availability by County

Aetna Medicare Advantage plans are not confined to just a few counties in Maine. They are widely available throughout a broad range of counties, spanning the length and breadth of the state. These plans come in various types, such as HMO, PPO, and Special Needs Plans (SNPs), addressing diverse healthcare requirements and personal preferences.

This extensive coverage ensures that no matter where you’re located in Maine, Aetna has got you covered.

Extra Benefits with Aetna Medicare Advantage


Aetna Medicare Advantage Plans Maine 2025, Extra Benefits with Aetna Medicare Advantage


Aetna Medicare Advantage plans aren’t just about standard healthcare coverage. They’re about providing a comprehensive healthcare solution that addresses all aspects of your health.

These plans offer additional benefits that extend beyond those of Original Medicare, giving you more for your money. To find the right Medicare Advantage plan for your needs, consider your healthcare requirements and budget.

One of the key highlights of Aetna’s Medicare Advantage plans is the inclusion of a variety of wellness visits. These include the ‘Welcome to Medicare’ visit, the Healthy Home Visit, and the Annual Wellness Visit.

Enrollees also get access to exclusives like the Resources For Living concierge service and the SilverSneakers fitness membership. And if you’re someone who values oral health, be sure to check if your plan offers dental coverage, as it’s one of the extra benefits.


SilverSneakers Fitness Membership

The SilverSneakers fitness membership is an exclusive benefit that comes with some Aetna Medicare Advantage plans.

This membership enables beneficiaries to stay active by offering access to a variety of gyms and fitness classes at no additional cost. And it’s not just about physical fitness. The program also fosters a sense of community among participants through social activities such as ice cream socials and group walks.

The SilverSneakers program is designed to be as inclusive as possible. Not only do members have access to standard offerings, but they can also join a wide range of fitness classes.

The program provides both in-person and online fitness options, catering to different member needs and preferences. Whether you’re someone who prefers the energy of group classes or someone who enjoys working out at your own pace from the comfort of your home, SilverSneakers has something for you.


Resources For Living Concierge Service

Another exclusive benefit that Aetna Medicare Advantage members enjoy is the Resources For Living concierge service. This service is designed to help you navigate everyday life, assisting you in locating local services such as meal delivery, home cleaning, caregiver support, and recreational activities, providing more benefits to the members.

So, whether you’re in need of a little help at home or looking for ways to stay engaged in your community, the Resources For Living concierge service is there to assist you.

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Prescription Drug Coverage with Aetna Medicare Advantage


Aetna Medicare Advantage Plans Maine 2025,Prescription Drug Coverage with Aetna Medicare Advantage


Prescription drug costs can take a significant chunk out of your budget, especially if you’re on multiple medications. That’s why Aetna Medicare Advantage plans offer an integrated solution by combining medical coverage with prescription drug benefits.

This integrated approach not only makes managing your prescriptions easier but can also lead to potential cost savings.

Aetna provides a comprehensive list of covered drugs that includes both brand-name and generic options. Should the formulary undergo changes that affect your current medications, Aetna ensures to notify its members promptly.

To add to the convenience, Aetna Medicare Advantage plans also offer a mail-order delivery service for prescription medication.


Formulary Management

Aetna’s formulary is a well-organized list of covered medications categorized into cost-sharing tiers. Each tier represents varying co-pay or co-insurance levels for enrollees, which means you can easily find a medication that suits your health needs and budget.

It details coverage rules such as prior authorization, step therapy, and quantity limits that might apply to certain drugs. This means you’ll always know what to expect when it comes to your prescription coverage.

Should the formulary undergo any changes throughout the year, Aetna ensures to avoid removing drugs or moving them to a higher cost tier unless the drug is deemed unsafe or becomes unavailable.

Plus, enrollees can benefit from lower medication costs when using Aetna’s mail-order prescription service, enjoying the plan benefits.


Mail-Order Delivery Service

Aetna Medicare Advantage includes mail-order pharmacy services through CVS Caremark Mail Service Pharmacy as part of the pharmacy benefits. With no additional fees for standard shipping, getting your prescriptions delivered to your doorstep has never been easier.

Prescription orders typically arrive within 10 days, and members can manage prescriptions online through a secure member website.

Plus, members can select an alternate shipping address for their prescription deliveries, subject to certain restrictions. And if you need your medication sooner, expedited shipping is available at an additional fee.

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Enrolling in Aetna Medicare Advantage in Maine


Aetna Medicare Advantage Plans Maine 2025


Enrolling in Aetna Medicare Advantage in Maine is a straightforward process, with multiple methods to accommodate your preferences whether you’re a individual who prefers to do everything online or someone who values the personal touch of a phone conversation.

Ways to enroll:

  • Online enrollment: This convenient option allows you to effortlessly browse and contrast various plan features and prices to ensure you’re making a well-informed choice. Just enter your zip code in the designated box, and you’ll be able to:


    • Evaluate different Medicare Advantage and Prescription Drug Plans


    • Concentrate on medication coverage and expenses to select the ideal plan for your healthcare requirements


    • Submit your details and sift through an array of plan options


    • Consider the advantages and disadvantages of each plan in relation to your unique circumstances


  • Phone enrollment: Opting for this method connects you with a knowledgeable licensed agent who can answer your questions and provide immediate assistance. To speak with an agent, dial 1-844-350-0776 (TTY users dial 711) Monday through Friday, from 8 AM to 9 PM Eastern Time.


Eligibility Criteria

To enroll in Aetna Medicare Advantage in Maine, there are certain eligibility criteria that individuals must meet. For starters, you need to be a Maine resident aged 65 or older. Additionally, you must be a legal U.S. resident.

Certain residents of Maine under the age of 65 may also be eligible for Medicare if they have specific health conditions. And remember, to enroll in Aetna Medicare Advantage, individuals must first be enrolled in Original Medicare, which includes Part A and Part B.

Eligibility to enroll in Aetna Medicare Advantage plans begins three months before the month of your 65th birthday, extends through the month of your birthday, and concludes three months after your birthday month.


Enrollment Periods

When it comes to enrollment, timing is everything. Aetna Medicare Advantage plans have specific enrollment periods. The Annual Enrollment Period, running from October 15 to December 7, is the time when residents can enroll in or make changes to their Aetna Medicare Advantage plans, with new coverage beginning on January 1 of the following year.

The Medicare Advantage Open Enrollment Period, from January 1 to March 31, allows enrollees to make a one-time change to their existing Medicare Advantage plan or switch back to Original Medicare, with coverage starting the month after the election.

For those who missed their initial chance to sign up for Medicare Advantage and are not eligible for a Special Enrollment Period, the General Enrollment Period from January 1 to March 31 each year provides another opportunity.

In certain situations, like moving out of the plan’s service area or losing employer-provided coverage, a Special Enrollment Period may be granted, allowing you to enroll in a new plan or modify your Medicare Advantage coverage outside the usual periods.

Provider Network and Plan Features


Aetna Medicare Advantage Plans Maine 2025


Aetna Medicare Advantage takes a holistic approach to healthcare, offering a wide network of healthcare providers and various plan features. This comprehensive approach ensures that you can manage your daily health needs effectively, potentially leading to cost savings.

For optimal benefit, it’s crucial to verify if your preferred medical providers are in-network with Aetna Medicare Advantage plans.

Utilizing in-network providers can result in more affordable healthcare costs for members, such as lower copays for services. So, not only do you get access to a wide range of providers, but you also stand to save on your healthcare costs.


In-Network Providers

Aetna Medicare Advantage plans in Maine provide access to a network of healthcare providers. This network plays a crucial role in reducing out-of-pocket costs for enrollees. By utilizing in-network providers, members can enjoy more affordable healthcare costs, such as lower copays for services.

So, whether you’re visiting your primary care physician for a routine checkup or seeing a specialist for a specific health concern, being in-network can make a significant difference to your wallet.


Plan Features Comparison

When choosing a Medicare Advantage plan, it’s critical to evaluate the various features each plan offers. Aetna Medicare Advantage plans in Maine are known for their competitive pricing, providing a cost-effective option for Medicare beneficiaries in the state.

The plans come with different cost structures, including deductibles, copays, and coinsurance. Some plans are particularly appealing as they offer very low or no deductibles for certain drug tiers and minimal or no copays for preferred generic drugs.

Medicare Advantage plans in Maine are evaluated on a 5-star rating system, which assesses a plan’s quality and performance. Prospective members can review the detailed coverage options, including exclusions and limitations, in Aetna’s Evidence of Coverage documentation for Medicare Advantage plans.

This way, you can ensure that the plan you choose aligns with your healthcare needs and budget.

Maine Medicare Resources


Aetna Medicare Advantage Plans Maine 2025, Maine Medicare Resources


Navigating Medicare can be complex, but you don’t have to do it alone. Maine’s State Health Insurance Assistance Program (SHIP) provides free and confidential counseling to older individuals and those with Medicare due to disability.

And if you prefer to do your own research, the official Medicare website allows Maine residents to access their personal Medicare information anytime, anywhere.

Whether you need help understanding your Medicare options or want to compare plans in your area, these resources can provide valuable guidance.


Navigating the world of Medicare doesn’t have to be overwhelming. With Aetna Medicare Advantage plans, you can enjoy a broad range of benefits, extensive provider networks, and affordable healthcare options. Whether you’re a Maine resident nearing retirement or under 65 with specific health conditions, Aetna has a plan to suit your needs.


Frequently Asked Questions


What is the difference between Aetna Medicare and Aetna Medicare Advantage?

Aetna Medicare Advantage plans, also known as Part C plans, are offered by private insurance companies and include additional benefits not provided by Original Medicare.


How do Aetna Medicare Advantage plans compare to Original Medicare?

Aetna Medicare Advantage plans often provide additional benefits such as dental, vision, and hearing coverage, which are not typically included in Original Medicare. They also offer out-of-pocket spending limits to help control expenses.


What extra services does Aetna Medicare Advantage offer?

Aetna Medicare Advantage plans may offer extra services like wellness programs, fitness memberships, and personalized health coaching, which are not covered by Original Medicare.


Are prescription drugs covered under Aetna Medicare Advantage plans?

Many Aetna Medicare Advantage plans include prescription drug coverage, unlike Original Medicare, which typically requires an additional Part D plan for such coverage.


What types of Aetna Medicare Advantage plans are available in Maine?

In Maine, Aetna offers a range of Medicare Advantage plans, such as HMO-POS, PPO, and Dual Special Needs Plans (D-SNP). Choose the plan that best suits your needs.

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